Between The Lines: Is 'Private Option' In Peril?

Here's hoping common sense will prevail when it comes to preserving Arkansas' "private option."

That's the state's compromise plan that uses federal Medicaid dollars to subsidize private insurance for the state's low-income people. Something like 172,000 people have enrolled, many of whom had no coverage before.

Unfortunately, money for the program must be appropriated over and over again, each time with a three-quarters vote of both houses of the Arkansas Legislature.

That has happened twice now, each time with few, if any, votes to spare in the 35-member state Senate and 100-member House of Representatives.

Hence, the past few days have been filled with suggestions that a Republican primary runoff in one state legislative district might be the death knell for the program.

True, state Rep. John Burris, R-Harrison, a strong supporter of the private option, lost the runoff for a state Senate seat.

True, too, his challenger, Scott Flippo of Mountain Home, pounded Burris for his role in crafting the law. And Flippo will take the District 17 Senate seat as an avowed opponent of the private option.

So, a vote for the private option is gone, traded for a vote against it.

Burris himself doesn't think he lost his race because of the private option. He notes other issues in that campaign, discounting the theory that the race was a referendum on the private option. His private option stance also won him votes, he said.

Whatever their motivation, his constituents turned Burris out on a 200-vote margin in the runoff, sparking this discussion of what that might mean the next time the Legislature takes up the private option.

Certainly, Burris' leadership on the issue will be missed, even if he was trying to change chambers. He was one of the architects of the program, created with money intended to expand the rolls of Medicaid as part of the federal Affordable Health Care Act, or Obamacare, as the law has become known.

Still, it is early to be counting votes on the private option. A lot could happen between now and the next legislative bout over the issue -- including the general election.

Burris isn't the only pro-option vote that will be gone but there could still be enough votes to pass the measure again.

Although Flippo will have no Democratic opponent in November's general election, there are other legislative races yet to be decided. The private option could gain a backer or two.

And, of course, Arkansas voters will elect a new governor.

Term-limited Gov. Mike Beebe, who worked with Burris and the Republican legislative leaders to secure the private option, will be gone.

His replacement will be either Republican Asa Hutchinson or Democrat Mike Ross, both former congressmen from the state.

They've staked out slightly different positions on the issue, Ross saying he'll work to keep the private option and Hutchinson saying he will evaluate the program.

Importantly, Hutchinson has not said he will oppose its re-authorization.

Both men likely understand that ditching the private option would be a costly decision, one that would negatively impact the state's overall budget.

Keeping the program or killing it is not just about the insurance it provides for more than 172,000 Arkansans.

The insurance is what matters most, not only to the individuals who've gained access to more affordable health care but also to the providers who treat them and get paid for their services.

But there are other considerations, including that budget impact, for the new governor and lawmakers to weigh when the next private option vote comes around.

That is why, as Beebe has said, logic and reason should prevail.

The focus has been on the numbers of lawmakers in each chamber of the Legislature who could kill the program.

But it is important, too, to remember that at least 75 percent of the members of each chamber have twice voted to fund the private option

Gov. Beebe reminded everyone of that reality recently as he mused about the private option's future.

"I'm still a believer that when you've got 70 percent, 72 percent, 74 percent of the General Assembly that favor a policy, it's going to be hard for 26 or 27 percent to reject that policy," he said.

"There may be all sorts of negotiations to get there. That's what we do all the time."

That is what they've done. Whether they can do what's necessary to keep the private option may depend on what influence the new governor wields and how divided the next Legislature turns out to be.

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

Commentary on 06/18/2014

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