LITTLE ROCK — A legislative panel Tuesday put the Arkansas plan to use Medicaid dollars to subsidize private insurance for thousands of poor workers in position for final consideration before the House.
The House Public Health, Welfare and Labor Committee endorsed Senate Bill 1020 and House Bill 1140, companion bills that encompass the so-called private option for expanding health care coverage under the federal Affordable Care Act.
The legislation would enable people earning up to 138 percent of the federal poverty level — $15,856 for an individual or $32,499 for a family of four — to use federal Medicaid dollars to buy private insurance through the state insurance exchange.
Officials say the measure would extend insurance coverage to up to 250,000 people who currently lack insurance. The federal government would pay the full cost of the expansion for the first three years, after which the state’s share of the cost would increase gradually to 10 percent.
Rep. John Burris, R-Harrison, the sponsor of HB 1140 and the committee’s chairman, told the committee that in addition to expanding insurance coverage to low-income people who now lack insurance, the legislation would allow Arkansas to shrink its Medicaid rolls by about 35 percent by making thousands of people now on Medicaid programs eligible for subsidies to buy private insurance through the exchange.
"Why I think that’s important: As I said yesterday, because I believe that the exchanges are reformable in a way that Medicaid is not," he told the committee, a day after spending two hours briefing House members on his bill.
Some lawmakers have expressed concerns about the federal government possibly failing to fulfill its obligations, failing to grant waivers the state has requested or eventually repealing the Affordable Care Act altogether. Burris said he shares those concerns and said that is why the legislation stipulates that if the federal government does not follow through with any of its commitments, "the whole thing’s off."
"Bottom line is, I think it’s good for Arkansans, the people we represent, and I think it stabilizes our health care system and our state budget and protects us from a lot of the negative implications that are going to hit other states because of what I believe to be a bad law passed by Congress three years ago," he said.
House Majority Leader Bruce Westerman, R-Hot Springs, presented amendments removing his name as a co-sponsor of HB 1140 and SB 1020, which he said he now opposes.
"I believe we are rushing this," Westerman told the committee. "We may be on the right path, but I don’t think we’ve arrived yet."
Some members of the committee also questioned why the decision could not be postponed. Burris said that with the protections built into the bill, he feels comfortable moving forward now. He also noted that the insurance coverage is required to be in place by Jan. 1, 2014.
"The only real deadline that I believe has ever existed is the ability to bid the (insurance) plans, because that is a massive undertaking and you can’t make a bid until you know who you’re bidding on," he said. "I think that process has to begin in May to June. If we don’t bid the plans in time, accept the bids, place them on the exchange, begin enrollment in October, you miss the coverage date in January — and if you miss the coverage date in January, you miss the calendar year."
No one testified against the bills. The committee endorsed the bills on voice votes — several "no" votes were heard — and sent them to the full House for consideration. The Senate bill previously passed the Senate.
House Speaker Davy Carter, R-Cabot, said Tuesday he believes there is enough support in the House to pass both the enabling legislation, which requires a simple majority, and a separate appropriation bill, which requires a three-fourths majority, or 75 out of the 100 House members.
Regarding Westerman’s opposition, Carter said, "It’s certainly not helpful, but I don’t think it’s fatal to the effort to pass the appropriation."
Westerman told reporters he has decided against filing a rival bill on health care expansion. He said expects the enabling legislation to pass in the House but does not know whether the appropriation would be able to garner enough votes to pass.
"That’s going to be a pretty exciting moment around here," he said.
Also Tuesday, the public health panel endorsed HB 1256 by Westerman, which calls for the creation of a seven-county pilot program in which Medicaid recipients would be issued identification cards that would be used for verification in all Medicaid transactions.
The committee had rejected the bill on Friday, an action that Westerman said at the time put passage of the private option "at risk" because it showed a lack of will to reform Medicaid.
The bill goes to the House.