Arkansas Surgeon General: 1332 Waiver Important To Task Force Work

Arkansas’ new Surgeon General, Dr. Greg Bledsoe, says the legislative health care task force that begins its work in earnest this next week will be looking at a much wider swath of reform than just the private option.

Appearing on this week’s edition of Talk Business & Politics, Bledsoe said Gov. Asa Hutchinson’s efforts and the legislation he got passed in this recent session will be all-encompassing.

“The private option is a good first step,” he said. “More importantly, we want to move it further from what we have right now.. . These last few years we’ve been talking solely about the private option. What the task force is looking at is all of health care reform.”

Gov. Hutchinson pushed state lawmakers to fund the private option through the end of 2016. The innovative and controversial program has led 230,000 enrollees into health insurance coverage, according to the latest statistics.

Hutchinson also convinced legislators to form a task force to recommend changes by the end of this year for ending the private option program by next year and to design a new marketplace for health care and insurance by the start of 2017.

Bledsoe sits on the 16-member legislative task force that meets Monday to begin that challenge. As a non-voting member, he’ll still be representing the Governor’s interests to the panel.

“I think this is a once in a generational opportunity to do this,” said Bledsoe, who added that a potential special session is “on the table” to ultimately address the task force’s recommendations.

A key reform driver that will quickly come up in discussion for the task force involves a federal waiver known as a 1332 waiver. It allows great flexibility within the Affordable Care Act, also known as Obamacare. In short, 1332 waivers allow states to:

• Modify or eliminate the Individual Mandate component of the ACA
• Modify or eliminate the Employer Mandate component of the ACA
• Modify Benefits or Subsidies
• Modify or eliminate Marketplaces and Health Plans

“When you look at the opportunity to truly remake Medicaid and remake health care in the state through these 1332 waivers, we’ve got an incredible opportunity. There’s a lot of flexibility built into the Affordable Care Act through the 1332 waivers,” Bledsoe said.

When asked how eliminating individual or employer mandates could impact health insurance participation, Bledsoe said he did not have a crystal ball on if the task force would keep those mandates in a state plan or create different incentives for participation.

He said one of his first meetings as state Surgeon General involved a face-to-face with Sylvia Burwell, Secretary of the U.S. Department of Health and Human Services. Bledsoe said he felt the feds would bend greatly in Arkansas’ efforts to reshape health care.

According to Bledsoe, Burwell said if the White House says no or the federal law forbids it, there is little she can do. “‘But everything else is on the table for discussion,'” Bledsoe says he was told. “I think the federal government is in a position where they’re willing to negotiate.”

Also, a U.S Supreme Court ruling, King vs. Burwell, could come down this summer. The challenge to the federal health care law is based on the constitutionality of exchange insurance subsidies created by the Affordable Care Act. A ruling against the subsidies could lead to the act’s demise. If upheld, it’s business as usual.

Bledsoe confesses that a ruling against the exchange insurance subsidies “could change the dynamic.”

“The governor and I and the rest of the staff have been looking at how we would respond in case they ruled against the government, against Burwell, and we have a plan in place to deal with that. But we’re not going to get out ahead of that and speculate until the Supreme Court actually makes its ruling,” he said, declining to offer more details when asked.

Watch his full video interview below.