Between The Lines: Legislature Pushes 'Private Option' Over Finish Line

Five switched votes in the Arkansas House of Representatives saved the insurance plan known as the "private option."

Those five representatives had last been recorded voting "nay" or "not voting" against reauthorization of funding for the program that uses federal Medicaid dollars to extend health insurance to almost 94,000 lower-income people.

Last week, they joined 71 other state representatives to pass the controversial measure 76-24. Gov. Mike Beebe signed it into law on Friday.

The Legislature, which had stalled during the private option debate, finally got back to considering the budget for the coming fiscal year and should wrap up work soon.

But the private option battle won't soon be forgotten and will apparently have to be waged again and again, because appropriations must have a three-quarters vote in both chambers of the Arkansas Legislature. That means 75 votes in the 100-member House and 27 votes in the 35-member Senate.

It is a high hurdle for any vote but an especially high one for a measure that is derived from the highly divisive federal Affordable Health Care Act, or Obamacare.

Obamacare allowed states to expand their Medicaid rolls to cover those who earn no more than 138 percent of the federal poverty level. In Arkansas, that standard was projected to produce about 200,000 newly eligible citizens.

The Arkansas twist, the private option, instead uses the available federal dollars to subsidize private insurance for these same qualifiers.

Something like 94,000 have enrolled to date and they could have lost their newly acquired health insurance if lawmakers hadn't found those extra votes.

State senators actually passed the measure by a 27-8 vote on Feb. 20 and sent it to the House.

Before the start of the legislative session, supporters of the private option were concerned the measure would hang up in the Senate.

The session started with senators pledging two less votes for the private option than that body had given in 2013, when the Senate originally passed it with one vote to spare.

Gov. Beebe negotiated a deal, however, with a senator on a different matter to secure her vote for the private option. The result was Senate reauthorization of funding for the program, this time with no votes to spare.

So the surprise came this year when state House members rejected the reauthorization of funding not once but four times.

Finally, last week, the House voted 76-24 for the Senate bill, just one vote more than needed to pass the measure.

State Reps. Les "Skip" Carnine, R-Rogers, and Kim Hammer, R-Benton, switched previous "nay" votes to "yea."

Reps. Stephanie Malone, R-Ft. Smith, Mary Lou Slinkard, R-Gravette, and Henry "Hank" Wilkins, D-Pine Bluff, voted "yea" after having not voted in the last recorded count.

Among them, only Hammer is seeking re-election. The others are term-limited or not running again.

Notably, the delayed House vote outwaited the closing of the filing period for the 2014 elections. That may have helped secure Hammer's vote because he found out on Monday before the Tuesday vote that he will have no opposition.

Chances are, some of the other "yea" votes would have been lost if they had drawn opponents in their re-election bids.

However it got done, the private option has been reauthorized for another year. The funding will come a year at a time and, most likely, with similar difficulty.

There is a misconception about the level of support for the program. Because passage is so difficult with that three-quarter vote requirement, people forget that way over a majority of lawmakers support the plan. By definition, three out of four have voted their support.

In fact, Arkansas lawmakers gained national acclaim for the private option, which may be mimicked in other states.

Like Arkansas, they'll have to get a waiver from the federal government; but the private option is a way to insure lower income people without directly accepting Obamacare.

Those who came up with the plan insist it is a way of reforming Obamacare while seeing to the health care of Arkansans.

Whatever the justification, it is a good program that deserves to be continued.

There is one little hitch. Another part of the negotiation for this year's reauthorization was an amendment that won't allow the state to publicize the program's availability.

So someone else is going to have to reach out to that other 100,000 or so Arkansans just to let them know they are eligible.

Commentary on 03/12/2014

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