A $10.6 million federal grant to help the state continue to work with the federal government in a health-insurance exchange narrowly cleared the Arkansas Legislative Council on Friday.
The council voted 21-18 to complete its review of the U.S. Department of Health and Human Services grant to the Arkansas Insurance Department for the state partnership marketplace, after Insurance Commissioner Jay Bradford pleaded with lawmakers to sign off on the grant to help Arkansans learn more about the Patient Protection and Affordable Care Act.
The grant includes $3.5 million for outreach and education campaigns; $2.9 million for continued implementation of the in-person assistance program to help people enroll for health-insurance coverage; $713,800 for planning, coordination and integration operations development; and $705,401 for personnel costs, plus other expenditures, according to a summary of the grant provided to the Legislative Council.
The department previously received $43.7 million in federal grants for the state partnership marketplace, according to a department spokesman.
Seventeen Democratic lawmakers and four Republican lawmakers voted to complete the council’s review of the grant, while 18 Republican lawmakers dissented.
Reps. David Branscum of Marshall, Jeremy Gillam of Judsonia and Stephen Meeks of Greenbrier and Sen. Johnny Key of Mountain Home were the four Republicans who voted to allow the grant to clear the council. Meeks noted that the council still will have to review any proposed contracts awarded by the department with the federal grant funds before the department could spend the money.
Bradford said the department is a consumer-driven agency under his direction, “so whatever comes out in the national scene, we are going to try to make it work for the best of your constituents.”
“There are some deep, deeply philosophical positions in this room against the Affordable Care Act and that’s a debate that’s going to go on for a long, long time,” he told the council. “But what I am asking the body to do is to let us take care of Arkansans during this process, and whatever changes changes.”
The department received nearly 500 calls this week from Arkansans about the Affordable Care Act, and countless calls from Medicare recipients who are needlessly panicking, afraid that they will lose their health insurance under the federal law, Bradford said.
“This is a way we can continue to at least have a friendly face to your constituents and we have worked out a lot of issues and we want to keep doing that,” he said. “I am really, really concerned about losing this ability to help folks. I know nobody ran on the premise to tie the hands of your Department of Insurance to help constituents. That’s my bottom line on this.”
Bradford said the state’s private option, under which the Republican-controlled Legislature authorized the use of federal funds made available under the Affordable Care Act to purchase private health insurance for uninsured Arkansans earlier this year, is “a wonderful program.”
So far, more than 61 ,000 Arkansans have completed enrollment for healthcare coverage under the private-option law as of Dec. 14, according to a spokesman for the state Department of Human Services.
Through the end of November, about 1,400 Arkansans had enrolled for health-care coverage by way of the federal government’s website, healthcare.gov, said state Insurance Department officials.
But Sen. Jason Rapert, R-Bigelow, who voted against signing off on the $10.6 million federal grant, said the premises under which the Legislature approved the private option earlier this year have changed.
“We had a whole different set of rules and expectations as it related to rollout [of the Affordable Care Act], on the individual mandates, on the employer mandates,” he said. “We have stress that has occurred already within the insurance industry in the state of Arkansas.
“Folks are not very happy about the fact that we have gone through all this work and put in all this time and now we are at a point where literally everything has changed,” he said.
Rapert pressed Bradford about whether he is confident “in the decisions that are being made that your department is having to sign off on things when we literally have a completely different marketplace expectation right now.”
Bradford replied, “No senator. I am not confident.
“We are not in control of certain federal issues that are changing,” he said. “I don’t know what is coming down the pike, but I do want the Arkansas Legislature and the [Insurance Department] to have at least some input and authority to be able take care of Arkansans.”
Rapert said he wished “we could focus on really the central issue around the private option, which is the fact that the [Obama] administration really didn’t want us to do that and [grant] a waiver for that.”
“I remain fully opposed to the Affordable Care Act, and I am even more opposed to it than I was three years ago,” he said. “It’s getting very, very difficult for me to continue to support this process.”
Afterward, Rapert, who voted to authorize the use of federal funding of the private option earlier this year, said he doesn’t know whether he’ll vote to reauthorize federal funding of the private option in the fiscal year starting July 1.
It’s unclear whether there is enough support in the Legislature to reauthorize federal funding of the private option, which will require 27 votes in the 35-member Senate and 75 votes in the 100-member House of Representatives. Earlier this year, the measure to authorize the funding of the private option cleared the Senate with 28 votes and the House with 77 votes.