The Arkansas Health Insurance Marketplace board decided Wednesday to heed an appeal from Gov. Asa Hutchinson to delay issuing a request for information to technology vendors regarding a state health insurance exchange for individual Arkansans.
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But Sen. David Sanders, R-Little Rock, said at the board meeting that a state-based exchange may still be needed to comply with recommendations presented to a legislative task force by a New Hampshire-based consultant earlier that day.
"Any amount of customization is going to require the ability to be quick, to be nimble on the ground and not sitting around and waiting for someone at [the federal Centers for Medicare and Medicaid Services] to make some determination," Sanders said.
"I think we are coming to a place very soon where our deliberations and our work will soon round out some of these open questions."
Hutchinson's letter, sent Monday, said lawmakers should decide on changes to the state's private option and other parts of its Medicaid program before the marketplace board gathers more information about a state insurance exchange for individuals.
"Until more information is available and policy decisions have been made, it is premature for your organization to proceed with any development of a software solution," Hutchinson wrote.
The marketplace is already developing an insurance exchange for small businesses. Hutchinson said his directive did not apply to that exchange, which is known as SHOP.
Sanders told board members he did not believe the governor had seen the report from consulting firm The Stephen Group before writing the letter.
Though no board member audibly voted against delaying the request for information in a voice vote, several expressed discontent with the letter.
"I'm frustrated," said Sherrill Wise. "I believe that by not posting the [request for information], I am failing to complete my mission."
The board had planned to issue on Monday a request for information on the cost of transferring to Arkansas the technology used by one of the seven state-based exchanges that the board considers to be successful.
Those states are California, Colorado, Connecticut, Kentucky, New York, Rhode Island and Washington.
Arkansas is among 34 states with federally run insurance exchanges. The remaining states and the District of Columbia opted to set up their own exchanges.
Wise said the Legislature had previously directed the board to look into the issue with Act 1500 in 2013, which created the Arkansas Health Insurance Marketplace to establish Arkansas-based exchanges for individual consumers and small businesses.
"My concern is that the governor or his advisers don't really understand the purpose of the [request for information], in that it is truly informational," Wise said. "We're in the first quarter. We're just trying to move the ball down the field toward our intended goal. There's no commitment associated with it."
Board members also were unsure what holding onto federal money required to be spent on the individual exchange would mean.
"We can't be in a holding pattern forever," said Chris Parker, board chairman. "We can buy some time because it's the prudent thing to do, and I think we can buy some time because we're concentrating on SHOP, but I'm looking out two or three months."
In contrast, Hutchinson said in the letter that if the state decides not to go forward with the exchange project, it "may be required to pay back funds we have received from the federal government."
Sanders, who has been supportive of the individual exchange, said he understood the board's frustration, but said that delaying the request for information now would allow each director's input to be heard in the Capitol later.
"Today was an important day. We would be having a fundamentally different conversation if we were combing through this report and there were recommendations that didn't require an enormous amount of state customization," Sanders said.
"We all are in this together and we can move together. I understand that if we are to do that it means you guys are going to be moving at a little bit slower clip."
Metro on 10/08/2015