Category Archives: Legislature

Private option still splits GOP despite decrease in uninsured

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

Arkansas got some news last week regarding its uninsured population. Whether you think it was good news or just news depends on what you think about the “private option.”

The Gallup organization released a survey finding that the state led the nation in reducing its uninsured adult population. In 2013, 22.5 percent of the state’s adults were uninsured – the second worst rate after Texas. In 2014, only 12.4 percent were uninsured. Nearly half of all adult Arkansans who didn’t have insurance last year have it this year. Arkansas rose to 22nd, tied with New Hampshire. Texas is still last.

The increase in the number of insured Arkansans can be credited mostly to the private option, which is the state program that uses federal Medicaid dollars through Obamacare to purchase private insurance.

Under Obamacare, those residents were supposed to become Medicaid recipients, but the Supreme Court gave states the option of saying yes or no. Instead, some Arkansas Republican legislators said “yes, but” and fashioned the private option with Gov. Mike Beebe’s administration. The result is that about 200,000 Arkansans now have health insurance. According to Gallup, the top 10 states that showed the most improvement all took the federal money. Texas didn’t, and 24 percent of its residents still don’t have health insurance.

So that’s a slam-dunk case for the private option, right? Not exactly.

The private option barely passed in 2013 and barely survived in 2014. Like other state programs, it requires the support of three-fourths of the Legislature before any money can be spent on it. All the Democrats support it. Republicans are split between three groups – the yeses, the no’s, and the “heck, no’s.” There are enough no’s and heck no’s to kill it. For it to survive, the yeses must pull a few no’s to their side.

How could anyone be against something providing health insurance to 200,000 people? Cost, uncertainty, and concerns about the growth of government. The cost to the federal government is expected to be $1.59 billion in fiscal year 2015 and $2.35 billion in fiscal year 2020. Those may be federal dollars, but they come from actual taxpayers, including Arkansans. While the feds are paying for everything initially, in 2017 Arkansas will be responsible for 5 percent – a number that rises to 10 percent by 2020. Because the federal government is paying for most of it, the state supposedly gains $670 million over a decade. But that’s assuming Uncle Sam holds up his end of the bargain.

The Republican Party divide is illustrated in the state Senate. The soon-to-be top dog, incoming Senate Pro Tempore Jonathan Dismang, R-Searcy, is a private option architect. Last week, Republicans nominated Sen. Jim Hendren, R-Gravette, as their Senate majority leader, their number two. He’s part of the “no caucus.” Their new number three, Sen. Jimmy Hickey, R-Texarkana, the majority whip, is a private option supporter.

Hendren told me that while he’s glad that 200,000 Arkansans now have insurance, he remains opposed. He’s a chemical engineer who deals with numbers, and to him, the numbers just don’t add up. However, he said the facts have changed since he first started voting no in 2013.

“We have this program, and I’m one who believes you’ve got to be fair with people,” he said. “So anything that’s done, we have to take into account the fact that we’ve got a lot of people in Arkansas who are playing by the rules and who are working hard, and to just yank that away from them without any consideration is not something that I think is the right thing to do. So we’re going to have to look at how we can find some middle ground, or find some sort of process that gets us to a program that’s more sustainable.”

The private option debate dominated the 2013 and 2014 sessions, which Hendren doesn’t want to repeat this year. He wants Republicans to fashion a compromise or simply vote on the issue and move on. He said his goal will be to “not let that define us as a caucus.”

He wants there to be one Senate Republican caucus. Currently, on this issue, there are three: the yeses, the no’s, and the heck no’s.

Note: Here’s the Gallup survey.

Credit legislators: They made the hard choices

By Steve Brawner
© 2014 by Steve Brawner Communications

Let’s give credit to Sen. Jim Hendren, Rep. Harold Copenhaver, and other legislators – not because they necessarily made the right decisions, but because they definitely made the tough ones.

Hendren, R-Gravette, and Copenhaver, D-Jonesboro, are leading a task force charged with reforming the school employee health insurance system, which is a mess. Costs are rising so fast that the Legislature twice has had to meet in special session – last year to pour money into the system as a quick fix, this past week to reduce spending. Many school employees have been paying too much for premiums and others not nearly enough. The big fear is that the system will tumble into a death spiral where, as costs rise, more and more young, healthy employees opt out, eventually leaving only older, less healthy employees in the pool. No insurance fund can survive that.

