- Associated Press - Wednesday, February 12, 2014

LITTLE ROCK, Ark. (AP) - Trying to find a way to keep Arkansas’ compromise Medicaid expansion alive, lawmakers moved forward Wednesday with an effort to prevent the state from promoting the program or other parts of the federal health care law.

A legislative committee was expected to take up the proposed amendments Thursday to Arkansas’ “private option,” approved last year as an alternative to expanding Medicaid’s enrollment under the federal health care overhaul. Under the private option, Arkansas is using federal Medicaid money to purchase private insurance for thousands of low-income residents.

The proposals endorsed Wednesday are aimed at swaying opponents of the private option. They would bar the state from spending public money to promote or advertise the private option.

“We’re simply barring solicitation and promotion of the idea,” state Rep. Nate Bell, R-Mena, told members of the Joint Budget Committee’s subcommittee on special language before it adopted the amendments. “We’re not barring someone who needs the program from being able to utilize it.”

The proposed changes aren’t clearing up the uncertainty about the private option’s future. Senate President Michael Lamoureux, R-Russellville, said the amendments don’t help win the vote needed to pass the measure in his chamber, and Democrats in both chambers said the moves may cost their support.

“There are some really unhappy people in this building right now,” House Speaker Davy Carter told reporters.

State Medicaid officials were also less than enthusiastic in their support for the changes.

“Bluntly, yes, we think it’s harmful. We think it’s not as harmful as losing coverage for 100,000 people,” state Human Services Director John Selig told lawmakers.

Arkansas was the first state given federal approval to use Medicaid funds to purchase private insurance for the newly eligible under the health law. More than 87,000 people in Arkansas have been enrolled in the program, and several other states are pursuing or exploring similar plans.

Bell, who voted against the private option last year, said he’d back the program’s reauthorization if the amendments are included. Bell painted the proposal as a way to limit the private option’s enrollment but avoid a showdown over the state budget because of the program’s future.

Bell’s proposal would also prevent the state from promoting or conducting outreach for the insurance marketplace created under the federal health care law. Other changes include requiring the federal government to approve key parts of the private option, such as creating health savings accounts for some participants, by the end of the year to keep the program alive.

Gov. Mike Beebe’s office said he agreed to the changes dealing with the expansion’s promotion, but was concerned about the proposed deadline for the approval of other parts of the program.

“He worries that that pretty much abdicates the entire future of the private option to the feds,” Beebe spokesman Matt DeCample said.

The private option debate has sharply divided Republicans, who control both chambers of the Legislature, and questions about its future come as they near an election season where GOP candidates are running against the federal health care overhaul.

Reauthorizing the private option will require 27 votes in the 35-member Senate and 75 in the 100-member House. Senate leaders have said they’re at least one vote shy of being able to keep the program alive.

Carter said he hoped to see the House vote on the private option funding on Friday if it wins support from the Joint Budget Committee on Thursday. Carter indicated little appetite to negotiate further on the program’s future, saying he didn’t want to consider any other changes. The private option is included within the budget bill for the state’s Medicaid program.

“If we send a bill down to the Senate, then that’s it. If you’ve got nine people who want to shut the thing down, then they can live with it,” Carter said.

House and Senate Democrats said they were surprised by the proposed changes, and several expressed worries about moves intended to restrict enrollment in a program they support continuing.

“We need people to know about how to enroll in the program for the program to be healthy and successful,” House Minority Leader Greg Leding, D-Fayetteville, said.

The changes also did little to sway some of the most outspoken opponents of the health care expansion, who said the only amendments they’d accept would be ones that lead to the private option’s dismantling. The special language panel rejected a proposal to phase out the program by the end of the year.

“My view is if we’ve got a chance to reject Obamacare in Arkansas, we need to do that,” House Majority Leader Bruce Westerman, R-Hot Springs, said.


Follow Andrew DeMillo on Twitter at www.twitter.com/ademillo

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