Health Care Task Force Divided, But Seeking Common Ground

The 16-member Arkansas Health Care Reform Legislative Task Force, charged with recommending changes to the private option and traditional Medicaid, is split nearly evenly between legislators who voted for and against the Medicaid private option. Two of the task force’s members voted against creating the panel itself.

But the sponsor of the legislation, Senate Majority Leader Jim Hendren, R-Sulphur Springs, said the task force’s members will work together to find common ground “because we’re going to act like grown-ups.”

The task force, which will elect a chairman at its first meeting Tuesday, was created this year by Act 46, the Arkansas Health Care Reform Act. Gov. Asa Hutchinson initiated the task force to resolve the impasse over the private option.

Under the act, the private option ends at the end of 2016 unless the Legislature votes to extend it. The task force must make its first report by the end of this year. Complicating its efforts is the fact that the U.S. Supreme Court is considering a case, King v. Burwell, regarding the constitutionality of the exchange insurance subsidies created by the Affordable Care Act. A ruling against the subsidies could lead to the act’s demise.

Prior to this year, there have been four votes on the private option: Acts 1497 and 1498 of 2013, which created the private option through companion bills both known as the Health Care Independence Act; Act 1496 of 2013, which funded the Department of Human Services Division of Medical Services that year; and Act 257 of 2014, which funded DMS that year.

The panel consists of four senators who could be considered private option opponents based on their voting records: Sens. Terry Rice, R-Waldron; John Cooper, R-Jonesboro; Cecile Bledsoe, R-Rogers; and Hendren. Four senators could be considered supporters: Sens. David Sanders, R-Little Rock; Jason Rapert, R-Conway; Linda Chesterfield, D-Little Rock; and Keith Ingram, D-West Memphis.

The panel consists of four three representatives who have consistently voted against the private option: Reps. David Meeks, R-Conway; Joe Farrer, R-Austin; and Michelle Gray, R-Melbourne. Three representatives consistently have voted for it: Reps. Charlie Collins, R-Fayetteville; David Murdock, D-Marianna; and Deborah Ferguson, D-West Memphis.

Justin Boyd, R-Fort Smith, is a first-term legislator who voted for the creation of the Health Care Reform Legislative Task Force and voted for funding the Division of Medical Services.

(Editor’s note: An earlier version of this story incorrectly listed Rep. Boyd’s votes)

If there’s a swing vote on the panel, it could be Rep. Kim Hammer, R-Benton. He voted no all three times in 2013, but voted yes to funding the Division of Medical Services in 2014.

The senators were appointed or designated by Sen. Jonathan Dismang, the Senate president pro tempore, except for Hendren, who is serving as majority leader. The representatives were appointed or designated by Speaker Jeremy Gillam, R-Judsonia, except for Gray, who is a designee of House Majority Leader Ken Bragg, R-Sheridan.

Hendren said the approximately 50-50 split was by design in order to pass the act. He said he asked Dismang and Gillam to appoint legislators inclined to solve problems. The task force’s proposals likely will require the support of 75% of the Legislature, the percentage required to pass appropriations.

“I think both sides are going to have to realize that if their only acceptable solution is something they agree with a hundred percent, we’ll get nowhere,” he said.

The Arkansas Health Care Reform Act passed the House, 80-16 on Feb. 5, and the Senate, 26-5, on Feb. 9. Everyone serving on the task force, including the private option opponents, voted for its creation except for Rice and Gray. Act 41, which funded the Department of Human Services Division of Medical Services, passed the Senate, 29-2, on Jan. 29, and the House, 82-16, on Feb. 5. Everyone on the panel voted to fund the Division of Medical Services except Gray, who voted against it, and Rice, who did not vote.

As a state representative, Rice voted against Act 1496 of 2013, the Division of Medical Services appropriation that funded the private option. He did not record a vote for the final House and Senate bills on the Health Care Independence Act of 2013, which created the private option, though he had voted against earlier versions. He voted against the appropriation funding the Division of Medical Services in 2014.

Rice said his opposition to the private option has been based on his belief that it’s unsustainable and that it will contribute to the national debt. He said his non-votes occurred because he had made his statement against the private option and did not want to overtly oppose the new governor or his fellow legislators.

“You can poke people in the eye, and you’re not any better off,” he said.

Gray, a freshman, voted against both the creation of the task force and this year’s appropriation.

Hendren said the disparate group potentially could create a solution better than the private option or the reality that existed beforehand, where a greater number of uninsured Arkansans received uncompensated care in hospitals and emergency rooms. Ideally, he said, the task force’s proposals will “meet the needs of those people that need it and encourage them to improve their station in life, and we also do it in a financially sustainable way, and I think everyone would define that as something better than either extreme.”

He said it’s unlikely the group will simply disband the private option at the end of 2016 with nothing in its place. “Obviously we’re not going to have a society in Arkansas where people can’t get health care at all. It’s just a question of how we deliver that in an affordable way,” he said.

Hendren said while the task force is composed of members who have consistently voted for or against the private option, the lines separating the two are not clear.

“I think that many people who supported the private option are very concerned about the fiscal impact on down the road, and many of us who opposed it are equally concerned that we treat people responsibly and fairly about what we do now that we’re into this program,” he said. “So I think those lines are not as sharp as people would like to make them. I think there’s more of a philosophical difference. I don’t see us voting things eight to eight based on how we voted on the private option on recommendations. There’s more common ground than you would tend to think on that.”

Rice agreed that the group can find common ground.

“Everybody’s wanting to do the right thing,” he said. “We’ve got different opinions on how to do it and what we can do, and that’s what the task force is for.”