Health Care Proposals In The Spotlight And On The Hot Seat

Health care reform will find itself under a glaring spotlight on Wednesday as state lawmakers review proposed changes to Medicaid and consider how to construct Arkansas law to deal with federal health care reform.

On Wednesday, a Joint Public Health Committee meeting will be held to discuss Gov. Mike Beebe’s proposed changes to Medicaid. The meeting, which will be held in Room 171 after the Senate and House chambers adjourn, will include a presentation by Arkansas Dept. of Human Services Director John Selig and Arkansas Medicaid Director Gene Gessow.

Beebe is seeking a federal waiver to alter the state’s Medicaid delivery system. As we’ve previously reported, Beebe wants to experiment with its Medicaid program in order to corral costs and, in theory, create better health care outcomes.

On the same day, the House Insurance and Commerce Committee is expected to  take up HB 2138 by Rep. Fred Allen, an amended bill that outlines how Arkansas Insurance Department Director Jay Bradford proposes the state should regulate federal health care reform.

Arkansas has been given two $1 million grants to implement different aspects of the federal law. First, the state has begun a health benefits exchange to allow for rate comparisons and regulation of the insurance industry. In HB 2138, many details of how the state would embark on this exchange are outlined. It also directs the exchange to be "self-sustaining" by Jan. 1, 2015 and requires an annual budget to be prepared and approved by Bradford’s office.

A second million dollar grant will oversee the study of medical loss ratios. Under the new federal law, health insurance companies are required to spend 80-85% of their premiums on medical claims. The grant money will be used to assess and assist the agency’s rate review system under changes from the new law.

A third smaller federal grant has also been received by the Insurance Department. It will pay for planning to beef up consumer protection under health care reform.

Insurance Commissioner Bradford has warned that if Arkansas doesn’t pass state laws to govern the implementation of federal health care, U.S. regulators will set the rules.

"Let’s take care of our people," Bradford has told state legislators in previous committee hearings on the subject.

State lawmakers opposed to federal health care reform – which is being litigated in the U.S. court system and contested in Congress – have been looking for ways to slow down or stop its enactment in Arkansas. They have also questioned the financial burdens that federal reforms may force the state to pay in the future.

On Wednesday, it’s a good bet that both supporters and opponents will have lots of questions. Whether or not they get the answers they’re looking for will be subject to interpretation, partisan spin and philosophical differences.