story by Roby Brock, with Talk Business & Politics, a content partner with The City Wire
Gov. Mike Beebe says math, not health, may eventually determine the fate of the Private Option.
During an interview with Talk Business & Politics, Beebe said it would be difficult to throw 180,000 people off health care, but he said percentages and dollar figures are likely to influence votes to see if the Medicaid expansion-funded health care program survives.
“We are going to be paying for this whether we take the federal money or not,” Beebe said, repeating an argument he made when the program was first funded.
The Private Option takes federal tax dollars to be used for expanding Medicaid under the Affordable Care Act and uses that money to subsidize insurance plans for working Arkansans. With the loss of two key Senate votes in recent elections, funding for the Private Option appears in jeopardy.
“Here is another reason for my optimism,” Beebe said. “If you’ve got 74% of the legislature that is for this and 26% that is against, do you think that 74% is going to let the 26% get away with that? I suspect there will be as much, because it takes a three-fourths vote. I expect there will be as much of that 74% as is possible to force somebody’s hand.”
Beebe is term-limited and will not be Governor in 2015 when the Private Option is debated again. Lawmakers must approve funding for the program, which will require a three-fourths vote of both chambers of the General Assembly.
Last week, lawmakers also rolled out several new phases of the Private Option that will begin implementation in the next year. Dubbed the Private Option 2.0, those new elements include independent savings accounts, cost-sharing, and changes to transportation payments.
Beebe contends that because of political rhetoric boxing some legislators into positions from which it will be hard to pivot, additional changes may be made to the Private Option in next year’s legislative session.
“That’s why you may see some tweaking to the point that it allows some cover for those folks that once they look at the whole world and see the whole picture, they back off the rhetoric,” he said. “When they were running and didn’t know any better and when they look at the realities, there’s a $100 million hole in the budget if they do away with it. You’re not going to take it away from education, the Supreme Court won’t let you. Prisons are already in trouble. Where are you going to get the money?”
Beebe also discussed positive results from the state’s Payment Reform Initiative, a cost-containment effort he started two years ago. The effort moves Medicaid reimbursement away from a “fee-for-service” model to a “bundled services” model.
Hospital executives say it is bending the cost curve, while improving health care.
“America has to do this and I think the other 49 states are going to follow Arkansas,” Beebe said. “I think the federal government is going to follow Arkansas. The old ‘fee-for-service’ model is unsustainable. It’s never going to continue to be able to work. This is the way the country has to go and Arkansas is leading the way.”
A WORKFORCE CZAR
As changes are being made to overhaul the state’s approach to workforce education, Beebe is not closed to the idea of creating a workforce czar to push for faster reforms.
“[T]here is a good point to be made that a good governor has so many plates that he has to balance from education to prisons to health care to all sorts of things that sometimes it’s hard to devote as much time to that one topic,” Beebe said. “So if a governor is not going to do it, a czar certainly could. But you could also have an agency that with a cabinet head that you designate as a lead to go get it done. Right now, the Legislature is doing a good job of being a czar on this expanded and collaborative effort. So I expect you’ll see, you may end up with, a bunch of czars which may be as problematic as not having one at all.”
Beebe was complimentary of efforts by Sen. Jane English, R-North Little Rock, who begins this week a series of meetings focused on reviewing workforce training and education programs.
English says the series of meetings over the next several weeks and months are aimed at educating lawmakers on the resources that exist and the possibilities for better coordination among programs.
Beebe says it is imperative to streamline the moving parts of workforce training in order to continue successful economic development.
“What we don’t have is the kind of coordinated, across-the-board, everywhere success stories that you would like to have, and workforce development may be the number one key to economic recruitment, retention, expansion,” he said. “We hear stories that a lot of people are unemployed and we’ve got a lot of jobs open and waiting. But the skill levels of the people unemployed don’t match the needs of business and industry so it’s part of the state’s responsibility.”
Beebe added, “What’s going on now — and Senator Jane English deserves a lot of credit, but so does my workforce cabinet — pooling the resources from all of those different resources that currently exist and trying to do it a comprehensive and cohesive way gets the best bang for the taxpayer’s buck.”