The state House speaker-designate said Friday he is optimistic that renewing funding for the so-called private option will be less difficult next year than it was this year.
"If it’s working, and if the membership is all in agreement that it is working, hopefully they’re going to get their questions answered, be able to have their input as we go into it, and we won’t see as much drama as we may have in the past," Rep. Jeremy Gillam, R-Judsonia, said during a panel discussion on the private option at the Governor’s Mansion.
The Political Animals club sponsored the program two days after the Legislature officially ended the fiscal session and after House members elected Gillam speaker-elect. Also participating were House Minority Leader Greg Leding, D-Fayetteville, and Sens. Linda Chesterfield, D-Little Rock, and David Sanders, R-Little Rock, all supporters of the program that uses federal Medicaid money to subsidize private health insurance for low-income Arkansans.
A second round of federal funding for the private option received legislative approval during the fiscal session after much debate, particularly in the House, where it failed four times before passing on the fifth vote.
Reporters asked Gillam on Friday how he would measure whether the program is working.
"The enrollment number is going to be significant, but I think the overall goal of this was to create a path in which we saw costs controlled, also the number of folks that were involved in the traditional Medicaid program, those rolls declining and shifting over," he said. "I think there’s multiple components to it, but I think those will be some that I think the membership will be looking at."
At this point "I think all the evidence is showing that it’s progressing according to plan," he said.
By mid-March, 221,309 Arkansans had applied for the private option and 144,358 had been found eligible, according to the state Department of Human Services. Among those found eligible, 104,649 had completed the process of enrolling in private plans and another 14,338 had been determined to be better served in traditional Medicaid.
During Friday’s panel discussion, the speakers talked about the origin of the program, which was conceived as an alternative to the federal Affordable Care Act’s proposal that states expand their Medicaid rolls, and the impact it has had on the nation.
Sanders noted that Iowa has modeled its approach on Arkansas’, the governor of Pennsylvania is pursuing a similar plan and the governor of Utah has proposed following Arkansas’ lead.
"Even if we were to walk away from it, the innovation has been embraced," he said.
The federal government will pay the full cost of the program for the first three years, after which the state’s share of the cost will increase gradually to 10 percent. Opponents have expressed concerns about the program’s impact on the national debt and the state’s ability to pay its eventual 10 percent share of the cost.
During a question-and-answer period Friday, an audience member said she was disappointed that the Legislature obtained a waiver allowing it not to provide non-emergency medical transportation to participants in the private option.
Sanders said the Legislature last year obtained a one-year waiver on transportation, but instead of seeking to renew the waiver this year, the Legislature chose to seek a waiver allowing the state to develop its own transportation plan.
"This population really doesn’t need it," he said. "These are folks who are working poor. Many or most of them have access to transportation."
Chesterfield said she was "extremely disappointed" when the Legislature opted out of providing non-emergency transportation. She said low-income families often have a single car shared between two or more people, so obtaining transportation for a doctor’s visit can be a problem.
"The question became: Do you throw out the baby with the bathwater?" she said.