BETWEEN THE LINES: ‘Private Option’ Gets A Checkup

Arkansas’ “private option” plan to buy insurance coverage for 250,000 citizens is apparently ready for public scrutiny.

The state Department of Human Services has released a draft of the necessary waiver request to the U.S. Department of Health and Human Services.

The feds must approve the waiver before Arkansas can implement its alternative to direct expansion of Medicaid enrollment in the state.

But the state agency is going to give Arkansans a chance to react before submitting it to federal authorities.

You’ll recall that state lawmakers approved the private option in the latest session of the Legislature, agreeing to use federal dollars available to the state to expand Medicaid to instead buy private insurance for those newly eligible Arkansans.

Expansion of Medicaid nationwide is part of the federal Affordable Health Care Act, also known as Obamacare.

Gov. Mike Beebe and Republican legislators brokered the deal and Beebe got encouragement from the feds at the time to pursue this private option.

Now that the Legislature has passed the law to authorize the program, the state has readied the formal waiver.

DHS will hold public hearings in Little Rock and Fort Smith on July 2 and July 8, respectively, and is accepting public comments for a month.

According to DHS Director John Selig, while the waiver must track the state law, there is room for some change in its implementation. DHS intends to submit the waiver to the feds on Aug. 2 and hopes for approval by Oct. 1.

Eligible Arkansans would be able to buy insurance from a state exchange next year, if the proposal survives federal scrutiny.

The federal law extends Medicaid to persons earning up to 138 percent of the poverty line, or $15,415 for individuals. In Arkansas, roughly 250,000 people would be eligible for the coverage.

Meanwhile, a separate effort is under way to scuttle the private option in Arkansas at the ballot box.

Arkansans Against Big Government is circulating a petition to get the issue on the 2014 ballot but has only until Aug. 15 to submit the necessary signatures.

The group will need 46,880 signatures from registered voters to refer the act the Legislature passed to voters. And they’ll need to gather a significant percentage of those names in at least 15 Arkansas counties.

There is little time for the petition drive, but a spokesman for the organization expects volunteers to gather the signatures.

Note that the petition will be passed by volunteers, not paid canvassers. That fact may raise the odds against the petition drive’s chance of success.

What the group has in its favor is whatever residual opposition is out there to “Obamacare” and to President Obama.

In recent years, both have been targets in Arkansas elections. If the early opposition to U.S. Sen. Mark Pryor’s re-election campaign is any indication, there’s still a lot of that thinking among the Arkansas electorate.

The way the issue might play in Pryor’s race is predictable. More interesting may be what happens in state legislative contests as those lawmakers who backed the private option, Republicans as well as Democrats, face re-election.

If there were to be a ballot question referring the private option law to voters, the issue could be made more significant.

Certainly, the emphasis would be less if everything goes according to plan and the state gets the necessary waiver and moves on with implementing the private option, providing all these low-income workers health insurance.

The argument gets back to the assertion the Department of Human Services makes in the waiver request, which notes that providing these people the means to buy health insurance benefits everyone in Arkansas. The plan should cut healthcare costs and improve access to care. It also aids struggling hospitals and boosts others involved in the delivery of healthcare.

Ultimately, those are the reasons a majority of legislators approved the private option plan and why a majority of Arkansans ought to back them up.

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BRENDA BLAGG IS A FREELANCE COLUMNIST AND LONGTIME JOURNALIST IN NORTHWEST ARKANSAS.