There are developments regarding the state’s innovative Medicaid private option — developments beyond the potentially tragic political signals sent by the Jonesboro area in the special election Tuesday.
First: The state has compiled the demographics on the tens of thousands of persons below 138 percent of poverty who have been enrolled so far, and they show most of them are younger.
That is the full opposite of the state and nationwide experience in the non-Medicaid health care exchange — where few young people have enrolled so far, but plenty of folks my age have, leading to concerns about “adverse selection” and “death spirals” by which Obamacare rates might be expected to explode to unaffordable levels, causing the entire reform to collapse under its own weight.
The remarkable thing in Arkansas, then, is that we are using our federal Medicaid expansion money to deliver poor folks to private insurance and produce a more actuarial credible risk pool for Blue Cross and Qual Choice. Our rates conceivably — conceivably — could remain at or near current levels in the second year if not beyond.
That is to say — just to put it in clear individual terms — that my own Obamacare options to be unveiled in October might remain relatively reasonable thanks totally to our state’s private option.
Furthermore, the preponderance of younger folks in this PO pool means they’ll pay relatively lower premiums — to the extent, it seems, that we are going to tap less federal money than previously estimated.
All of that is to say our private option is unfolding as a smashing success just in time for know-nothings to kill it in the budget session beginning Feb. 10.
Second: The Joint Public Health Committee will meet at 3 p.m. today to hear the state’s star consultant, former Utah Gov. Michael Leavitt, a Republican, testify about the personal health saving account component of the private option on which Sen. Missy Irvin of Mountain View insisted on the next-to-last day of the session before casting her vote.
I am advised to expect a bold proposal. It will require getting the federal government to approve an amendment to the waiver by which we’ve done the private option. It ought to be enough to hold Irvin’s vote.
Senate President Pro Tem Michael Lamoureux is quoted today as worrying about several more senators than Irvin.
One Republican legislator favoring the private option told me the only way it survives in February is if something really conservative is put into it.