House Vote On ‘Private Option’: 69 Votes For, 28 Against

HB 1219, the appropriation bill for the “private option” enabling legislation, failed its first test 69-28 with one abstention. The bill needed 75 votes for passage.

House Speaker Davy Carter (R-Cabot) had delayed a vote on the funding measure Friday to allow House members to travel home to meet with constituents to discuss the controversial bill.

In today’s action, Carter convened the House and only allowed a vote on the one bill, HB 1219.  There was no debate from members.

Lawmakers and Gov. Mike Beebe (D) have obtained permission from federal officials to use Medicaid expansion money promised in the federal health care law to subsidize insurance for low-income Arkansas workers. The money would help currently uninsured citizens who earn up to 138% of the federal poverty level to obtain insurance. By some state estimates, that universe could include as many as 250,000 Arkansans.

The “private option” enabling proposal charges the Department of Human Services to:

• Maximize available service options
• Promote accountability, personal responsibility, and transparency;
• Encourage and reward healthy outcomes and responsible choices; and
• Promote efficiencies that will deliver value to taxpayers.

A provision of the bill requires DHS to promote insurance coverage in the exchange for children and parents currently utilizing the ARKids First program. Populations from 0% to 17% of the federal poverty level would be included. The program would also allow for cost-sharing in certain situations.

HB 1219 is the appropriation bill for the Arkansas Department of Human Services Division of Medical Services, where Medicaid is housed and administered.

It creates a Health Care Independence Program Trust Fund that will accrue money sent from the U.S. Department of Health and Human Services to the state for the purposes of Medicaid expansion.

Along with the agreement between the state and feds on the flexible use of the Medicaid money, the trust fund will also collect:

• Increases in premium taxes
• Reductions in uncompensated care
• Other spending reductions resulting from the “private option” plan

“The fund may be used by the Department of Human Services to pay for future obligations under the Health Care Independence Program created by the Health Care Independence act of 2013,” the amendment reads.

No line-item dollar figure is expressed in the amendment regarding the federal money.

The DHS Division of Medical Services appropriation bill also includes funding for all salaries in the Medicaid division as well as billions of dollars in funding for nursing homes, prescription drugs, hospitals, infant care and ArKids First.

By folding the health insurance expansion spending permission into the DHS budget bill, a vote against the “private option” has set up lawmakers to have on their record a vote against those other constituencies.

The House is scheduled to meet again at 9 am on Tuesday morning.