About 50 people gathered Monday outside U.S. Rep. French Hill's Little Rock office to protest his vote for the Republicans' American Health Care Act.
A smaller delegation of protesters later went into Hill's office, on University Avenue, and aired their concerns with his chief of staff over speaker phone.
Camille Richoux, an event organizer and student at the University of Arkansas for Medical Sciences, told a reporter that the group was concerned about how the bill would affect those with pre-existing conditions. They also were concerned about its affect on the Medicaid expansion in Arkansas, also known as Arkansas Works.
She said the result would be more uninsured Arkansans. Under the current federal Affordable Care Act, the uninsured rate dropped from 22.5 percent to 10.2 percent from 2013 to 2016, according to Gallup polling.
"The fundamental problems are containing costs in a way that doesn't sacrifice the health of the poorest and sickest and oldest Americans," Richoux said. "This bill absolutely does not do that."
In an interview, Mike Siegel, a spokesman for Hill, said the Republican bill would continue to help those with pre-existing conditions.
The bill would allow states to opt out of an Affordable Care Act requirement that prohibited insurers from charging more for patients with pre-existing conditions. However, a state would only be allowed to opt out if it used a high-risk pool to subsidize coverage for those patients who are especially costly. The proposed American Health Care Act would provide an additional $8 billion for the federal pool.
"The purpose is that so if you're 29 and healthy or 29 and have a pre-existing condition, you're paying roughly the same amount for health insurance," Siegel said. "The federal risk-sharing program would subsidize whatever the additional costs are."
Asked what Arkansas would choose under the bill, J.R. Davis, a spokesman for Gov. Asa Hutchinson, said in a statement: "It's important to note that the Governor strongly supports returning the power to regulate insurance to the states and would thus look closely at any opportunities to make regulatory changes that are tailored to the needs of Arkansans."
Protesters said there was no guarantee that costs would be similar if a state chooses to seek the waiver.
"Most of us have pre-existing conditions," said Laura Frankenstein, a former family practice physician from Little Rock. "Young, healthy men may not, but in 10 years they will. So we can't be careless about this."
In a statement released after the House approved the bill, Hill said H.R. 1628 would bring costs down.
"The reform measure that we advanced today will lower the cost of care for individuals and families, provide coverage for those with pre-existing conditions, and shift power back to the states with added flexibility in determining what policies will have the most positive outcomes on their own citizens and populations," he said.
The protesters and Siegel agreed on one aspect of the bill -- the cost of the Medicaid expansion would increase for states but decrease for the federal government.
The bill phases out "enhanced funding" for Arkansas Works. Arkansas is now paying 5 percent of the total cost for the program, which cost more than $1.5 billion last year. Under current law, the match would go up to 10 percent.
Under the House bill, the match rate would go to 30 percent in Arkansas, potentially costing the state hundreds of millions in additional dollars per year to keep the program.
"I think it's not unreasonable to ask certain states to contribute more," Siegel said, referring to states that have large surpluses, unlike Arkansas.*
Davis said the state would continue to implement changes to Arkansas Works approved in a special session last week. One of the changes was aimed at shifting about 60,000 Arkansas Works recipients into the insurance market exchanges set up by the Affordable Care Act.
"The House bill will go through many changes in the Senate before a final bill is passed, and we cannot speculate as to how the Arkansas Works program would be affected until we have a final bill," Davis said. "However, all of the [state legislative] changes that were approved last week will put Arkansas in a better position to adapt to whatever changes come out of Washington."
State Department of Human Services officials have said they will send President Donald Trump's administration an application next month for a waiver allowing the state to make the changes to Arkansas Works approved in the special session.
Brandi Hinkle, a spokesman for the department, said it had not done any analysis to see how the Republican health care plan would impact its programs.
Metro on 05/09/2017
*CORRECTION: A previous version of this article failed to make clear the context of a comment by Mike Siegel, spokesman for Rep. French Hill, R-Ark.. Monday’s protest was over a health care bill passed last week by the U.S. House that would, among other things, increase how much states pay for the expanded Medicaid program to insure poor people. Hill voted for the bill. Siegel told a reporter, “I think it’s not unreasonable to ask certain states to contribute more.” He was referring to other states, unlike Arkansas with its budget cuts, that have had large surpluses.