Private-option panel is urged to skip rehash

Governor seeking solutions, task force co-chairman says

An Arkansas legislative task force studying the state's Medicaid program for changes to recommend to the governor will fail if "we spend the next six or seven months re-litigating the private option," task force co-Chairman Sen. Jim Hendren, R-Gravette, said Monday.

At Monday's meeting, he urged fellow task force members to seek new solutions instead of rehashing old decisions about the state's private option program.

The private option uses federal Medicaid dollars to purchase private health insurance for some low-income Arkansans. The issue has deeply divided Republicans in the Arkansas Legislature and on the campaign trail during the past two years.

Earlier this year, the Republican-dominated Legislature authorized the creation of the legislative task force and federal funding for the private option in fiscal 2016, after Republican Gov. Asa Hutchinson asked them to do so.

In proposing the task force, Hutchinson said it should create an "alternative health coverage model" for "vulnerable populations" now covered under the program. Recommendations are due by the end of the year; lawmakers have set a Dec. 31, 2016, date for ending the current program.

At the outset of Monday's meeting, Rep. Charlie Collins, R-Fayetteville, the other co-chairman, said that "we want to find an innovative solution for Arkansas for our entire Medicaid program ... and that's a pretty heavy charge to be what I would call the No 1 innovator in the country."

Authorized under the 2010 federal Patient Protection and Affordable Care Act and approved by the Legislature in 2013, the expansion of the state's Medicaid program extended eligibility to adults with incomes of up to 138 percent of the poverty level -- $16,105 for an individual, for instance, or $32,913 for a family of four. The federal law is often referred to as "Obamacare" because President Barack Obama fought for the legislation and signed it into law.

More than 200,000 Arkansans have been enrolled in private health insurance through the private option, according to the state Department of Human Services.

The state will have to pick up 5 percent of the private option's cost starting in 2017, and its share of the bill will gradually increase to 10 percent in 2020, when Hutchinson said it will cost the state more than $200 million a year.

In advance of presentations from Arkansas Hospital Association and the University of Arkansas for Medical Sciences and the Community Health Centers of Arkansas Inc. about uncompensated care costs, Hendren told the task force that "you will see some things thrown out here [Monday] that believe me you are going to say 'I have to refute that or I have to argue with that.'

"Now if you have a legitimate question about that that will help your understanding, then certainly ask those questions. But let's avoid the tendency to get drawn back into a fight that is not going to be productive for us to continue to battle," said Hendren, who is a nephew of Hutchinson.

"We are going to spend these next several months understanding where we are, so we have a good understanding of the Medicaid program, the expansion program, the cost and the benefits, and try to get a good grasp of where we are before we start making decisions about where we are going to go," he said.

Hendren told task force members to expect a lot of questions. "

"There is a lot of impatience. The media is determined to get us to comment on where we are going to go and what we are going to do," he said. "Don't be afraid to say, 'I don't know. I just don't know yet because I don't have the information to make an informed decision yet."

Key data will be coming from the Bureau of Legislative Research and the Division of Legislative Audit as well as experts and state agencies, Hendren said

As task force members get that information, "The goal is to get us all in a position where we can make an informed decision and come to that conclusion of where we should go together," he said.

Paul Taylor, chief executive officer of Ozarks Community Hospital in Gravette, later praised Arkansas lawmakers for adopting the private option program in 2013.

Taylor said he operates a 25-bed hospital in Gravette, which opened in 2008 and added 100 employees last year, while he cut his 45-bed hospital in Springfield, Mo. to three beds and laid off 100 employees last year. The three beds were kept so that he could keep his Missouri license for several health clinics, he added.

"The only good news I had from 2010 up until 2013 is what was happening here in Arkansas," he said after the federal health overhaul was enacted in 2010.

Taylor said he spent $7 million in real estate and $2 million on upgrading radiology equipment in Gravette last year.

Missouri doesn't have a private option. Arkansas does, and it's made a difference, he said. "We are scraping [by] in Missouri and we are growing in Arkansas.

"For my money, I don't know what it is you are going to do," Taylor said. "I am really hoping that the next thing you do makes at least as much sense or more [than the private option]. For me, I am betting on you guys, so please come through."

State Rep. Kim Hammer, R-Benton, noted that the private option's end date is approaching.

"We have basically said the private option is going away in December of 2016," he said, and asked how Taylor plans to deal with the future.

Taylor replied, "Call me an eternal optimist.

"Arkansas did this once and it tells me there is political will a bit beyond the semantics of politics, which often gets too much in the way," he said. "Arkansas wants to present itself as being a welcoming place for business investment and business innovation. Don't make it any more complicated than that."

Hendren said that "the vision that we have laid out in Arkansas is to figure out something that is reasonable and affordable and I don't think that is going to change."

But State Sen. Terry Rice, R-Waldron, later in the meeting asked whether the task force is going to have "balanced testimony" from people who are concerned about the private option's long-term costs.

"I want some critical data for the objective other side. Are we going to have that also instead of just people saying we need that?"

Hendren said his intention is to provide objective information to the task force.

"I want to try to avoid making a re-litigation of an issue that is a small part of what our task is. We will strive to be fair," he said.

Collins added that the task force will "absolutely" look at the program's long term costs and how to pay for them.

Metro on 04/21/2015