The Improbable Path to Success HB1219 | SB1020 Ray Hanley AFMC | 2013 The Arkansas Health Care...
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The Improbable Path to Success HB1219 | SB1020 Ray Hanley AFMC | 2013 The Arkansas Health Care Independence Act of 2013
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Transcript of The Improbable Path to Success HB1219 | SB1020 Ray Hanley AFMC | 2013 The Arkansas Health Care...
The Improbable Path to SuccessHB1219 | SB1020
Ray HanleyAFMC | 2013
The Arkansas Health Care
Independence Act of 2013
1874ARKANSAS • Democrats could not vote until citizenship
was restored• Republicans control legislature
November 2012• GOP takes control of Arkansas Legislature for
the first time since 1870’s
• DC Style gridlock forecast
Was there any hope to pass health care expansion for the 250,000 hard working
Arkansans below 138% of poverty??
The Arkansas Times tracked chances of passing the expansion…
“I put it this year’s session at 5%” Max Brantley, February 8, 2013
• At least 150,000 adults below poverty would have no coverage option
• Arkansas hospitals would continue to suffer from uncompensated care while taking deep Medicare cuts, regardless
• Employers would be at risk for an estimated $35M in penalties
Consequences of Failure (do nothing) were enormous
The ObstaclesMajority vote for the enabling legislation
BUT…We had to have a “super majority” vote for the necessary appropriation 75 of 100 votes in the House 27 of 35 votes in the Senate
How did Arkansas succeed where so many other states
have failed?
A Governor with a lifetime of political skill who could both work with the other Party’s ideas but who also could sell the Democratic HHS Secretary on the innovative private option plan no state has done before
On getting a “super majority” of 75 votes in House and 27 in Senate:
“It is almost impossible to get a 3/4 vote for motherhood and apple
pie… to do so is the equivalent of scaling Mt. Everest.”
Governor Mike Beebe
A talented, articulate, GOP Legislative leadership team who could have easily said
“NO, it’s still ObamaCare,” F BUT instead they said “we have a better idea.”
Sen. Jonathan DismangRep. John Burris Sen. David Sanders
Senate and House Leaders who understood all that was at stake and who delivered the
votes at crunch time
Rep. Davy CarterSpeaker of the House
Sen. Michael LamoureuxPresident Pro Tempore
A dedicated, stalwart Democrat legislative team who reached across the aisle in the best
interests of the people of our State
Rep. Darrin Williams Sen. Larry TeagueSen. Paul BookoutRep. Reginald Murdock
An HHS Secretary willing to work with Arkansas on a never-before-seen, innovative approach to further expand access to health insurance coverage through the Arkansas health insurance exchange.
Secretary Kathleen SebeliusUS Department of Health and Human Services
“Recognizing the decisions facing your General Assembly and the impact on your health insurance marketplace, let me assure you that we will work with you on this innovative approach for Arkansas.”
A DHS Democratic Administration, leadership team who won the respect of GOP Legislators and who had the ability to put the complex, never done before “Private Option” into language that should win Federal approval
John Selig Andy Allison
A Surgeon General willing to go anywhere to speak to any group on the merits of the Private Option
Dr. Joe Thompson
A legion of grassroots organizations who came together to form the
“AR Health, AR Jobs” Coalition
A dedicated group of public policy relations folks to help guide our public outreach…
Clint ReedChase Dugger
Richard Bearden
A drafted AR Health, AR Jobs Coalition Leader
We worked the phone, email, text… ran TV and radio spots, organized tele-town halls, lined the hallways and even the marble steps…
The Votes at Crunch Time…
Senate 28 (we needed 27)
House 77 (we needed 75)
What the Private Option would do…
Allow DHS to purchase a private “silver” insurance plan within the State’s Health
Insurance Exchange for any uninsured adult below 138%* of the poverty level
*(approximately $15,000 for one; $32,000 for a family of four)
This accomplishes several things a regular Medicaid expansion
could not…
• Avoids “churn” – flipping on and off Medicaid as income goes over and under 138% of poverty
• Allows Exchange Commercial Plans to pay higher provider rates needed to assure access to care
• Protects businesses from penalties where the newly covered may work
• Stabilizes the State’s health care system for ending most uncompensated care
Other states openly discussing following Arkansas’ lead on the
Private Option
OklahomaFloridaOhioIdaho
PennsylvaniaLouisianaIowaTexas
What’s next• DHS will write and submit to
CMS for approval the necessary 1115 “Research & Demonstration” Waiver
• AID will be accepting proposals from private insurance plans to serve the expanded population within the exchange
AR Insurance ExchangeHow much competition???
• Arkansas Blue Cross Blue Shield of Little Rock
• National Blue Cross Blue Shield Multi-state Plan
• QCA Health Plan of Little Rock (dba QualChoice of Arkansas Inc.)
• Celtic Insurance Co. of Chicago, through its subsidiary NovaSys… parent is Centene, a Medicaid managed care firm HQ in St. Louis
The REAL Winners…• 250,000 low income, hard-working Arkansans• The State of Arkansas who showed the
nation how leaders come together to solve the most complex issues
