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Lawmakers consider whether private option, Medicaid waiver conflict


LITTLE ROCK — Arkansas’ so-called private option for expanding health insurance coverage does not conflict with the federal Medicaid waiver that allowed the state to implement the program, state Department of Human Services officials and a legislative researcher said Tuesday.

Representatives of three conservative groups disagreed.

The House and Senate committees on public health, welfare and labor took up the issue less than a week ahead of the start of this year’s fiscal session, during which lawmakers will decide whether to appropriate a second round of federal funding for the private option. The program uses federal Medicaid money to provide private health insurance to low-income Arkansans.

Breck Hopkins, general counsel for DHS, state Medicaid Director Andy Allison and Matthew Miller, a legislative analyst with the state Bureau of Legislative Research, testified that although the waiver contains language requiring a period of several months to amend it, that restriction would not apply if the state were to choose to cancel the program.

Hopkins said the waiver deals with how the state provides coverage, not whether it does. The U.S. Supreme Court has said the federal government cannot force states to expand Medicaid coverage, so the waiver’s restrictions have no affect if Arkansas drops the program, he said.

“If you want out of the private option, you don’t do that by amending the waiver,” Hopkins said.

David Ferguson, Edmund Haislmaier and Jonathan Ingram, representing conservative groups Conduit For Action, The Heritage Foundation and The Foundation for Government Accountability, testified that the program and the waiver do appear to be in conflict.

Ferguson said the state at least should seek guidance from the federal government on the issue.

“We’re sitting here with something that is unclear,” he said.

The witnesses also argued against continuing the private option. Haislmaier said the program, which is open to people earning up to 138 percent of the federal poverty level, will discourage participants from increasing their income level.

“That is a terrible disincentive to upward economic mobility,” he said.

DHS officials have said they do not expect participants in the program to choose to remain in poverty.

Sen. Joyce Elliott, D-Little Rock, complained that she did not know opponents of the private option had been invited to speak at the hearing and said that “it appears stacked.”

Sen. Cecile Bledsoe, R-Rogers, chairman of the Senate public health panel, said the witnesses were added to the agenda on Friday and that if members wanted to invite supporters of the program to testify, they could have done so.

“There is nothing stacked about it,” she said.

The fiscal session begins Monday.