Category Archives: Legislature

The debt, the private option, and the painter

CapitolBy Steve Brawner
© 2016 by Steve Brawner Communications, Inc.

If you’re helping a lot of people but contributing a few drops in the bucket to a big problem, should you stop helping those people? That’s one of the issues confronting legislators.

What’s helping people is the private option, which Gov. Asa Hutchinson is trying to rebrand as Arkansas Works.

Created in 2013, the program provides health insurance for Arkansans with incomes up to 138 percent of the federal poverty level, which is $11,880 for a single person. It uses Medicaid dollars – Medicaid being a federal-state program that serves lower-income people – that were made available by the Affordable Care Act (a.k.a. Obamacare). When the U.S. Supreme Court said states could choose whether or not to participate, many Republican states said no. Arkansas instead received federal permission to use the Medicaid money to buy private insurance.

It expires this year. On Thursday, legislators voted to extend it as Arkansas Works. But it lacked the 75 percent margins it will need to be funded in a fiscal session that begins next week. So we’ll see.

As of the end of January, 267,590 Arkansans were eligible. About 40 percent of recipients have no income. The others do, but many can’t get insurance. Speaking to legislators April 6, Hutchinson pointed to a pregnant mother employed at a West Memphis sandwich shop, and a 60-year-old painter and handyman from Jonesboro whose heart condition reduced his income so he couldn’t afford coverage. They’re both on the private option.

However, the program also is a few drops in the bucket of another problem. If it survives, Arkansas Works will bring about $9 billion in federal funds into Arkansas from 2017-21. During that time, the White House Office of Management and Budget projects another $3.766 trillion will be aded to the national debt, which is already more than $19 trillion. The math says Arkansas’ $9 billion would be one quarter of one percent of the new debt being created.

Opponents say Arkansas should do its part and say no to the money. The country already owes $19 trillion because too few will say no.

Sen. Terry Rice, R-Waldon, the lone no vote against Arkansas Works in a committee meeting Wednesday, made that point, saying, “I want to be as helpful to people as I can, but we are enslaving future generations, our children and grandchildren, to debt that we are irresponsibly putting on their credit card.”

But while the Affordable Care Act giveth, it also taketh away. The various taxes and changes to the law will take $5 billion out of Arkansas over that same time period. If Arkansas says no, it loses that money with nothing to offset it. Nineteen Arkansas hospitals are considered financially vulnerable, and without Arkansas Works, some will close. It’s happened in other states that rejected the money.

If Arkansas says no, there’s no guarantee the national debt will be $9 billion smaller. The federal budget is a huge, swirling pot of money. Meanwhile, the majority of other states – including those much richer than Arkansas – are taking the money. Louisiana, which first said no, recently elected a Democratic governor promising to say yes. So Californians and Louisianans will get health coverage, but the West Memphis working mom and the Jonesboro painter probably will lose theirs.

That’s why Rep. Charlie Collins, R-Fayetteville, a sponsor of the Arkansas Works bill, said in committee, with passion and emphasis, that he would support killing the program, but only on one condition: “Not only punishing our people.”

Perhaps the bigger issues are how the private option/Arkansas Works indirectly affects the national debt. You can say it grows government and contributes to a culture of dependency, which adds to the debt.

You also can say it’s a more honest way of paying for health care. The uninsured still seek care, but they wait until they are sicker, and then they can’t afford to pay for it. Then the costs are passed on to taxpayers, current and future, through government reimbursements to hospitals. At the same time, people who have insurance pay higher premiums. Local taxes are raised to save the hospital that’s been giving free care. The system shuffles money around like a streetside shell game scam artist. That process steals money from the future, too. It’s just not as obvious.

Lawmakers will need the wisdom of Solomon on this one. The bucket is filling up, but in this case, the drops are painters and sandwich shop employees.

Related:
Cynicism, watchfulness, the presidential campaign and Arkansas Works.

Arkansas Works and the private option: What’s all the fuss about?

Cynicism, watchfulness, the presidential campaign and Arkansas Works

CapitolBy Steve Brawner
© 2016 by Steve Brawner Communications, Inc.

Watchfulness is a cornerstone of a free society. Cynicism leads to the decay of it. There’s a huge difference between them, but not much distance.

What’s the difference? Watchfulness means being aware that people are sinful and selfish, that we seek our own glory and power and riches, and that we abuse and misuse other people and institutions. But it also takes into account that people make choices, and often the right ones. So it does the hard thing: It gathers facts about each individual situation and then makes a determination of what is happening, knowing that it’s probably neither all bad nor all good.