Bills passed by the Legislature this past week, as well as other actions based on recommendations by the task force, are expected to reduce a potential 35 percent premium increase into an average 3 percent increase, assuming the plans don’t change much. Significantly more work remains to stabilize the system long term.

The most noteworthy legislation removed 4,000 part-time school employees from being eligible for school health insurance.

That’s a tough one. As Rep. Sue Scott, R-Rogers, pointed out in a hearing, these employees include bus drivers and cafeteria workers – the people who offer some students their first smile of the day, or who serve an extra helping of lunch to those they know don’t get fed enough at home. Some of these employees work for schools precisely because it offers them the best health insurance they can get.

Hendren and Copenhaver explained their reasoning during the lead-in to the session. Cuts had to be made in order to prevent premium increases for everyone. Part-timers rarely receive health insurance benefits in the private sector, and schools should be no different. Because school districts are saving money on insurance, they will have more flexibility in giving some employees full-time responsibilities, thereby making them eligible. Those who lose their insurance will have other options, including the “private” one passed by the Legislature that uses Medicaid dollars to buy insurance for low-income Arkansans.

Opponents countered that the private option’s future remains in doubt. It passed with zero Senate votes to spare in the fiscal session earlier this year. Two additional opponents of the program have already won Republican Party primaries and are headed to the Senate. Hendren himself has consistently voted against it.

Removing part-time employees from eligibility was not an ideal solution, and there may or may not have been a better way, but at least lawmakers acted, and for that they deserve praise. In crafting this and other parts of the legislation, they made hard choices about how to responsibly allocate finite resources for a critical need, rather than putting off those choices and letting others deal with the consequences. Hendren, a Republican, and Copenhaver, a Democrat, could have played partisan games with the issue. It doesn’t appear that thought ever occurred to them.

Congress, please take note.

Choices are hardest when they involve one of two scenarios. In one, the options are all so wonderful – like a menu in a good Mexican restaurant – that the mind locks up. In the other, the options are all so distasteful that it’s hard picking one over the other.

In politics, it’s usually the latter. Nobody wants to take insurance from part-time school employees, but, given the fact that school starts soon and time was limited for making more foundational changes, legislators decided it was a better bad choice than raising rates for everyone. As Copenhaver told representatives, “Some people say this is a Band-Aid. Well, I say what we did last session is a Band-Aid. We covered it up by providing funding. We have now taken that Band-Aid off, and it is somewhat painful.”

If it was the right decision, it will help stabilize the fund. If it was the wrong one, legislators can reverse course when they meet again in January. But you can’t reverse course when you’re not going anywhere. Again, Congress, please take note.

Don’t write private option’s obituary

By Steve Brawner
© 2014 by Steve Brawner Communications

In 1837, during a debate about a bill regarding paying bounties for wolf scalps, Arkansas Speaker of the House John Wilson left his chair and stabbed to death Rep. Joseph J. Anthony with a bowie knife. He didn’t like something Wilson had said about him.

Please keep that story in mind as Arkansas continues to debate the so-called private option. It will be one of the most contentious debates in memory, but no one will be stabbed on the House floor.

The debate over the private option, however, will dominate next year’s legislative session, just as it’s the most important issue in this year’s campaign.

As you may know, the private option uses Obamacare dollars to purchase insurance for more than 172,000 low-income Arkansans. Many Republican-leaning states have turned down that money, which was intended to enroll people in Medicaid, a government program. In Arkansas, Republican lawmakers and Gov. Mike Beebe’s administration instead worked out a deal where those dollars are used to buy private insurance.

Legislators are divided into three camps. Republican opponents say it’s Obamacare, and that it adds to the national debt, and that soon Arkansas will pay more and more for a program it can’t afford. Sen. Bryan King, R-Berryville, described it in an interview as “running up a credit card.” Republican supporters say it’s making lemonade out of lemons, that Arkansas and its struggling hospitals would be foolish to turn down the money, and that the private option’s reforms are being considered by other states and might make the entire health care system better. Democrats are just glad to get those dollars however they can.

The money must be appropriated by a 75 percent majority of both houses of the Legislature every year. This year, it passed with zero votes to spare in the Senate and one in the House. Two of the yes votes in the Senate have already been replaced by candidates who campaigned saying they would vote no. In one case, the losing candidate was one of the private option’s architects, Rep. John Burris, R-Harrison.

