Senator favors Arkansas giving up insurance role

The new chairman of the Senate Insurance and Commerce Committee said Tuesday that he favors ending the state’s partnership with the federal government for its health insurance exchange.

Sen. Jason Rapert, a Bigelow Republican, said he prefers a federally run exchange and he wants lawmakers to settle the issue early in the session to avoid a later logjam of health-care topics, including in-state Medicaid payment changes and Medicaid expansion.

He’s not sure whether he will introduce a bill to abolish the partnership, but enough lawmakers are dissatisfied with Gov. Mike Beebe’s approach to a key component of the Affordable Care Act that an effort to repeal the partnership model will probably occur, he said.

No bill on the matter has been filed yet.

“I feel like it’s very important that the Legislature exercise not only its responsibility, but its duty to make a statement on the issue,” Rapert said after the committee’s brief initial meeting. “The Legislature needs to make a decision one way or another - pursue a partnership or a federal exchange.”

Rapert said he is frustrated that lawmakers have never voted on the partnership model in a regular session. Instead, since a staterun model was killed by lawmakers in 2011, the planning for the state’s partnership model has been authorized by Beebe and supported by federal grants.

The latest $18.6 million grant was approved by a voice vote at a December meeting of the Arkansas Legislative Council over GOP opposition.

“Those grants were approved by a completely different leadership,” Rapert said, alluding to the Legislature’s former Democratic majority. This session, the Republicans control both the House and Senate.

“There is a new leadershipin place. And a majority of that leadership is not happy with what’s been going on in Arkansas.”

A partnership model allows the state to retain more control over assisting and educating the approximately 211,000 Arkansans who are expected to be eligible to buy health coverage on the exchange, set to begin in January 2014. Enrollment begins in October. A partnership model also allows the state more power to determine which plans will be offered. So far, Delaware is the only other state pursuing a partnership to be conditionally approved by the federal government.

Illinois, Iowa, Michigan, North Carolina and West Virginia also have signaled that they want a partnership but have yet to receive federal approval, according to the Henry J. Kaiser Family Foundation, a nonprofit that focuses on health-policy analysis and communication.

Jonesboro Democrat Paul Bookout, also a member of the Senate panel, said he supports the partnership model.

“We’re quite capable of doing that kind of job. It’s just not the sort of thing you hand off to the federal government,” Bookout said after the meeting.

Bookout said he was more comfortable with having local officials contributing to the exchange, designed to be primarily an online marketplace where consumers can purchase health-care coverage. Individuals and families with incomes of up to 400 percent of the poverty line,or $92,200 a year, will receive federal subsidies to lower the cost of their premiums.

“You’re more vested in it running well if your families and friends are here. It seems like the fiscally conservative, responsible way to approach it,” Bookout said.

Bookout said Republican opposition to a partnership is “somewhat ironic.”

“They say they don’t like what’s going on there [in Washington] and, yet, OK, we don’t want to handle [the exchange], we want to turn it over to the feds. It defies logic,” he said.

Rapert said President Barack Obama’s signature legislative achievement is deeply unpopular in Arkansas. And the federal government hasn’t yet told the state how exactly the exchanges will work, he said.

“If you’re not going to give us confidence of how this will operate, we’d rather have [the federal government] responsible for the money and the mess,” Rapert said.

Beebe wants the state to continue with the partnership model unless lawmakers decide in the future to switch to a state-run exchange, but he doesn’t support the federal option, said Beebe’s spokesman Matt DeCample.

“The governor has said all along that he has felt Arkansas should try to maintain as much control and input over the health-insurance exchange as we can,” De-Cample said.

Exchange officials, who have repeatedly said a partnership model is the best fit for the state, didn’t immediately respond to a request for comment.

Front Section, Pages 4 on 01/16/2013

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