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story.lead_photo.caption Attorney Brenda Vassaur Taylor, spokesperson for Conduit for Action, speaks Thursday in her office in Fayetteville. Conduit is a strong opponent of the private option health care plan, which administers the expansion of Medicaid in the state by enrolling Medicaid-eligible citizens in private health plans funded by Medicaid. - Photo by Andy Shupe

Opponents of the governor's Arkansas Works health care plan say they represent the majority of Arkansans despite being outvoted in the state Senate and seeing candidates they supported lose in the Republican primary.

"The vast majority of Arkansans has said over and over that they don't want Obamacare in Arkansas," said David Ray, director of Americans for Prosperity Arkansas. "It's toxic. Its supporters know that. That's why they keep changing the name." His group is the state chapter of the conservative group founded by Charles and David Koch of Wichita, Kan.

Private option

Arkansas’ Medicaid expansion plan was enacted by the Legislature in 2013 and provides health care coverage to adults with incomes of up to 138 percent of the poverty level: $16,394 for an individual or $33,534 for a family of four.

Source: Staff report

The proposed Arkansas Works plan retains the Medicaid expansion implemented as private option under then-Gov. Mike Beebe, but adds requirements.

The budget bill funding the governor's plan received a 25-10 favorable vote in the Senate on Thursday, but 27 votes are required to pass a spending measure. The Senate is working to resolve the impasse.

Gov. Asa Hutchinson, a Republican, campaigned against candidates backed by Americans for Prosperity Arkansas and by fellow conservative group Conduit for Action in his party's March 1 primary. Candidates backed by the governor prevailed in six of those eight campaigns.

Brenda Vassaur Taylor of Fayetteville is a tax attorney and co-founder of Conduit for Action.

"If you read the ads and listened to the robo-calls, they told you that their candidates were voting to end the private option and were against Obamacare," she said of the governor's intervention in the primary.

Taylor did not call the governor's claims deliberately false. She said those making the claims see differences between Obamacare's expansion of Medicaid, the private option and Arkansas Works her group does not.

Obamacare, or the federal Affordable Care Act, includes provisions to expand state-run Medicaid, which pays for health care for the poor. States have the option to refuse that expansion to people above the federal poverty line, up to 138 percent of that income. However, doing that would also leave hospitals and other health care providers without reimbursement for many medical services that were paid for before the reform passed.

The governor's plan requires premiums of about $19 a month to participants whose incomes are above the poverty level, subsidizes some people's coverage through employer plans and refers some beneficiaries to job training programs.

The new requirements would require permission from the federal Department of Health and Human Services.

Supporters of Arkansas Works say the changes mark an important difference from the current, private option plan. Taylor said adding some requirements and having Medicaid expansion go through the middlemen of private insurance contractors are not fundamental changes.

"The only difference is that it costs more," she said.

Ray expressed the same view as Taylor in a separate interview. There is no meaningful difference between Medicaid expansion, Arkansas Works or Beebe's previous private option program, he said.

Hutchinson has said failure to approve his plan and the $1.7 billion in federal taxpayer dollars that come with it in the state's next fiscal year would require drastic cuts in the state budget.

THE OPPOSING VIEW

Rep. Charlie Collins, R-Fayetteville, helped design and pass private option. He is now a supporter of Arkansas Works and sees it as a path leading out of Obamacare toward something better.

"There are too many mandates and restrictions in Obamacare for it to work, and all the changes we've proposed are conservative," Collins said. "The states are the ones who put things into practice and find out what really needs to be done. That's how the federal system works."

Those who do not see the difference between Obamacare and Arkansas Works are looking at where those programs are, not the separate directions they are headed, he said.

"If we get rid of Arkansas Works, we become a follower and not a leader," he said.

"I'm looking forward to working with grassroots groups like these again when we get past this issue," Collins said of Conduit and American for Prosperity. "Conduit for Action in particular is the kind of group we need, because too few conservative groups are really working for things like individual income tax relief and other basic, conservative things that really help working people."

Sen. Jim Hendren, R-Sulphur Springs, voted against the original private option plan. He supported Hutchinson's call for a task force to find an alternative to the state's health care policy. Hendren, who is a nephew of the governor, was elected chairman of the task force.

The study by the Stephen Group, a Manchester, N.H.-based consulting firm, concluded keeping the Medicaid expansion money was the state's best option. It also recommended greater cost control efforts on traditional Medicaid programs. The governor proposed the Arkansas Works plan, which is the one that failed the Senate vote Thursday.

"People say we ought to run government more like a business," said Hendren, who also is president of a plastics company. "Well, when you have a tough decision to make in business on a subject you don't know, you hire the best analyst you can to look at all the facts. That's what we did."

Hendren said turning down Arkansas Works would leave a hole in the state budget and in the Arkansas economy. Billions in federal dollars would be lost.

Ray argued the expansion money comes from unsustainable levels of federal spending.

Hendren cautioned against trying to fight federal battles at the state level.

"I was speaking to the Gravette Kiwanis Club this morning," he said Friday. "I went through the whole thing. I had Democrats, Republicans and Tea Party Republicans in there. When I laid out the math, nobody questioned that we should do this."

PRIMARY RESULTS

Looking at defeats from the last primary was "cherry picking," Ray said. He said he could point to other results in previous elections.

"They tried running on the merits of the program in 2014, and their candidates lost," he said, referring by name to the victory of Sen. Scott Flippo, R-Bull Shoals. Flippo defeated then-Rep. John Burris, R-Harrison, one of the chief legislative supporters of the private option and one of its most outspoken defenders. The governor's move to change the program's name to Arkansas Works shows he thought it was a political liability, Ray said.

Taylor gave a more detailed view of the defeats of Conduit-supported candidates in March. She pointed to the big increase in Republican primary participation this year and attributed much of that to the "Trump phenomenon."

Arkansas moved its primary up from May to March as part of a Southern regional effort to have an earlier say in presidential races. The competitive GOP presidential race featuring businessman Donald Trump also drove the primary numbers up, she said, which affected the outcome of the election.

For example, Conduit supported candidate Sharon Lloyd in the race for the District 7 state Senate seat in Springdale, Taylor said. Lloyd received enough votes to have won the primary in a previous year.

"Our candidate won among informed Republican voters who had voted in Republican primaries for years," she said, saying Lloyd's campaign focused on those more established Republican voters.

Another factor is most of the candidates supported by the governor were incumbents, and incumbency is always an advantage, both Taylor and Ray said.

Taylor added the possibility of cross-over voting by Democrats. Democratic primary turnout was much lower than in previous years, state election results show.

Finally, the governor and his allies' intervention was effective, Taylor said.

"They put real money in it," she said. "Their message was effective to people new to the Republican primary."

NW News on 04/17/2016

Print Headline: Health Plan Opponents: No Plan to Back Down

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