A proposal to limit the time when low-income Arkansas
can sign up for coverage under the state's compromise Medicaid
expansion may be key to breaking a legislative deadlock over the future of the nationally watched program, lawmakers said Thursday.
Some opponents of Arkansas' "private option" are considering backing the program's reauthorization if state officials agree to seek limits on the program's enrollment period. Under the private option, Arkansas is using federal Medicaid funds to purchase private insurance for low-income residents.
Approved as an alternative to expanding Medicaid under the federal health law
, the program is at risk of being abandoned after its funding bill stalled on four separate votes last week before the state House. Adjourning for the weekend, House leaders said they're exploring the limited enrollment idea as a potential compromise.
"I think it's something that's worthy of attention and worthy of discussion," said House Speaker Davy Carter, R-Cabot.
The idea surfaced during private meetings Carter and other private option proponents had with several lawmakers opposed to the program Wednesday and Thursday. Opponents of the program said setting a specific open enrollment period — rather than allowing signups throughout the year — would achieve their goal of slowing down the program's growth.
"I think that is a key piece to me, even beginning to look at the idea of voting for it, because nobody who operates a business and nobody that's fiscally responsible at home or any entity or group believes that you can just leave the checkbook open to write checks all day long," said Rep. Kim Hammer, R-Benton, who has voted against the private option legislation but said he's looking at the compromise proposal.
The proposal would end enrollment in the private option March 31, 2015 and re-open the enrollment period in October of that year. Those who apply for coverage outside of the enrollment period would instead be placed on Medicaid but could switch to the private option later. Nearly 94,000 people are enrolled in the private option.
The plan would not require legislative approval, and would depend on the state receiving approval from the federal government. A spokesman for Gov. Mike Beebe said the governor had not agreed to the compromise, but was open to discussing the idea since it wouldn't require a legislative change and wouldn't prevent anyone from receiving coverage.
"It's something the governor is definitely open to," Beebe spokesman Matt DeCample said.
Supporters of the private option have said they weren't open to any more changes to the funding bill, noting that they already agreed to changes aimed at swaying opponents of the program. Those changes include a prohibition on the state spending any public money to promote the private option.
The top Democrat in the House said that implementing the limited enrollment in 2015 eases concerns he had that the promotion ban would prevent the state from telling potential private option applicants about the new time frame.
"We could have just about every eligible Arkansan already in the program by the end of the year," said House Minority Leader Greg Leding, D-Fayetteville.
Previously, the main alternative floated by opponents of the private option was a plan to halt enrollment in the private option and end the program by March of next year. That idea, however, has been dismissed by supporters of the program as a non-starter since it kills a program they're trying to save.
Rep. Bruce Cozart, who was involved in the talks over the open enrollment compromise, said it's still not enough for him to vote for the private option. But Cozart said he doesn't believe opponents can realistically end the program during this year's session.
"Are we going to make the program go away? I doubt it," said Cozart, R-Hot Springs.