A measure allowing the Arkansas Insurance Department to hire outreach workers known as "navigators" and promote enrollment in the state's health insurance exchange cleared its first hurdle Tuesday.
With little discussion, the Special Language Subcommittee of the Legislature's Joint Budget Committee approved the amendment to Senate Bill 117, which appropriates funds to the Insurance Department for the fiscal year that starts July 1.
The change, approved in a voice vote with no dissent, next goes to the full committee for inclusion in the bill.
Proposed by Sen. Jason Rapert, R-Conway, the amendment would lift restrictions on outreach in place since 2014.
Rapert said the change would work "hand in hand" with legislation, passed by the Senate on Monday, that would transfer responsibility for the exchange to the Insurance Department from the Arkansas Health Insurance Marketplace.
The change to SB117 wouldn't affect similar restrictions that have been imposed by lawmakers on the state Medicaid program, the Department of Health, and state colleges and universities.
[RELATED: Complete Democrat-Gazette coverage of the Arkansas Legislature]
Sometimes called the "Bell amendment," the restrictions were first proposed by then-state Rep. Nate Bell of Mena as a way of winning support for the Medicaid funding bill from lawmakers who opposed expanding Medicaid.
Hired last week as interim director of the marketplace, Bell said Tuesday that he still supports keeping the restrictions in place.
"As I said when I originally helped craft it, I don't believe the state should be in the insurance marketing business," Bell said.
Federal regulations would require the Insurance Department to conduct outreach and pay for navigators if it takes over responsibility for the exchange, as Rapert has proposed through Senate Bill 113.
Implementing the recommendation of a Legislative Council subcommittee formed in 2017, SB113 would fold the marketplace into the department, a move Insurance Commissioner Allen Kerr has said would save money and reduce a fee charged to insurance companies.
Rapert said the department would educate consumers and answer questions but wouldn't be marketing policies.
He also criticized as "tacky" Bell's response to the Senate's 32-0 vote, with one senator voting "present," on SB113.
Bell said Monday that the vote was "not at all unexpected," especially given what he described as an emotional response to remarks by Sen. Ron Caldwell, R-Wynne, who is recovering from injuries he suffered in a horse-riding accident in December.
Caldwell, who was a chairman of the Legislative Council subcommittee, received a standing ovation from senators and spectators after he rose from a wheelchair to speak in support of SB113 on the Senate floor.
"That's so disrepectful to a man that co-chaired that committee for 18 months," Rapert said of Bell's remark after the vote. "It was not well-received.
"All [Bell has] done is come down here and in a matter of a few days, make his reputation worse than it was, and I feel sorry for him for doing that."
Bell said he didn't intend to suggest that senators voted for the bill out of emotion, but that "the emotion of the moment certainly contributed to support for it."
"I would just say that clearly the love for Sen. Caldwell is evident and the respect for Sen. Caldwell, and that it clearly had an effect on the passage of the bill," Bell said. "Everybody was very happy to see him on his feet, as was I."
Under the proposed change to SB117, the Insurance Department would still be prohibited from applying for or accepting federal funds to promote enrollment.
The department would also continue to be prohibited from promoting enrollment in the state's expanded Medicaid program, known as Arkansas Works.
The amendment would require the department to report to lawmakers twice a year on the number of navigators and other outreach workers it employed and how many people were helped.
As an alternative to SB113, Bell has proposed keeping the marketplace as a separate entity while reducing its spending and lowering the fee it charges to insurers.
The marketplace would also turn over excess money it collects from the fee to the state's general budget.
Bell said he has spoken to "several" legislators who have agreed to present his proposal as an amendment to SB113.
He said he hopes the House Committee on Insurance and Commerce will put off a decision on the matter until next week. In the meantime, he and Kerr would present details about their competing proposals to the committee at a meeting this week.
"The members of the House are being asked to make a big decision with long-term impacts on the state of Arkansas and the state's general revenue," said Bell, who left the Republican Party to become an independent in 2015. "I would like for them to do so with a full recounting of the facts."
Rep. Deborah Ferguson, D-West Memphis and SB113's lead sponsor in the House, said she plans to present the bill to the Insurance and Commerce Committee for approval today.
Delaying it until next week "will just give [Bell] more time to lobby and produce hostile amendments," she said.
"I think we've studied this for 18 months, and I think everyone agrees we're looking at government transformation and making things more efficient," she said. "It just makes a lot more sense to send it back to the department, where everything's under one roof and coordinated."
Metro on 02/06/2019