LITTLE ROCK — Republicans who oppose state participation in the Patient Protection and Affordable Care Act were stymied Friday as the Arkansas Legislative Council approved an $18.6 million federal grant to set up the state’s insurance exchange.
Afterward, Insurance Commissioner Jay Bradford said he was pleased that planning and implementation of the exchange will continue under a partnership with the federal government. The state would be better off with Arkansas retaining control of what types of health-care plans are offered, he said. The state also will be better at finding and assisting the estimated 211,000 people — many of them currently uninsured — expected to buy policies on the exchange, he said.
“I was encouraged by the action today and the vast numbers of votes in favor. It’s not an issue about the Affordable Care Act, it’s really an issue about being able to respond to Arkansans on Arkansas issues,” Bradford said.
A voice vote passed the motion to accept the U.S. grant.
Arkansas is one of six states planning to partner with Washington, D.C. On Friday, Delaware was the first to receive approval from the U.S. Department of Health and Human Services for a partnership exchange.
Under the health-care law, states can choose whether to run their own exchanges, partner with the federal government or let Washington run their exchanges. All exchanges will begin in January 2014.
Some Arkansas Republicans are now questioning that partnership model, saying that it doesn’t seem to offer any advantages over a federally run exchange.
“I don’t see any advantage to a [partnership] exchange right now,” said Rep. Mark Biviano, R-Searcy. At Friday’s hearing, former Republican Rep. Dan Greenberg of Little Rock circulated a position paper advocating for a federally run exchange.
Rep. Greg Leding said it surprises him that Republicans want a federal exchange.
“It does seem counterintuitive. You would think they would want to retain as much control as possible and not be dictated to by [Washington],” said Leding, D-Fayetteville.
The grant, which received an extensive hearing at the subcommittee level, wasn’t discussed by the full council on Friday, as a Republican effort to force a vote and debate on the grant failed by a 29-17 margin. That vote fell along partisan lines with just one Republican, Rep. Les Carnine of Rogers, voting with Democrats.
Carnine later said he had voted mistakenly. He thought a “no” vote was a vote to kill the measure, he said. It wasn’t.
“I had been out of the room, then came back. I wish I had recognized what was happening. I remain adamantly opposed to it,” Carnine said.
Rep. John Burris, a Harrison Republican who led the effort to restart the debate over the exchange, criticized Democrats for quashing his effort and reminded them that Republicans would control the committee — and the Legislature — in January. He said the council should not approve money for an exchange “that the Legislature never authorized.”
“We should allow members of this Legislature to vote the way their conscience dictates. I thought we were better than that,” Burris said.
Republicans killed efforts to create a state-run exchange in 2011. Later that year, Gov. Mike Beebe, a Democrat, authorized the Insurance Department to proceed with the partnership model.
The law, championed by President Barack Obama, is here to stay, Leding said.
“The Supreme Court upheld it. President Obama was re-elected. Even Speaker [John] Boehner made it clear it’s the law. It’s here to stay and it’s up to us to implement the law responsibly,” he said.
A member of the exchange’s steering committee who hasn’t attended recent meetings, Biviano, the Republican from Searcy, said he planned to become more involved.
“Obviously, we prefer no exchange. It’s a bureaucratic process with a lot of people involved in it. My concern is what’s best for the state of Arkansas. I want to see a more competitive environment and lower costs for consumers,” he said.
After Friday’s vote, about a dozen Tea Party supporters milled outside the committee room at the Big Mac Building. They voiced their unhappiness with “Obamacare” but also with GOP members who didn’t attend the meeting.
“It’s possible we can overturn it in January. Arkansas can’t afford it. We don’t have the money for Obamacare,” said Ed Hairston, a Saline County Tea Party member.
A protest against the health-care law promoted by Secure Arkansas, a conservative group, never materialized. The group’s leader, Jeannie Burlsworth didn’t immediately return a request for comment.
The Legislature still could decide to switch to either a state or federally run exchange, but a state-run exchange would take about a year to complete, exchange officials have said.
Among other things, the grant will fund the training of about 500 temporary “guides” that will help people navigate the new system when enrollment begins in October 2013. It also will pay for a publicawareness campaign that should begin in the spring, said Cindy Crone, the exchange’s planning director.
Front Section, Pages 1 on 12/22/2012