So it’s time to write the private option’s obituary, right? Well, no. Regardless of what happens in the next election, considerably more legislators will be for it than against it. Asked if House Democrats would consider shutting down the entire Medicaid budget rather than let the private option die, Rep. Greg Leding, D-Fayetteville, the minority leader, told me, “I wouldn’t want to commit it to that at this point, but I don’t think anything is off the table, including that.” Among the two major party candidates for governor. Democrat Mike Ross has made it clear he supports it. Republican Asa Hutchinson has not said he’s against it, which means he isn’t.

Even among private option opponents, there are “no” and “heck, no” factions. According to Sen. David Sanders, R-Little Rock, one of the private option’s architects, a number of “no votes” are waiting to have their questions answered, including how many carriers are offering insurance and what the rates are.

Regardless of what they think about the private option in principle, a lot of legislators will have a tough time simply taking insurance away from 172,000 people. King, a consistent opponent, told me that, while he wouldn’t rule it out, “Realistically, I don’t see how a defund, total defund could happen.” Instead of repealing the private option, the Legislature may reform it – maybe significantly. As Sanders described it, “With regard to the policy, we’re not pouring concrete. We’re modeling clay, and we’re shaping the policy as we go.”

So maybe the private option survives close to the way it is, or maybe it’s changed a little, or maybe it’s changed a lot. But simply grabbing a knife and stabbing it to death? That doesn’t happen very often at the Capitol – at least not since 1837.

Arkansas Week, June 6

I appeared on AETN’s “Arkansas Week” Friday with host Steve Barnes, longtime journalist Ernie Dumas, and KUAR’s Ernie Dumas. We discussed the upcoming runoff elections, the Pryor-Cotton Senate race, state revenues and the possible upcoming special session about school employee insurance.

Rise of the whippersnappers

Maybe it’s a coincidence, and perhaps it doesn’t matter, but it’s hard not to notice how many leaders in the Arkansas Legislature are in their 30s.

The House last week elected Rep. Jeremy Gilliam, R-Judsonia, 37, as its presumed incoming speaker. He will replace Rep. Davy Carter, R-Cabot, who is about to turn 39.

On the Senate side, the incoming president pro tem, Sen. Jonathan Dismang, R-Beebe, is 34. He will replace Sen. Michael Lamoureux, R-Russellville, 37.

Dismang rose to prominence as an architect of the Medicaid private option, one of Arkansas’ most significant and controversial pieces of legislation in a long time. Other legislative architects were Sen. David Sanders, R-Little Rock, 37, and Rep. John Burris, R-Harrison, 28. Meanwhile, House Democrats are led by Rep. Greg Leding, D-Fayetteville, who is 35.

Why is this happening? In interviews, Gov. Mike Beebe, first elected to the Legislature at the age of 36, and legislators credited term limits for opening up leadership positions to younger people. In Beebe’s day, the Legislature was controlled by a few old-guard legislators who had been there forever. Younger members had to wait their turn.

Could there be other factors in the rise of these whippersnappers? Maybe 30-somethings can thrive in a job that Leding told me “is absolutely exhausting, physically mentally.” Perhaps a young and idealistic legislator is more likely to create and pass an out-of-the-box idea like the private option, and not be discouraged because things haven’t been done that way before. Maybe young people better understand social media and other aspects of contemporary politics. Maybe these legislators entered office at about the same time and formed alliances with people their own age. Dismang said younger legislators may have an extra motivation to excel. After all, when he’s carrying out his duties, he’s leaving behind his wife and young children. “If I’m going to be in Little Rock working, I’m going to make the most of that,” he said.

All of that would imply this is a trend, but Beebe rejects that. He said the high number of young legislators is an “anomaly,” that there just happens to be many exceptional young legislators at the moment, and term limits have allowed them to shine.

“Whether you’re an older guy or a younger guy, you’re on equal footing, and the talent is going to be what ends up creating the leadership, not the experience, because nobody’s got any experience,” he said.

He believes term limits eventually will lower the number of 30-something legislators because few in that age bracket will want to start political careers that will end so quickly. He thinks it will be more of an activity for retirees.

Lamoureux said that simple geography played a part in his selection as Senate president pro tem. As a resident of Russellville, he can drive back and forth from the Capitol more easily than legislators who might live three hours from Little Rock. He minimized the power of his office, explaining, “They may let us have those positions, but by no stretch of the imagination are we barking out orders.”

Nobody with whom I spoke believes an age of 30-something domination is upon us, nor should it be. A diversity of life experiences is the goal.

“I guess I haven’t thought about it all that much,” Lamoureux said. “I go back to, when we were making decisions, who was in my office? It was really just a wide range of people.”

Maybe so, but they were in his office.