Arkansas legislators exploring insurance exchange

At a health insurance expansion rally on Thursday (Mar. 7), Gov. Mike Beebe (D) encouraged stakeholders in the debate to be patient with lawmakers as they grapple for a fiscal and political solution to insuring more Arkansans.

“They’ve got to figure out a way to work together,” Beebe told the crowd gathered for a AR Health + AR Jobs coalition rally on the capitol steps.

Beebe urged the group, which includes nearly 30 health care advocacy organizations, to “listen” to legislators as they seek information to make decisions on how to extend health insurance to lower income citizens through provisions of the Affordable Health Care act.

Federal officials have given Arkansas permission to use funding earmarked for a Medicaid expansion in its health insurance exchanges – a “private option” for expanding health care coverage.

With that framework in place, legislators and Beebe administration officials are now working on details to flush out how a program within those guidelines might work.

Sen. Jonathan Dismang, R-Beebe, spoke at the health care rally and told supporters that he didn’t know what the final outcome would be, but that the group should be thankful that lawmakers are engaged in the process and are being diligent in shaping a long-term policy that works for Arkansas.

“The only thing I’m willing to handicap is that we’re going to do our job,” Dismang said at the rally.

Afterward, Dismang sat down with Talk Business Arkansas executive editor Roby Brock for a lengthy interview on the subject.

He said legislators are still waiting on data that will show how certain population groups might financially impact the health care system through the new private option model. Administration officials indicated it would be next week before those projections were finalized. Early reports are that the private option model could cost more than a more straightforward pure Medicaid expansion.

“I think some of the folks at DHS (Department of Human Services) will tell you they’re not certain that it will cost more,” said Dismang.

A key component to possibly making the private option model work is a health insurance exchange that would allow citizens at different income levels and with certain needs to shop for insurance plans. Currently, the state has adopted a state-federal partnership exchange system after Republican legislators successfully blocked a state-specific exchange in the 2011 legislative session.

Dismang said attitudes have shifted among legislators, who are shying away from the state-federal or federal exchange options because of a 3.5% premium tax tied to its administration. He said there is growing support for a non-profit health insurance exchange that would have a quasi-private quality to it, but would allow for legislative oversight.

“In the immediate future, we’ll probably have to move forward with a partnership exchange because of time constraints,” he said. “I think the attractiveness of the non-profit model is that it builds a firewall between the state obligations and that entity. It would be something that would self-sustain based on some of those premium taxes collected and you might even have some additional revenue left over after those premium taxes are collected.”

Dismang also said he expects two bills to be filed this session if legislators continue the progress they’re making. The first bill would be an appropriation bill to allow for the expenditure of the new federal funding.

The second bill would lay out the framework for where and how the legislature would be involved in future decision-making.

“A bill that actually puts in some teeth, making sure that we were involved in the process even after we left the session and also sets some preliminary parameters for the exchange,” he added.

Dismang also touched on the subjects of a Medicaid consultant being hired by the legislature, continued efforts to reform the existing Medicaid system, and whether he’s a “Beebelieber,” a new nickname to describe Gov. Beebe, who happens to be one of Dismang’s constituents.

Link here for a video interview with Sen. Dismang.