Cynicism sees bad qualities in others but often doesn’t see it in the mirror. Instead of gathering many facts to form a belief, it takes the lazy shortcut of forcing a few facts into a predetermined belief. It substitutes mockery for joy, and it builds its own worth on the shaky foundation of other people’s flaws.

Cynicism leads to inaction. Because cynicism says that nothing can be fixed, then there’s no reason to try. That’s why everyone who ever did anything great was optimistic about something. Worse, cynicism can lead to scorn, and scorn can lead to blaming, and blaming can lead to dehumanizing, and dehumanizing can lead to a lot of terrible things.

The challenge with watchfulness, on the other hand, is that it requires a delicate and difficult balance. Tip too far in one direction, and it falls into naivete. Tip too far in the other direction, and it leads to cynicism. There’s a huge difference between the two, but not much distance.

So let’s try to look, not on the bright side, but on the true side. It is true that the presidential race includes four candidates who for many people elicit strong negative emotions: Donald Trump, Sen. Ted Cruz, Secretary Hillary Clinton, and Sen. Bernie Sanders. (I wish Gov. John Kasich would elicit some negative emotions, too, but alas.) It would be easy to watch what has happened in this campaign and become cynical. Very easy.

But remember that watchfulness doesn’t take that easy route. It looks at the whole picture. So while it can be dismayed that the system isn’t working as well it should, it doesn’t ignore that the system is working much better than it could. For all the system’s flaws, we can be virtually certain there will be an orderly transfer of power come next January, and that’s a pretty uncommon thing in world history. The next president of the United States, far from seizing power with a sword, is traversing the country begging little ole’ you and me to vote for him or her and, to some degree, listening to our concerns. Yes, the watchful person says, money has far too much influence. On the other hand, Jeb Bush had a lot of it.

Closer to home, legislators during the next month will be engaged in a fierce debate about extending the private option, the program that uses federal dollars through Obamacare to purchase private health insurance for Arkansans with incomes up to 138 percent of the federal poverty line. It serves about a quarter of a million Arkansans. It expires at the end of this year, but Gov. Asa Hutchinson is trying to save it by making some changes and calling it “Arkansas Works.”

It’s a very divisive issue. Democrats unanimously support it; Republicans are split. Cynicism from one direction says it’s all part of a movement to nationalize the health care system. Cynicism from the other direction says some people don’t care enough about the poor or simply oppose whatever President Obama supports. There are elements of truth to all those charges, and they should not be ignored.

But the rest of the truth is that a legitimate debate is occurring about the role of government in imperfectly addressing a problem that can’t be perfectly solved. Health care is hard. It’s a product we naturally think should be cheap and limitless, and that’s just not possible. So we try to find that delicate balance between spending enough and spending too little, and doing it the right way.

Where is that balance? No one knows. But we’ll come a lot closer to finding it by being watchful than we will by being cynical.

Related: What exactly is Arkansas Works?

Hutchinson’s ham and egg election

Gov. Asa Hutchinson

Gov. Asa Hutchinson

By Steve Brawner
© 2016 by Steve Brawner Communications, Inc.

You know that old saying about the difference between ham and eggs? The chicken is involved but the pig is committed. Gov. Asa Hutchinson was both during this year’s primary elections.

With the presidential race, he was merely involved. He endorsed Sen. Marco Rubio for president eight days before the vote. He made a couple of appearances and a TV commercial. Donald Trump won Arkansas. Rubio was third, which he was going to be anyway.

Hutchinson, however, was committed in the state legislative races, where his political action committee, ASA PAC, donated money to eight Republican candidates who had Republican opponents.

This happened because the eight he supported also support, or at least would consider supporting, Hutchinson’s Arkansas Works. That’s the continuation of the private option, the state program that uses federal Medicaid dollars through Obamacare to purchase private insurance for adults with incomes up to 138 percent of the federal poverty level.

Created in 2013 by Republican legislators and Gov. Mike Beebe’s administration, it now covers 200,000 Arkansans. It brings a billion dollars in federal money to the state’s economy annually and has saved hospitals from providing millions of dollars in uncompensated care. But some Republicans are opposed because of its association with Obamacare, because it’s another government entitlement, and because they say neither the state nor the country can afford it.

Because it involves spending money, it requires a three-fourths vote for passage every year, which means nine senators can kill it. It barely reached three-fourths in 2013 and in 2014.

In 2015, Hutchinson persuaded legislators to accept a truce: Fund the private option through 2016, when it would end, and he and a task force would look into creating something else. That alternative is Arkansas Works, which is like the private option except that it requires a bit more personal responsibility on the part of beneficiaries. He says it’s a real change. Opponents say it’s cosmetic.

