Analysis: Hutchinson walks fine line in addressing future of state's compromise Medicaid plan

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LITTLE ROCK, Arkansas — Goodbye, private option. Hello, AsaCare.

Calling on lawmakers to keep Arkansas' compromise Medicaid expansion alive through 2016 as he eyes a longer term health care plan, Republican Gov. Asa Hutchinson is trying to take ownership of an issue where he's tried to tread carefully over the past two years. It's an approach that sends him straight into the political minefield that he acknowledges has sharply divided his party.

"The phrase 'private option' itself has become politically toxic, so much so that it's almost impossible to have a constructive conversation about health care reform without passions rising and folks taking sides," Hutchinson told a packed auditorium at the University of Arkansas for Medical Sciences last week.

The question Hutchinson now faces is whether he's trying to end the private option, or merely repackage the program.

Crafted as an alternative to expanding Medicaid under the president's health care overhaul, the private option is using federal funds to purchase private insurance for the poor. It's a program that's extending coverage to more than 213,000 people, and credited for savings hospitals millions by cutting down the number of uninsured patients seeking care.

Arkansas was the first state to win approval for such a hybrid approach, and it paved the way for other Republican-leaning states to negotiate similar compromises. But it's also led to protracted fights in the Republican-led Legislature and led to political defeats last year for several key supporters of the program.

Walking through the program's benefits as well as its costs, Hutchinson tried to cast the state as moving away from the type of divisions that have marked the private option debate in the Legislature. Underscoring how much the issue could dominate his governorship, the half-hour speech was three times as long as his inaugural address.

"It is time to close this chapter and start a new one," Hutchinson said. "It is a new day for health care in Arkansas and I pledge to work with you to find the right solution for all of Arkansas. While we're turning the page and beginning a new effort, our innovative efforts in Medicaid reform will continue."

The next chapter, however, could look very familiar when it comes to debate over the private option's future. Reaction to Hutchinson's speech was the equivalent of a Rorschach test that depended on your view of the program. Several anti-private option legislators cast it as the program's demise.

"To me, I'm going to tell you, it ends it," said Rep. Joe Farrer, R-Austin.

Democrats in the Legislature welcomed Hutchinson's remarks and said they don't see the program going away.

"I don't think this is in any way an indication that there is an end to the private option on the horizon," said House Minority Leader Eddie Armstrong, D-North Little Rock.

Hutchinson offered a broad outline of the reforms he wants to see from a task force he's proposing to issue recommendation on health care by the end of this year. He wants to look at reforms that would encourage those receiving coverage to work and to provide incentives for healthy behavior.

"This gives us stability for the present and an opportunity in the future to create new reform that accomplishes the objective of compassion for those currently being served but looking broadly at how we accomplish that in an affordable way," Hutchinson told reporters.

But first Hutchinson has to find the three-fourths support needed to keep the program alive another year, a hurdle the Legislature barely cleared last year. He seemed to acknowledge the uphill fight ahead, as he joked about the lack of "resounding applause" at the end of his health care speech.

"I think that simply means that we recognize how important it is and whatever we do, we're going to get criticized and we're going to get applauded by various sides," he said.


Andrew DeMillo has covered Arkansas government and politics for The Associated Press since 2005. Follow him on Twitter at http://www.twitter.com/ademillo

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