In D.C. talks, private-option disputes cited

Dismang: But U.S.’ Burwell ‘seemed’ open to dialogue

Health and Human Services Secretary Sylvia Burwell is shown in this 2014 file photo.

Gov. Asa Hutchinson has some "differences of opinion" with the U.S. health and human services secretary on potential changes to the state's private option, Arkansas Senate President Pro Tempore Jonathan Dismang said Tuesday.

But during a meeting Monday in Washington, D.C., Health and Human Services Secretary Sylvia Burwell "seemed like she was willing to work with the state to try to get those differences hammered out," Dismang said.

Hutchinson and a group of state legislators and officials met with Burwell to discuss proposed changes to the private option, which covers about 200,000 low-income Arkansans. The program uses Medicaid funds to buy health insurance through the state's federally run insurance exchange for adults within a certain income range.

Citing the eventual cost of the expanded Medicaid program to the state, Hutchinson has called for changes that he said would encourage private-option enrollees to stay employed and take more responsibility for their health care.

"I think the governor is willing to push, and I think there's a strong likelihood that we get where we need to be regarding the Arkansas Works policy," said Dismang, R-Searcy.

Arkansas Works is the new name Hutchinson has proposed for the state's expanded Medicaid program, including a revamped private option.

Dismang also attended the 45-minute meeting with Burwell, along with House Speaker Jeremy Gillam, state Surgeon General Greg Bledsoe, state Medicaid Director Dawn Stehle and Hutchinson health care policy adviser John Martin.

Gillam, R-Judsonia, called it "a good step and a good meeting."

Burwell "seemed very genuine in wanting to partner with us to come up with a framework that would work for Arkansas," he said.

Approved by the state Legislature and federal officials in 2013, the private option took effect in 2014.

The expansion extended coverage to adults with incomes of up to 138 percent of the federal poverty level: $16,243 for an individual, for instance, or $33,465 for a family of four.

Almost 250,000 Arkansans had been approved for coverage under the program as of Nov. 30. That included about 199,000 people who were in private-option plans and more than 22,000 others who were being covered by the traditional, fee-for-service Medicaid program because their health needs are considered exceptional.

Thousands of others had been approved for coverage but had not yet completed enrollment.

The changes Hutchinson is proposing include providing subsidized coverage through employer plans to enrollees with job-based coverage, charging premiums to enrollees with incomes above the poverty level, requiring referrals to job-training programs for unemployed enrollees and curtailing coverage or charging more in premiums for enrollees with substantial assets.

Dismang said none of the ideas was "flat-out rejected" although the details of how some would be implemented have not been decided.

Gillam said the differences mainly concerned "logistics."

"We still have a little work to do before we can reach a consensus," he said.

Hutchinson is expected to present the details of his proposal to the Legislature's Health Reform Task Force on Feb. 17.

Spokesman J.R. Davis said the governor doesn't plan to comment on the meeting with Burwell until he addresses the task force.

The Health and Human Services Department hadn't responded late Tuesday afternoon to a request by the Arkansas Democrat-Gazette for comment on the meeting with Hutchinson.

Created by the Legislature last year, the task force last month endorsed Hutchinson's plan to seek changes to the federal waiver that authorized the creation of the private option.

The panel is expected to make recommendations next month on whether to continue the expanded Medicaid program beyond the end of this year, when the federal waiver expires.

The Legislature will vote on the matter during a special session that Hutchinson has said he plans to call in April.

A Section on 02/03/2016