Hutchinson says Arkansas needs it. His budget depends on it. He doesn’t want to take insurance from 200,000 people. He needs $50 million in extra money for highways so the state will be eligible for $200 million in matching federal dollars. Take away the private option, or Arkansas Works, and that money’s hard to find without a tax increase, which isn’t happening.

On April 6, legislators will meet in special session to vote on Arkansas Works, or something. It can pass with a simple majority, which isn’t that high a bar. Then they’ll meet in the fiscal session, which occurs every even-numbered year, to vote on funding. And because a three-fourths majority will be needed, that session could be a doozy.

Arkansas Works was a central issue in those eight Republican primaries, which left Hutchinson a choice: Do nothing so as not to offend the potential winners; get involved like the chicken; or be committed like the pig. He was committed. He openly supported candidates. He held a press conference defending them. His political action committee gave each of them $5,400.

His job would have become much harder had those candidates lost. While the winning candidates would not take office before the special session, the current legislators would see Arkansas Works as a losing bet. Then Hutchinson next year would be dealing with as many as eight new legislators he’d worked to defeat.

Instead, six of the eight won, including all three in the Senate, where Hutchinson has no votes to spare. On the House side, three of his five candidates won, and one who lost was challenging an incumbent, Rep. Josh Miller, R-Heber Springs. Miller was already in the House, so Hutchinson’s situation didn’t change there.

The next day, Hutchinson addressed the Political Animals Club at the Governor’s Mansion. His mood was not quite jubilant, but it was definitely somewhat north of relieved.

“I think everybody in this room knows that if those three state senators had lost their race, it would not be a pleasant day for me in this room,” he said. “I would have to be explaining. It would have been considered a referendum on me and my leadership.”

Yes, it would have been, in a way that the presidential race was not. He was merely involved with Rubio for eight days, but he’s staking a big chunk of his first term as governor on Arkansas Works. That’s commitment.

Related: Coming health care debate a “cage fight,” says leading legislator.

Presidential and private option politics

Hand with ballot and boxBy Steve Brawner
© 2016 by Steve Brawner Communications, Inc.

Primary elections were moved this year from May to March 1 to give Arkansans a voice in the presidential election and to help former Gov. Mike Huckabee win an early state. The more important result will be that state lawmakers will make a lot of decisions about Arkansas’ future with an election in their rearview mirrors instead of in their windshields.

Legislators wanted Arkansas’ primary to occur earlier in the election calendar, on the same day as votes in other states in the South, to create an “SEC primary.” With contests in 11 states across the country, Republicans will award 595 delegates – a fourth of the total. The big prize is Texas, with 155 delegates, while Arkansas will award 40. Democrats will award 957 delegates – again, Texas leads with 252 votes, while Arkansas has one of the smallest totals with 37.

The move appears to have achieved its goals. Arkansas is relevant, or is at least among a relevant group of states, so it’s warranted a few visits from candidates, if that means anything. It won’t help Huckabee, who has suspended his campaign, but, among the Democrats, it does help the state’s former first lady, Hillary Clinton. At least Arkansas is in the game, though mostly watching from the bench.

More important is what’s happening in state politics. During even-numbered election years, the Arkansas Legislature typically holds a fiscal session early in the year to vote on budget-related issues. Because of the early primary, that session was moved to April, after the primary. Meanwhile, Gov. Asa Hutchinson has announced plans to call two special sessions, one to vote on health care reform that will occur shortly before the fiscal session, and one to vote on his highway funding proposals.

The highway session will be big but not huge. Hutchinson has proposed a plan to increase highway money using a variety of means, including shifting some dollars from the state’s general revenue budget, but without raising taxes. There will be shouts of anguish from those who might be affected, but the average Republican primary voter won’t be mad.

The health care special session, however, will be a doozy. Legislators will vote on a package that will include Arkansas Works, which is Hutchinson’s version of the private option with important but not earth-shattering changes.

The program, whatever it’s called, uses federal dollars to purchase private health insurance for Arkansans with incomes up to 138 percent of the poverty level. It’s been hugely controversial since it was created in 2013 because it’s an extension of Obamacare passed by legislators who decided Arkansas might as well get its share. Unlike some states that turned down the money, Arkansas’ uninsured adult population has been more than cut in half, 200,000 people have health insurance, and its hospitals are providing a lot less unpaid care.

Republicans either don’t like it or, often, don’t like saying they’re for it. Its roots are in Obamacare, which is enough for many voters to oppose it. Opponents say it’s unsustainable. Sometimes, candidates sincerely oppose it on the campaign trail, but then they come to the Capitol and, seeing the numbers, decide they have to support at least something.

