Jason Rapert threatens to withhold his vote on Medicaid expansion over morning after pill | Arkansas Blog

Jason Rapert threatens to withhold his vote on Medicaid expansion over morning after pill

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RAPERT: Contraceptive pill is "the killing of a little baby." - BRIAN CHILSON
  • Brian Chilson
  • RAPERT: Contraceptive pill is "the killing of a little baby."
Sen. Jason Rapert, who has been a stalwart backer of "Arkansas Works," the governor's plan to continue the Medicaid expansion private option, today raised concerns about beneficiaries having access to the Plan B morning after pill. Rapert said that he considers this form of contraception to be equivalent to abortion. 

"I have been standing strongly in favor of Arkansas Works," Rapert said during the Joint Budget Committee meeting. But after finding out that the morning after pill was covered by private option plans, he said that "it's going to be really hard for me to move forward." Rapert said that the morning after pill "is not contraception, it's the killing of a little baby." 

Part of Rapert's anger seemed to be based on his assertion that he had only learned about this today — but that's puzzling. The private option has always covered Plan B, a matter which caused some minor controversy in 2014.

On his Facebook page, Rapert stated his belief that "the Morning After Pill was NOT covered when the Private Option was originally passed in Arkansas ... subsequently, the Obama administration has mandated the Morning After Pill to be covered." That's not quite right. The private option has covered Plan B from the beginning, just as every private health insurance plan in the country has been mandated to cover emergency contraception since the passage of the Affordable Care Act (there are some very limited exceptions to that requirement, such as for religious institutions). The Obama administration issued a rule last year making it crystal clear that Plan B had to be covered (though typically only with a prescription; an over-the-counter purchase would not be covered). It is a requirement under federal law. Presumably, Rapert's own health insurance plan covers Plan B. 

Both the federal Hyde amendment and state law prevent the private option plans from offering elective abortions — with exceptions for rape, incest, and preventing the death of the mother. But the plans do cover emergency contraception (again, they're required to by federal law). For what it's worth, Arkansas Right to Life does not take a position on contraceptive methods like Plan B and does not consider that to be abortion (Rapert acknowledges this in his Facebook post). 

Rapert expressed interest in the state's Department of Human Services making a choice not to cover Plan B, but there's simply not a mechanism to do that under federal law. 

States do have some flexibility under Medicaid: while family planning services is a required benefit, states have some discretion over which services are covered and not all states cover Plan B under Medicaid (Arkansas has covered Plan B under Medicaid since well before the private option).

But the private option uses Medicaid funds to purchase private health insurance plans on the exchange. And those plans must cover emergency contraception (again, the coverage mandate is only with a prescription).

DHS spokesperson Amy Webb said in a statement: 

Arkansas Works purchases private insurance plans that are required under the Affordable Care Act to include certain essential health benefits, including access to contraceptives like Plan B. The U.S. Supreme Court has provided some limited exceptions to that requirement, such as for religious institutions, but those exceptions do not provide the state any flexibility on this issue. These are the same rules that govern businesses or anyone else buying non-grandfathered individual or group insurance plans.
In his Facebook note, Rapert seemed to suggest that he would only withhold his vote on "Arkansas Works" if there was actually a way to stop the morning pill from being covered by private option plans. Since that's impossible, perhaps he'll vote for Arkansas Works after all. Here's Rapert: 

I will not support any program that supports abortion related services, and this pledge prevents me from supporting Arkansas Works if coverage of the Morning After Pill is an option we can actually opt out of. If we have the ability to stop this on the state level, I intend to see that we do. I hope that we are successful. If we cannot, this proves my point again that states must band together and use Article V of the U.S. Constitution to reassert our fundamental rights under the Tenth Amendment which has been shredded.
For all the grandstanding, it sounds like Rapert will complain about Obama rather than shut down the Medicaid budget. 

The part that is strange is Rapert's repeated assertions that he was "shocked," and his expectation that his colleagues would be shocked too. There was a very public fight about this two years ago. 


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