Gov. Hutchinson opens health care special session

Gov. Asa Hutchinson opened a legislative special session on health care Wednesday by quoting the biblical book of Isaiah: “Come now, and let us reason together.”

The special session will give legislators a chance to vote on a government program where the state uses federal dollars to purchase private health insurance for about 250,000 people with incomes up to 138% of the federal poverty level. The poverty level is $11,880 in a household size of one. Known as the “private option” since it was created in 2013, it expires at the end of this year.

Hutchinson told of two Arkansans who benefit from the program: a pregnant woman in West Memphis who works at a sandwich shop and has a four-year-old daughter; and a 60-year-old painter and handyman from Jonesboro who suffered heart problems that reduced his income and left him unable to afford health insurance on his own. He said the painter did not want to accept the benefit but would have died without the coverage.

Hutchinson wants to extend the private option under a new name, Arkansas Works, and with four changes that he described in his address to legislators:

– Enhancing work and work training referrals for people who benefit from the program
– Requiring those beneficiaries whose incomes are between 100-138% of the federal poverty level to pay up to 2% of their income in insurance premiums;
– Requiring individuals who can get health insurance through their employers to do so rather than rely on the government program
– Measures that reduce costs and make the program more responsible with taxpayer dollars

Afterwards, the bill was sent to the House Insurance and Commerce Committee, which is chaired by Rep. Charlie Collins, R-Fayetteville. That committee was to meet at 3:30 p.m. Meanwhile, in the Senate, the bill was sent to the Senate Insurance and Commerce Committee, chaired by Sen. Jason Rapert, R-Conway. It was meeting at 1:15 p.m.

The private option/Arkansas Works is made possible by the Affordable Care Act, which created Obamacare. Hutchinson told legislators he would not have designed that system, but he must work with what he inherited.

Under the Affordable Care Act, states were expected to expand their populations served by Medicaid, which serves lower income people, to residents making up to 138% of the federal poverty level. The private option instead uses that Medicaid money to buy private insurance. It does so through a waiver from the federal Department of Health and Human Services that changes the rules in Arkansas’ case.

Hutchinson has been meeting about the waiver with HHS Secretary Sylvia Burwell, whom he called “my favorite pen pal.” He read a letter dated April 5 from Burwell in which she reiterated that some of his past requests would not be allowed, such as an asset test for new recipients, or a requirement that recipients work.

As for Hutchinson’s four major reforms, she wrote, “In each of these areas, I look forward to continuing our discussions to find acceptable approaches that maintain coverage and access for Medicaid beneficiaries and are consistent with federal law.”

As of the end of January, 267,590 Arkansans had been approved for benefits, but the private option has been controversial since it was created in 2013. Opponents say Arkansas will not be able to afford its share of the cost once it starts paying 5% in 2017, a number that increases to 10% by 2020. They also say it is an expansion of a government entitlement under Obamacare that will add to the national debt.

During the special session, Arkansas Works needs a simple majority to pass. Hutchinson expressed confidence during a news conference Tuesday that it has that much support. However, to be funded, it must achieve three-fourths support during a fiscal session that starts April 13 – a much higher bar. Fiscal sessions occur every even-numbered year.

Hutchinson began his address by describing Arkansas’ current economic situation: 38,000 more Arkansans employed; the lowest unemployment rate in decades; a private sector growing faster than the government sector, and a budget surplus.

“Yes, the state of the state of Arkansas is strong,” he said to applause.