By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.
Arkansas got some news last week regarding its uninsured population. Whether you think it was good news or just news depends on what you think about the “private option.”
The Gallup organization released a survey finding that the state led the nation in reducing its uninsured adult population. In 2013, 22.5 percent of the state’s adults were uninsured – the second worst rate after Texas. In 2014, only 12.4 percent were uninsured. Nearly half of all adult Arkansans who didn’t have insurance last year have it this year. Arkansas rose to 22nd, tied with New Hampshire. Texas is still last.
The increase in the number of insured Arkansans can be credited mostly to the private option, which is the state program that uses federal Medicaid dollars through Obamacare to purchase private insurance.
Under Obamacare, those residents were supposed to become Medicaid recipients, but the Supreme Court gave states the option of saying yes or no. Instead, some Arkansas Republican legislators said “yes, but” and fashioned the private option with Gov. Mike Beebe’s administration. The result is that about 200,000 Arkansans now have health insurance. According to Gallup, the top 10 states that showed the most improvement all took the federal money. Texas didn’t, and 24 percent of its residents still don’t have health insurance.
So that’s a slam-dunk case for the private option, right? Not exactly.
The private option barely passed in 2013 and barely survived in 2014. Like other state programs, it requires the support of three-fourths of the Legislature before any money can be spent on it. All the Democrats support it. Republicans are split between three groups – the yeses, the no’s, and the “heck, no’s.” There are enough no’s and heck no’s to kill it. For it to survive, the yeses must pull a few no’s to their side.
How could anyone be against something providing health insurance to 200,000 people? Cost, uncertainty, and concerns about the growth of government. The cost to the federal government is expected to be $1.59 billion in fiscal year 2015 and $2.35 billion in fiscal year 2020. Those may be federal dollars, but they come from actual taxpayers, including Arkansans. While the feds are paying for everything initially, in 2017 Arkansas will be responsible for 5 percent – a number that rises to 10 percent by 2020. Because the federal government is paying for most of it, the state supposedly gains $670 million over a decade. But that’s assuming Uncle Sam holds up his end of the bargain.
The Republican Party divide is illustrated in the state Senate. The soon-to-be top dog, incoming Senate Pro Tempore Jonathan Dismang, R-Searcy, is a private option architect. Last week, Republicans nominated Sen. Jim Hendren, R-Gravette, as their Senate majority leader, their number two. He’s part of the “no caucus.” Their new number three, Sen. Jimmy Hickey, R-Texarkana, the majority whip, is a private option supporter.
Hendren told me that while he’s glad that 200,000 Arkansans now have insurance, he remains opposed. He’s a chemical engineer who deals with numbers, and to him, the numbers just don’t add up. However, he said the facts have changed since he first started voting no in 2013.
“We have this program, and I’m one who believes you’ve got to be fair with people,” he said. “So anything that’s done, we have to take into account the fact that we’ve got a lot of people in Arkansas who are playing by the rules and who are working hard, and to just yank that away from them without any consideration is not something that I think is the right thing to do. So we’re going to have to look at how we can find some middle ground, or find some sort of process that gets us to a program that’s more sustainable.”
The private option debate dominated the 2013 and 2014 sessions, which Hendren doesn’t want to repeat this year. He wants Republicans to fashion a compromise or simply vote on the issue and move on. He said his goal will be to “not let that define us as a caucus.”
He wants there to be one Senate Republican caucus. Currently, on this issue, there are three: the yeses, the no’s, and the heck no’s.
Note: Here’s the Gallup survey.