For 2nd time, private option fails in House

Will keep voting on bill till it passes, speaker declares

“We can play this game every day, and I’m prepared to do that and will do that, but the end result will be the same,” House Speaker Davy Carter said Wednesday after the second straight House vote against extending the state’s private-option Medicaid expansion plan.

“We can play this game every day, and I’m prepared to do that and will do that, but the end result will be the same,” House Speaker Davy Carter said Wednesday after the second straight House vote against extending the state’s private-option Medicaid expansion plan.

Thursday, February 20, 2014

The House of Representatives on Wednesday failed to approve funding for Arkansas’ private-option Medicaid expansion for the second day in a row, but the leaders of both chambers said they will take up identical measures today and expect that they will pass.

The House voted 68-27 on the appropriation bill for the state Department of Human Services’ Medical Services Division, which oversees the state’s private-option program. House Bill 1150 requires 75 votes to pass in the 100-member House. It received 70 votes in the chamber Tuesday.

All of the members who voted against the bill Tues-day, also voted against it Wednesday. Three supporters of the bill did not vote Wednesday because they were outside the chamber when the vote was taken.

One legislator who voted for the program’s funding last year and didn’t vote Tuesday, voted for the measure Wednesday.

House Speaker Davy Carter, R-Cabot, said the chamber will vote on the bill until it passes and will not take up an alternative measure, which was promoted during a news conference earlier in the day.

“We can play this game every day, and I’m prepared to do that and will do that, but the end result will be the same,” Carter said.

The private option was set up after the state received a waiver from President Barack Obama’s administration to use federal funds from the 2010 Patient Protection and Affordable Care Act to expand Medicaid health-care coverage in Arkansas.

The state uses federal Medicaid dollars to subsidize private health insurance plans that poor Arkansans can pick from the state’s health insurance exchange.

The expanded Medicaid program extends private-option eligibility to adults with incomes of up to 138 percent of the poverty level - $15,860 for an individual or $32,500 for a family of four.

The private option doesn’t yet have the backing of three-quarters of the members of the House and the Senate - the minimum necessary to pass reauthorization of the program.

Senate President Pro Tempore Michael Lamoureux, R-Russellville, said the Senate is to vote this morning on Senate Bill 111, which would fund the private option in fiscal 2015, and he’s pretty confident that it has the 27 votes required for passage in the 35-member chamber.

He said he wants the Senate to vote on the measure this morning because “I just think the members are ready to.”

Lamoureux said the Senate didn’t vote on the measure Wednesday because he wanted to give the House another shot at approving its bill, which is identical to SB111.

Though the vote tally doesn’t show it yet, Democratic Gov. Mike Beebe said the proposal is gaining support and that several House members are waiting for the Senate to pass the appropriation bill before casting their yes votes.

With regard to Wednesday’s House defeat, “It’s not unexpected, but it’s disappointing,” Beebe said. “You’re sitting there with 70 or 71 people for it and others who say they are, but they’re not ready to vote yet because they’re waiting on the Senate,” he said.

Supporters of the program have said that ending funding for the private option would strip health insurance from at least 100,000 people who have recently enrolled in insurance plans. Opponents argue that the Affordable Care Act will add to the national debt and that the state can’t afford the 10 percent cost of the program, which it will be required to pick up beginning in 2020.

Beebe estimated that ending the program will put an$89 million hole in the state’s proposed $5 billion budget for fiscal 2015, because the state would lose out on hundreds of millions of federal Medicaid dollars. But critics say they doubt that eliminating the private option would affect the budget that dramatically.

Earlier in the day, private-option critics Sen. Jim Hendren, R-Sulphur Springs, and Rep. Bob Ballinger, R-Hindsville, held a news conference in the state Capitol with about 20 other lawmakers to outline their proposal for freezing and possibly eliminating the private option.