The health care special session is occurring in early April-ish because of the federal government’s timelines. Then we’ll have the fiscal session starting April 13, where legislators will vote to spend the money. Had the primaries not been moved, candidates would have had to vote for the private option in the special session, and then fund it in the fiscal session, and then campaign in a Republican primary. Naturally, their opponents would have accused them of selling out to President Obama.

Now, they can finesse the issue on the campaign trail and then come to Little Rock to vote on Arkansas Works – either as newly re-elected incumbents or as defeated lame ducks with nine months left to serve and nothing left to lose.

Presidential politics is what drove this decision to move the primaries, but at least some legislators were also thinking about private option politics.

Of course, if several legislators who support Arkansas Works lose March 1 to private option opponents, it will affect others currently on the fence. They won’t want to be losers next time.

So politics would have been involved no matter when the primary would have occurred. Oh, well. It’s a democracy, after all.

Steve Brawner is an independent journalist in Arkansas. Email him at brawnersteve@mac.com. Follow him on Twitter at @stevebrawner.

It’s the social issues, stupid

A pro-life supporter expresses his opinion at the Capitol in Little Rock during the March for Life January 17.

A pro-life supporter expresses his opinion about Planned Parenthood at the Capitol in Little Rock during the March for Life January 17.

By Steve Brawner
© 2016 by Steve Brawner Communications, Inc.

Current events are demonstrating that what moves political elites and what moves normal people often are two different things.

The big debate among the political elites is over the size and role of government, particularly regarding the economy. That’s why they donate hundreds of millions of dollars to an establishment candidate like Gov. Jeb Bush who promises to cut spending and taxes, and why they assume, like I did, that Donald Trump would eventually go away. As President Clinton’s 1992 campaign said, “It’s the economy, stupid,” right?

Well, not always. What really moves people often are social and cultural issues: guns, gay rights, abortion, etc. Economic issues are mostly about what people do. Social issues are about who they are.

The prevailing national example of this reality is this year’s presidential race, where Trump is driving conservative elites crazy because he’s never been one of them. He has a history of supporting liberal and moderate political positions and has given money to many Democrats, including the Clintons. During this campaign, he’s not really talking that much about cutting government, the Republican elites’ favorite topic.

But he’s established a connection with many voters talking about illegal immigration, which for elites is merely an economic issue but to average people is also a social and cultural one. He’s going to build a wall and make Mexico pay for it. That’s not an economic policy. And he’s made political correctness, which is definitely a social issue, part of his campaign by pushing the envelope with his words time and again and never apologizing for it.

Closer to home, on Sunday, thousands of Arkansans opposed to abortion participated in the annual March for Life at the Capitol. They carried handmade signs. They prayed. They donated money to Arkansas Right to Life, which has won a lot of victories in recent years and will push this next legislative session for a ban on dismemberment abortions, where the fetus is torn apart and then extracted from the womb.

Thousands of conservative Arkansans do not march on the Capitol to cut the capital gains tax.

This upcoming Saturday, the Arkansas Coalition for Reproductive Justice will respond with a pro-choice rally. Because this is Arkansas, and because abortion is already legal, there won’t be thousands of participants. But, weather permitting, there will be hundreds.

During the 2015 legislative session, the most far-reaching public policy debate was over Arkansas extending the private option, the program that uses federal dollars to purchase health insurance for 200,000 lower-income individuals.

But what really grabbed everyone’s attention was the Religious Freedom Restoration Act, which some saw as an effort to protect religious belief while others saw it as a tool for discrimination against gays. Activists chanted “Shame on you!” at legislators and then lined the steps inside the Capitol. Corporate interests like Wal-Mart also were opposed. Gov. Asa Hutchinson, who initially supported it, sent it back to the Legislature when it reached his desk, and a milder version mirroring federal law was passed.

With economic issues, a lot of people care a little. With social issues, a few people care a lot. In politics, the second is often more powerful than the first. In an October CBS News/New York Times poll, 92 percent said they support background checks for all gun buyers, but Republican candidates know the other 8 percent will base their votes on that issue alone. So no background checks for all gun buyers.

While compromise is doable when it comes to economic issues, it’s very difficult with social ones. If one side says a tax should be 10 percent and the other 14 percent, the two can meet in the middle. With social issues, where the debate is over absolute right and wrong, finding the gray middle ground is harder. Then those deep-seated social divisions bleed into other areas. Elected officials can’t make the difficult compromises needed to balance the budget, for example, after the trenches have been dug over gay rights and guns.

I guess it doesn’t matter that much. Few candidates are seriously talking about balancing the budget, anyway. Maybe they would, if someone could figure out how to turn it into a social issue.