Gov. Asa Hutchinson arranged a conference call Thursday morning so he could speak at once with as many of the 135 state legislators as could be assembled.
I'm advised that he briefed legislators on the ongoing "redetermination" of income eligibility for the private option and other Medicaid programs. And I'm advised that he announced that, as of that morning, more than 35,000 persons, mostly private-option clients, had been purged.
That's from a maximum enrollment nearing 250,000. And it's not the final number of purges.
Nearly all of those removals occurred because persons didn't respond within 10 days to protest the ineligibility finding as required by letters sent to them by the Human Services Department.
The number is expected to grow daily as the 10-day periods lapse for recipients continuing to be sent the letters.
So the governor wanted to know from legislators: What are you hearing about this back home? And what do you think about it?
There were the hard-liners who said it was about darned time the state start kicking cheaters off the dole.
Then there were those saying, you know, governor, this "re-determination" is a good thing--indeed, moving people from welfare to a better circumstance is the very idea. But they said the state Human Services Department was using new interfacing software to glean income information, and that there might be errors. And since there could be errors, they said, we might consider giving respondents more than 10 days to escape removal--because, you know, poor people move frequently from their last known addresses or don't always understand official-sounding mail.
For the record: The federal government says states must give people at least 10 days to respond before kicking them off Medicaid because of an ineligibility determination. So Arkansas, historically a poor state and a punish-the-poor state, adheres strictly to that minimum. We cut folks off as quickly as the feds will let us.
The governor could tell Human Services at any time to give notice of 20 or 30 days or more.
But this governor has enough trouble already with hard-liners on his right. And he needs to salvage some continuing remake of the private option. That's a daunting undertaking by any circumstance, but it becomes nigh unto undo-able if hard-liners rear up because they think he's gone soft on poor people.
As you know, Hutchinson has a certain cautious, deliberate and synthesizing nature. If he can find a third way--or a fourth or fifth or sixth--he'll take it.
In this case, I'm told, he has decided to stay the course for now and rely for balancing on insurers enjoying private-option premium income and now steadily losing it through these purges.
He believes the private sector has the will and skill to get in touch with clients and alert them to the letters and urge them to respond with an objection quickly if they believe themselves to be wronged. In that case they would get a 30-day appeal.
A spokesman for Arkansas Blue Cross and Blue Shield subsequently told me the firm is fully mobilized in that very way. Health-insurance agents, providers and pharmacists have been prompted to alert clients and customers who are on Medicaid.
At the Arkansas Blue Cross and Blue Shield website, the top line asks, "Did you get a letter from DHS?" Then it provides a link explaining the nature of the letter and the process to respond.
The point is not to keep persons on the private option inappropriately. Medicaid eligibility always ought to be a matter of ongoing verification.
The point is to try to keep a person from losing coverage incorrectly because he wasn't given sufficient time to understand what was happening to him.
That's especially so considering that the Human Services Department, a vast agency not previously known as a model of competence and efficiency, is in the infancy state of software monitoring.
State Sen. David Sanders, Republican of Little Rock and private-option architect, labeled as a "complete and utter failure" the "procuring, implementing and managing" of this income-verification system. He says the current rush "may create more problems without really solving any," by which he means purging people from the private option only to end up putting them back.
Sanders and other pro-private-option Republican legislators fully embrace ongoing "redetermination." It was, in fact, a condition of their support for the private option. And they think an ever-fluid private-option enrollment that fluctuates from 200,000 upward is probably the norm.
It's the deadly combination of early technological hiccups with a 10-day deadline that worries them.
So for now the governor is counting on the vested private sector to raise a backstop.
If you like irony, this one is worth mentioning: Here we have government trying to put people off welfare and the private sector trying to keep them there.
John Brummett's column appears regularly in the Arkansas Democrat-Gazette. Email him at jbrummett@arkansasonline.com. Read his blog at brummett.arkansasonline.com, or his @johnbrummett Twitter feed.
Editorial on 07/26/2015