SB96: Does it support or oppose Obamacare Medicaid Expansion

SB96 rockerThursday, SB96 passed the Arkansas Senate by a vote of 27 to 7. It now goes to the House of Representatives. [HERE IS THE SENATE ROLL CALL]

There are two drastically different views of SB96. It is supported by the Governor and many Republican and Democrat legislators, yet some conservatives oppose the bill as being pro Obamacare.

If SB96 ends the Private Option (Obamacare Medicaid Expansion), why are some conservatives so against it? The flip side of the question is: If Democrats were for the Private Option in 2013 and 2014, why are they supporting SB96?

Those against SB96 will tell you, “When it comes to Obamacare Medicaid Expansion in Arkansas, SB96 is like a rocking chair – keeps you busy but gets you nowhere.”

Does SB96 end the Private Option (Obamacare Medicaid Expansion)? Technically, yes.  So, why are some conservatives so strongly opposed to SB96?  SB96 keeps the status quo while setting up a task force to focus on how to keep Obamacare Medicaid Expansion.

  1. Even without SB96, the current authorization for the Obamacare Medicaid Expansion program ends at exactly the same time, December 31, 2016. With or without SB96 a new law is necessary to keep Medicaid Expansion going after December 31, 2016. So why bother having SB96?
  2. SB96 sets up a task force with the goal of keeping Obamacare Medicaid Expansion coverage going after 2016. The task force is even appointed by legislators who voted for the Private Option in 2013 and 2014. Taxpayers get to fund a task force to keep Arkansas as an Obamacare Medicaid Expansion State.

What about the Repeal?
SB96 ends the Private Option (Obamacare Medicaid Expansion) on December 31, 2016.  That is when it would end anyway without new legislation!  SB96 even acknowledges that the Private Option would end at the same time.

WHEREAS, the Arkansas Health Care Independence Program and the federal waiver under which the state operates the Arkansas Health Care Independence Program will terminate on December 31, 2016, which will have the effect of ending eligibility for Medicaid expansion populations in the absence of legislative action by the General Assembly;

Is the task force neutral or is it designed to keep Arkansas paying for the Obamacare Medicaid Expansion?
The duties show the task force will work on continuing expansion coverage under a new structure. This view is reinforced by who appoints the task force.

Appointments:  The appointing authorities are: President Pro Tempore of the Senate, Speaker of the House, and the majority and minority party chairs and whips.  Prior to this legislation, every one of these people (with the exception of the Majority Leader of the Senate) voted for the Private Option in 2013 and 2014.

Duties:  The primary duty of the task force is to find a way to keep covering the Obamacare Medicaid Expansion.  Here are some of the duties.  When you read the words “Arkansas Health Independence Act” below, that is the enabling legislation for the Private Option.

(d)(1)(A)  Recommend an alternative healthcare coverage model and legislative framework to ensure the continued availability of healthcare services for vulnerable populations covered by the Health Care Independence Program established by the Health Care Independence Act of 2013, §§ 20-77-2401 et seq., upon program termination;

 (d)(2) (B)  Identify the populations eligible for and participating in the Health Care Independence Program, including both: (i)  Individuals newly eligible for health coverage under the program; and (ii)  Individuals previously eligible for Medicaid before the effective date of the program, whether under a Medicaid waiver or some other eligibility criteria;

 (d)(2)(C)  Study the healthcare needs and other relevant characteristics of those populations served by the Health Care Independence Program;

 (d)(2)(D)  Recommend measures and options to preserve access to quality health care for those populations served by the Health Care Independence Program;

After reading that the “repeal” doesn’t change what would have taken place anyway and after reading the duties of the task force and after reading how the appointments are made, do you think SB96 is pro or anti Obamacare Medicaid Expansion?

Why is SB96 politically attractive?

  • Although the repeal in SB96 doesn’t change what would happen anyway, supporters of Obamacare Medicaid Expansion can go into the 2016 elections and tell conservatives “I voted to repeal Obamacare Medicaid Expansion.
  • If there is too much public opposition, the Task Force can delay its final report until after the 2016 elections. The final report can be filed as late as December 30, 2016.
  • Since the Private Option doesn’t end until December 31, 2016, it is possible to wait to hold a special session on continuing Obamacare Medicaid Expansion until after the 2016 election.
  • Voting for SB96 is what the Governor and legislative leadership wants.

Bottom line
Are you for expanding government or for limiting government? An unequivocal repeal would have sent a strong statement limiting government.

In 2012 the Department of Human Services warned Medicaid was teetering and could face a $400 million shortfall.  Arkansas is always concerned about drastic shortfalls from potential federal changes. Since then, however, Arkansas continued the path of growing its Medicaid Program with the addition of Obamacare Medicaid Expansion.  No lesson learned.