A day of back-and-forth at the state legislature led to a late afternoon attempt to compromise on the “private option” enabling and funding legislation.
After a delay on a planned morning vote to send HB 1219, the appropriation bill to authorize spending for the “private option” plan, Senators set an afternoon Public Health committee meeting to add an amendment on SB 1020, which outlines the framework for the GOP-crafted plan.
The amendment was not to be presented until 4 p.m.
Talk Business Arkansas sources confirm that wrangling is underway in order to secure the necessary 27 votes needed in the State Senate for passage of the appropriation measure.
The amending language to the enabling bill, which was already awaiting the Governor’s signature, was expected to “add teeth to the state’s flexibility in multiple ways,” according to one source. Another source described the change as “material” to the original enabling bill already passed by both chambers.
A third source said the effect of the amendment is to allow for a “global waiver for the state’s Medicaid program.”
Opposition groups were hoping that the amendment might be viewed unfavorably by the feds and, in effect, be a poison pill to the bill.
The appropriation bill needed a supermajority of votes in the Senate – 27 votes – but presumably does not have to be voted on again in the House. Lawmakers were attempting to address that concern as it was at the center of parliamentary debate. On Tuesday, the House of Representatives approved the funding bill for the “private option” on a 77-23 vote.
Senators eventually made changes to the enabling legislation, SB 1020 and HB 1143, that included clarification of existing principles in the measure. In short, they put in ALL CAPS the fine print they’ve been discussing for weeks.
The amendment clarifies:
• A request for a 1115 waiver – a research and demonstration provision in the Medicaid program that allows states to ask for test or pilot programs;
• That if any of the state plan changes the deal is off;
• That applicable employer penalties in the Affordable Health Care Act are revoked by the Arkansas plan; and,
• More specifically details a preferred Health Savings Account pilot program that lawmakers want to test.
The funding bill for the “private option,” HB 1219, was not amended; however, the changes to the enabling legislation mollified undecided Senators and secured enough votes for a supermajority passage.
The bill received 28 votes in favor and 7 against. It only needed 27 votes to clear the high hurdle.
Gov. Mike Beebe told reporters after the vote that the next step, after signing the bills, will be to forward them to federal Medicaid officials for approval of the conditions sought to depart from traditional Medicaid expansion.