Change may be the key to keeping the private option insurance plan afloat in the upcoming fiscal legislative session.

Change may be the key to keeping the private option insurance plan afloat in the upcoming fiscal legislative session.

Last week, I wrote about the effort underway from the architects of private option to save the plan from the possibility of defunding. The bipartisan approach crafted last year allows for expanded health insurance coverage funded with federal dollars from the Affordable Care Act. Funds designed for Medicaid expansion instead are directed to private insurance plans for the same target population.

With the fiscal session only a week away, the strategy is emerging to keep a handful of fence-sitting legislators on board while continuing to infuse conservative market-based principles into the plan.

I caught up with House Speaker Davy Carter, who is still fully committed to the plan but admits he is open to some tweaking as it continues to develop.

"First, I want to continue to make it clear that the vast majority of the members of the General Assembly, including myself, oppose the Affordable Health Care Act. If it was an option in Arkansas to abolish this federal legislation I think we would see 90 plus votes in the House and 30 plus votes in the Senate to do so. But unfortunately, that’s not possible. Indeed, the proper venue for that fight is in Washington D.C.," Carter said.

"Much has been written about Arkansas’ leading and unique approach to dealing with this difficult and polarizing issue," Carter explained. "The upshot is that the private option is designed to reduce the state’s exposure to the rapid growth in Medicaid by alternatively placing our citizens in private insurance policies. Although it is still very early in the process, we are seeing very positive results in this area. Additionally, we need to remember that the private option will save Arkansas businesses approximately $30 million in fees and penalties that otherwise would be levied against them beginning in 2015. Arkansas businesses are strong and vibrant, but do not need this additional burden, especially in today’s economic environment."

But if some changes are needed to continue the plan, Carter said he is willing to be flexible. Sen. David Sanders, one of the chief private option architects, gave a look at some possible changes, which he describes as important improvements.

"What we are working on right now is the heart and soul of the private option," Sanders said in an interview with Roby Brock over the weekend. "What is going to be a formula for success is when we stop being users of health care and become consumers of health care. So what we are working on right now is a very significant component of this and that is the development of the health saving account for this population."

State legislators have brought in former Utah Gov. Mike Leavitt to help craft the Health Savings Account program for implementation in the plan. Leavitt served as the Secretary of Health and Human Services under President Bush, where he was vocal that the current Medicaid was unsustainable without significant reform. He is now one of the leading consultants to states on how to put these reforms in place.

Sanders emphasized that the changes are not just minor cosmetic changes but a key component to getting the health consumer involved in the delivery of his or her health care. Part of the plan will be to expand the HSA’s from a pilot program to full implementation as soon as 2015.

Changes that beef up conservative reforms in the health care system could be a key selling point for holding some important swing votes. And more importantly, it could actually make the health care system work better in Arkansas.


Jason Tolbert is an accountant and conservative political blogger. His blog — The Tolbert Report — is linked at His e-mail is