Category Archives: Legislature

Is Asa the private option’s better option?

Elections, Health care, Legislature, Politics, State government

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

Want the private option to go away? Maybe you should root for the candidate for governor who seems most supportive of it. Want it to survive? Maybe you should root for the candidate who seems most on the fence.

Let’s review the backstory before explaining.

The private option came about because of two provisions in the Affordable Care Act, otherwise known as Obamacare. First, it required states to expand their Medicaid rolls to serve more poor people. Second, because it was doing that, it cut government reimbursements to medical providers for giving uncompensated care to people who don’t have insurance and don’t pay. The thinking was there would be less uncompensated care because more people would have Medicaid.

When the Supreme Court ruled Obamacare constitutional, it also said states didn’t have to expand Medicaid, and many Republican-led states did not. Arkansas legislators – Republicans, actually – along with Gov. Mike Beebe’s administration instead created the private option, which serves the same population by using government dollars to buy private insurance instead of enrolling them in Medicaid.

As a result, about 200,000 Arkansans are benefitting – most through the private option, and the rest because they were routed into Medicaid while trying to enroll in the private option. The federal government is paying for almost all of the private option now; the state will begin kicking in a small share in 2017, eventually paying 10 percent under the program’s current terms.

Supporters say it’s is a rational mechanism for funding health care for 200,000 people. We’ll end up paying for health care for them anyway – often in the emergency room if they don’t have insurance. Smaller hospitals have closed in states that turned down the money. The private option’s mechanisms encourage recipients to behave like health care consumers and be more picky and choosy with their decisions, in theory reducing the cost. So far, it seems to be doing much of what it was intended to do.

Opponents say it’s just Obamacare by another name, inevitably resulting in more government and more debt. Doing business with the federal government is a risky deal, they say. That 10 percent will amount to real money, and at this point, we don’t even know how much it will cost.

The funding mechanism must pass the Legislature with a three-fourths majority every year. Democrats are all for it; Republicans, who likely again will have majorities in both the House and the Senate next year, are split between “yeses,” “no’s,” and “heck no’s.” It barely passed earlier this year, and there will be even more legislative opponents after this year’s elections.

Which brings us to this year’s campaign for governor. Democrat Mike Ross is totally for it. Republican Asa Hutchinson, knowing his party is split, has hedged throughout the campaign. In Tuesday’s televised debate, he referred to its successes but says Arkansas must know the costs before deciding whether or how it should continue.

If he’s really against it, he’d say so.

Let’s not ignore the other candidates: Green Party nominee Joshua Drake supports the private option, while Libertarian Frank Gilbert is opposed.

When the Legislature convenes in January, the new governor will have an agenda (along with all 135 legislators), but everything will hinge on the private option. It’s that big and that controversial, and Hutchinson probably gives it a better chance of continuing in some form.

That’s because Hutchinson, the Republican, would have much more pull with the Republican “no’s” than Ross. (No one will flip the “heck no’s.”) Every legislator in Ross’ minority party is already for it. He could use his veto if the Legislature left out the private option, but the Legislature could override that with a simple majority – the same percentage that passed the bill in the first place.

So Ross perhaps would be more eager to fight for the private option, but Hutchinson, the outwardly more reluctant warrior, would have more weapons.

Hutchinson would have his own motivations for saving it. He has plans, including cutting taxes by $100 million during his first year in office – a difficult prospect anyway and an impossible one without the private option’s federal dollars. He does not want to spend his first term reneging on his campaign promise, plugging budget holes, and trying to save endangered hospitals.

The private option may survive, albeit with changes, regardless of who wins. It may die either way. But it probably has a better chance of surviving with help from the candidate for governor who won’t say he supports it.

School elections: big issues, few voters

Education, Elections, Legislature

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

You wouldn’t know it from all the political ads still running, but some of the most important elections in Arkansas this year have already occurred.

Those would be Tuesday’s school elections.

In Jacksonville and north Pulaski County, 95 percent of voters elected to separate from the Pulaski County Special School District, a large doughnut-shaped district that surrounds Little Rock and North Little Rock. Voters wanted more of a say in a district whose administrative offices are on the other side of the county.

That’s a big deal. Ninety-five percent of voters don’t agree on anything unless they live in North Korea. It also represents a temporary break from a historical trend of school consolidation. According to a history written by Kellar Noggle, former executive director of the Arkansas Association of Educational Administrators, Arkansas had 4,734 school districts in 1927. Before Tuesday, that number had shrunk to 238. Unless another consolidates before Jacksonville’s separation is complete, there will be 239.

While the Jacksonville election attracted almost 4,000 voters, turnout elsewhere was low, as always. Two competitive school board races that unseated incumbents in the 25,000-student Little Rock School District attracted a little over 1,300 voters. Before the election, Randy Zook, head of the Arkansas State Chamber of Commerce, asked 400 Rotarians in Little Rock if they knew the date of the upcoming vote. Half a dozen raised their hands.

It’s a problem when a school board election in Little Rock is decided by a vote of 379-221. Those low numbers make it easier to manipulate an election and then manipulate policymaking. A candidate can be elected with the support of a few people with an agenda and then try to implement that agenda once in office.

The rest of this column will cover what, if anything, should be done about this low turnout. I should disclose that I publish a magazine, Report Card, in partnership with the Arkansas School Boards Association (ASBA). It is supported by advertising, and ASBA does not pay me, but I have done other work in which it has. I think I can play this straight.

