Former Rep. Nate Bell on Wednesday admitted that he had failed to save the Arkansas Health Insurance Marketplace after a bill that would fold the agency into the state Insurance Department cleared a final legislative committee.
"We are defeated," Bell, who was named interim director of the marketplace last week, said after Senate Bill 113 cleared the House Committee on Insurance and Commerce in a divided voice vote. "We just simply don't have an opportunity to defeat it in the House."
The marketplace board will meet Friday, he said, and will discuss issues related to the bill's implementation, including layoffs of all the agency's employees and the end of his contract.
"In general, I don't see a significant benefit to the organization for me being there through the transition," he said.
The Senate passed SB113 in a 32-0 vote, with one senator voting "present," on Monday. Rep. Deborah Ferguson, the bill's lead sponsor in the House, said she expects it to go to the full House on Monday.
[RELATED: Complete Democrat-Gazette coverage of the Arkansas Legislature]
Bell was hired by the board chairman four days after the previous director, Angela Lowther said she would resign, effective Feb. 21, to "pursue new opportunities."
The marketplace had eight other employees at the time.
Insurance Commissioner Allen Kerr said that Gov. Asa Hutchinson has committed to helping marketplace employees find jobs in state government. He said he doubted any will want to take jobs in the Insurance Department.
"I simply can't afford to pay them what they're getting paid now, and I don't know that they will work for what I can pay them," Kerr said.
As the entity responsible for Arkansas' health insurance exchange, the marketplace certifies the plans sold in the state through healthcare.gov, promotes enrollment in the plans and helps consumers sign up.
Kerr told the Insurance and Commerce Committee that his department already reviews the insurers' rates and policy details and that the marketplace simply signs off on the Insurance Department's work.
He has said his agency could take over the marketplace's duties at a cost of no more than $571,500 a year. By contrast, the marketplace's spending totaled about $2.6 million last year.
Bell said that Rep. Mark Lowery, chairman of the Insurance and Commerce Committee, had agreed to allow a vote on a motion to delay the committee's consideration of SB113 by one week and to allow Bell to present his proposal for keeping the marketplace as a separate entity.
During Wednesday's meeting, however, Lowery, R-Maumelle, ruled that a motion for the delay by Rep. John Maddox, a Republican from Bell's hometown of Mena, was out of order because Ferguson had already been recognized to present the SB113.
He said Maddox could make the motion to delay "at the appropriate time," but Maddox didn't bring up the motion again during the meeting.
Lowery also said during the meeting that Bell should limit his comments to SB113 rather than presenting an alternative plan. Lowery didn't return a call seeking comment after the meeting.
Bell said he had been working on an amendment to SB113 that would have implemented his proposed alternative but didn't have it ready Wednesday.
"They just ran the clock out on us," Bell said. "We were gaining ground, and a lot of people were becoming more and more receptive to the conversation.
But, he said, "There was a sense of urgency from the sponsors today that they had to get it done before we had an opportunity to tell our story."
Ferguson, D-West Memphis, said Tuesday that delaying the committee's consideration would "just give [Bell] more time to lobby and produce hostile amendments."
Explaining on Wednesday why a delay wasn't needed, she also noted that the bill contains an emergency clause giving it an effective date of March 15 and that it would implement the recommendation of a Legislative Council subcommittee that spent 18 months studying the issue.
"I just think that AHIM has run its course and has become unnecessary," Ferguson said.
The Legislature created the marketplace in 2013 to set up exchanges that consumers and small business would use instead of healthcare.gov.
Using money from a $99.99 million federal grant, the Arkansas marketplace set up the small-business exchange in 2015.
At Hutchinson's request during his first year in office, the agency scrapped its plans to use its remaining grant money to build an exchange for individual consumers. Instead, the marketplace took responsibility for certifying the plans sold through healthcare.gov and for helping consumers sign up for them.
According to the Insurance Department, 62,731 Arkansans were enrolled in such plans as of Jan. 15.
Meanwhile, enrollment in the small-business exchange ended in 2017 because Arkansas Blue Cross and Blue Shield, the only company offering plans, dropped out.
If the Insurance Department takes over the marketplace's duties, Kerr said it could eliminate the marketplace's portion of a fee charged to insurance companies that offer plans through the federal website.
Bell said he would reduce the marketplace's spending by enough to lower the marketplace's portion of the fee from 1.25 percent to 1 percent of the premiums for the plans.
The total fee is currently 4.25 percent, with a share equal to 3 percent of the premiums going to the federal government. The federal government's share of the fee wouldn't be affected by SB113.
Bell, who left the Republican Party to become an independent in 2015, said his plan would keep the state out of the business of marketing insurance policies. As a legislator in 2014, he proposed restrictions that have prevented the Insurance Department, Medicaid program, Health Department and state colleges and universities from promoting enrollment in exchange plans.
The Special Language Subcommittee of the Joint Budget Committee on Tuesday approved an amendment to the Insurance Department's appropriation bill for the fiscal year that starts July 1 that would allow the department to meet federal requirements for promoting enrollment in the exchange, including hiring outreach workers, known as navigators, to help people sign up.
Kerr said that consumer assistance will be comparable to help his department already provides to Medicare recipients and that its advertising will be "minimal."
"There will be less marketing," he said. "The bottom line is we're just going to be there to help people sign up."
Metro on 02/07/2019