Under their proposal, the state would be required to ask the federal government by March 1 for a waiver to cap enrollment in the private-option program, effective June 30, and the program would end July 1 if the federal government doesn’t approve a waiver by June 30, Ballinger said.

If the waiver were granted, funding for the program would run until March 1, 2015, under this proposal to allow the 2015 Legislature to consider its options, he said.

“This idea that we are ready to cast 100,000 people off their insurance plan is not part of this plan,” Hendren said.

“Because of the changing landscape [regarding the federal health-care law], let’s put a pause on this program, let’s protect those who are in it, let’s not penalize them because of a changing environment that they had no control over, and then allow the voters to have their voices heard in November,” Hendren said. “After that, legislators will have to decide do they continue the pause, do they push play and open up enrollment again, or do they push stop and allow the program to terminate,” Hendren said.

He called on private-option supporters to compromise.

“It is important to understand none of us legislators have the ability to declare negotiations over, so we believe negotiations will continue and should continue,” he said.

Carter said the minority will not be allowed to derail the measure, which has the support of the majority of House members.

“If there was a vote on the House floor to end the private option, it would fail miserably. So you can’t achieve that result by holding the budget process hostage. We’re not going to let that happen and in reality that’s what [we’re] being asked to do,” Carter said.

Ballinger said on the House floor that he would like an alternative to what he called the “bully politics” of the current private-option appropriation.

“We’re working to try to do everything we can to find a plan that would be something to bring some consensus,” Ballinger said.

Of the 27 members who voted against the bill Wednesday, five were Republicans who voted for the private option during the previous regular session but changed their votes Tuesday. All but one of the 48 Democrats voted to fund the program.

Democrat Rep. Tommy Thompson of Morrilton said he backs the private option but didn’t make it to his desk in time to vote for it Wednesday.

The five members who opposed the private option Wednesday after backing it in 2013 were: Rep. John Hutchison, R-Harrisburg; Rep. Ann Clemmer, R-Benton; Rep. Les “Skip” Carnine, R-Rogers; Rep. Allen Kerr, R-Little Rock; and Rep. Mary Lou Slinkard, R-Gravette.

Hutchison told the House on Wednesday that he had changed his vote because he had concerns about the eventual cost of the program and whether it has enough oversight.

Rep. Fred Smith, the House’s only Green Party member from Crawfordville, did not vote Tuesday but voted for the funding Wednesday.

Rep. Jon Eubanks, R-Paris, who voted to fund the program last year, did not vote Tuesday or Wednesday.

While 27 Republicans voted against the funding bill, 20 voted for it.

Four members did not vote and one member voted present.

Beebe said he was told that Republican Reps. Denny Altes of Fort Smith and Ken Bragg of Sheridan, still support the measure but were not in the chamber for the vote.

Carnine said he voted against the funding Wednesday because he was concerned over the number of changes made to the program on the national level since it was enacted. Carnine said he favors a compromise but he isn’t a “strong, strong no” and may eventually vote for the bill.

“I’m not absolutely [a] hard-liner on this, and yet I still look for the Senate potentially to find a compromise and send it over to the House,” Carnine said.

Rep. Mark Lowery, R-Maumelle, stated Wednesday that his reasons for voting present on the funding bill have not changed, saying that as the architects of the program the senators should vote first.

“There are discussions happening on the Senate end that might make this legislation more palatable to conservatives,” he said.

Eubanks, Clemmer, Slinkard and Kerr did not return phone calls seeking comment Wednesday afternoon. Clemmer, who is seeking the Republican nomination in the 2nd Congressional District, declined Tuesday to explain why she changed her vote.

House Minority Leader Greg Leding, D-Fayetteville, said the Democratic caucus was examining its options if the bill continues to get voted down.

“Honestly I believe the votes are there in both chambers, but I believe there’s just a handful of people who are playing politics based on campaigns they have coming up rather than focusing on the right policy for Arkansas,” Leding said.

Front Section, Pages 1 on 02/20/2014