It’s understandable that school board elections attract little attention. School board offices are unpaid, part-time, and nonpartisan. Most candidates don’t have the funds to advertise and attract voters’ attention – especially in a year like this when the U.S. Senate and governor’s races grab so many headlines.

If the problem is simply a lack of attention, could that be fixed? Last year, the advocacy group Arkansas Learns spent $100,000 on advertisements and automated phone calls encouraging people to vote – not for a particular candidate, just to vote – in various contested races. It made so little difference that it did not repeat the effort this year.

Arkansas Learns’ president and CEO, Gary Newton, instead favors holding school board elections in November with the other races. Doing so would result in more voters expressing their will and would reduce the potential for manipulation that can result from low turnout. The idea has been proposed in previous legislative sessions and been voted down, but it might pass in 2015. Arkansas has moved the date of school elections before. A few decades ago, they were in March.

ASBA is opposed. It says school elections should be a separate vote and that November elections would politicize a traditionally nonpartisan office. Don’t make the local banker and the local farmer running for school board compete for attention with Mark Pryor and Tom Cotton, it says. A lot of voters will just end up guessing.

I come down on ASBA’s side on this. My November ballot is already too crowded with races for U.S. Senate, U.S. Congress, governor, lieutenant governor, attorney general, secretary of state, treasurer, auditor, land commissioner, county judge, sheriff, and who knows what else. I don’t even know who some of these people are or what the offices really do.

On the other hand, I publish a quarterly magazine for school board members, and this election nearly snuck up on me as a journalist. Who thinks about voting in September?

There is one other alternative: Get rid of school boards. However, so much power in education has already moved to the state and federal levels. Unless mayors are put in charge, without school boards, there would be no local control at all.

You might argue it doesn’t really matter where school policy is made. It certainly mattered to the folks in Jacksonville.

The lieutenant governor: Change it, or get rid of it

Legislature, Politics, State government

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

For more than three years from 2003-06, your tax dollars were not spent very efficiently, and I was a beneficiary.

I was the communications director in the lieutenant governor’s office. My boss, Lt. Governor Win Rockefeller, was a very good man, but the lieutenant governorship, at least the way it is designed in Arkansas, is not a useful office.

Nothing occurs there that could not be done somewhere else. Under the Arkansas Constitution, the lieutenant governor presides over the Senate when it is in session (a ceremonial job) and serves as governor when the governor is out of state (an unnecessary responsibility in the 21st century). The other major duty, the one that really matters, is to serve as governor if the governor does not finish his or her term. Two of the past four lieutenant governors have been called upon to do that.

The office, when filled, consumes about $400,000 a year in order to employ state government’s backup quarterback and his or her staff. Currently, no one even occupies the office. With the resignation of former Lt. Governor Mark Darr, the doors have been locked and the lights off for months. As Sen. Keith Ingram, D-West Memphis, explained in an interview, “We’ve got an office that in all intents and purposes doesn’t exist right now, and there’s no clamor about some services that are not being met.”

Ingram and Sen. Jimmy Hickey, R-Texarkana, are proposing abolishing the office and making the attorney general next in line to be governor. This would require a constitutional amendment approved by the voters. Were it to pass, Arkansas would join five other states that don’t have a lieutenant governor.

The proposal has been far from universally embraced. There’s a natural resistance to changing the Constitution, which is a good thing. Plus, some legislators might want to be lieutenant governor someday and are reluctant to vote to get rid of the office. It’s hard to cut the backup quarterback when you hope to be one someday.

There’s some concern about making the attorney general next in line, which no state currently does, because doing so limits that opportunity to lawyers only.

But it not the attorney general, then who? The next highest statewide position after attorney general is the secretary of state, a job that deals primarily with running elections and maintaining the Capitol – not really governor-type duties. Still, that position ascends to governor in three states that have no lieutenant governor – Arizona, Oregon and Wyoming. In New Jersey, the lieutenant governor and the secretary of state are the same officeholder. Legislators deal with many of the same issues as the governor, so the speaker of the House or the Senate president pro tempore would make sense. The objection is that neither are elected by voters statewide, but that hasn’t stopped Maine, New Hampshire, Tennessee and West Virginia from making the leader of the Senate their next in line. In fact, Tennessee and West Virginia give their Senate leaders the title of “lieutenant governor.”

We could just make the lieutenant governor a real job. At one time, Arkansas’ lieutenant governor exercised real power in the Senate by appointing committees and committee chairs. There’s no way legislators are giving up those powers now, but perhaps the lieutenant governor could be made the head of a state agency or a member of some important commissions.

Or, the governor and the lieutenant governor could be yoked together on one ticket, like the president and the vice president are, instead of running separately as occurs now. That way the governor and lieutenant governor could be a team, maybe even share staff. That would be the opposite of what the state had before Darr resigned: a Democratic governor and a Republican lieutenant governor who couldn’t work together and didn’t even like each other.

Changing anything in government is hard, particularly when there’s no deadline forcing it to happen. We don’t have a crisis. We have an office that doesn’t do much when it has an occupant and currently doesn’t even have that. Ideally, Arkansas could either make it useful or just get rid of it.

Or we could just leave things as they are. It’s only $400,000 a year. Of your money.

Here’s a KARK-TV report about this subject.

Private option still splits GOP despite decrease in uninsured

Health care, Legislature

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.