If the Arkansas General Assembly was a Star Wars movie, Senate Bill 828 would be the Death Star of bureaucratic takeover.
SB828 gives three state entities and one non-profit organization the absolute authority to obtain federal waivers to change state policy concerning health care and insurance, without the need of future state legislation. SB828 sets the stage for continuation of Arkansas’ Obamacare programs without the issue having to comeback for new law by the legislature. What could these four groups do without the Legislature? Anything our crazy federal government would allow.
Broad power is given to the following:
- The Insurance Commissioner
- The Department of Finance and Administration
- The Department of Human Services.
- The Arkansas Health Insurance Marketplace (non-profit organization established under Act 1500 of 2013)
Amazingly, this big government plan is coming from a Republican – Senator David Sanders (newly appointed member under the Task Force of SB96.)
SB828 makes bills by Senator Jim Hendren (SB96 and SB343) appear like mere distractions to divide Obamacare opponents while the Death Star bill was being prepared.
HOW SB828 FITS WITH SB96 CONCERNING MEDICAID EXPANSION
SB96 (Act 46) divided opponents of Obamacare Medicaid Expansion by promising to end the Private Option at the end of 2016 and establish a task force which would make recommendations on how to move forward. Opponents of SB96 pointed out that:
- The bill protected Medicaid Expansion, instead of ending it, because the Private Option was already scheduled to end at the end of 2016.
- The task force’s first duty is to find a way to continue health care coverage of the Private Option Medicaid Expansion population.
Senator Hendren’s SB96 as filed gave total control to DHS, but as opposition grew to this plan he added language to require the issue of Medicaid Expansion after 2016 to be determined by “express legislative approval through a proper enactment of law by the General Assembly”, with this language Obamacare opponents were assured that the issue of Obamacare Medicaid Expansion (Private Option) still would have to come back to the legislature before Medicaid Expansion could extend beyond 2016. Not so under SB828 which will supersede the promise in SB96. Like Hendren’s first draft of SB96, Sanders’ SB828 gives bureaucrats the authority to continue Obamacare Medicaid Expansion in whatever form it wishes, without going back to the legislature. SB828 says:
(c) The Department of Human Services may promulgate rules to implement this subchapter and any federal waivers sought in furtherance of this subchapter, including without limitation any required state plan amendments to the Medicaid program, any waivers or other approvals required from the Centers for Medicare and Medicaid Services, and any other rules pertaining to the Medicaid program.
When it says “any federal waivers sought in furtherance of this subchapter”, how broad is that? It is an extremely broad grant of power:
The purpose of this subchapter is to explore, develop, and facilitate innovative approaches to improving access to, affordability, and quality of comprehensive health insurance coverage and health care, including without limitation waiver opportunities under federal law.
HOW SB828 FITS WITH SB343 CONCERNING ARKANSAS’ OBAMACARE EXCHANGE
SB343 (likewise sponsored by Senator Jim Hendren) also divides opponents of Obamacare by promising to put on “hold” Arkansas’ state-based Obamacare Exchange if the U.S. Supreme Court says that federal exchanges can’t offer tax subsidies like state-based exchanges. This small concession appears to have derailed efforts to repeal the Arkansas’ state-based Obamacare Exchange (HB1492 having been referred to Committee upon passage of SB343 by the Senate last week.)
Under SB343, the Arkansas’ Obamacare Exchange would be put on hold awaiting a “future act of the General Assembly” if the U.S. Supreme Court determines that tax subsidies can only be given by state exchanges not a federal exchange. Passing SB828 (likely after SB343) will replace any needed “future act of the General Assembly” and give the Arkansas Health Insurance Marketplace, a non-government entity, cart blanch authority to obtain any waiver it wishes. SB828 says:
(d)(1) The Arkansas Health Insurance Marketplace may promulgate rules to implement this subchapter and any federal waivers sought in furtherance of this subchapter, including without limitation rules pertaining to the Arkansas Health Insurance Marketplace.
To compound the problem, and as mentioned above, the Arkansas Health Insurance Marketplace is not even a state agency. Here is what A.C.A. 23-61-803 says about the entity. It is a “nonprofit legal entity” run by a Board. It is a “political subdivision, instrumentality, and body politic of the State of Arkansas and, as such, is not a state agency.” It is specifically exempt from a list of state laws (including those related to accountability) while also given the power to impose any “Rules” immediately and without due process on our population should its Board (in its sole discretion) determine the need is an emergency.
GROWING THE POWER OF GOVERNMENT
Obamacare supporters in the Arkansas legislature don’t want to be held accountable for promoting Obamacare. SB828 will let them say: “We didn’t do it. It was the mean ole state agencies.” But in shirking their legislative responsibility, they are subjecting Arkansans to a more powerful and difficult to control bureaucracy.
So what are the prospects for passage of SB828? It is sponsored by one of the three architects of the Private Option and a member of the newly appointed Task Force under SB96. Unfortunately, its path has been made easier by going through the Insurance and Commerce committees where Obamacare supporters hold the overwhelming majority. The first stop is the Senate Insurance and Commerce Committee.
Here is a link to SB828 and its latest status: [SB828]