Category Archives: Politics

Governor, enjoy this while it lasts

Asa for web

By Steve Brawner
© 2015 by Steve Brawner Communications, Inc.

We are witnessing the smoothest legislative session in recent memory, thanks to its placement on history’s timeline and the political skills of the state’s leadership, particularly Gov. Asa Hutchinson. He should enjoy this while it lasts.

I say it’s the smoothest because of what it could have been. Going into the session, the debate over the private option threatened to dominate the session. The program, which uses federal Medicaid dollars to purchase private insurance for 200,000 lower-income Arkansans, barely passed in 2013 and barely was reauthorized in 2014. A number of freshman legislators had campaigned promising to end it, but supporters weren’t about to let it die, either. In presenting to the House one of the bills that will keep it afloat for two years, Rep. Kelley Linck, R-Flippin, said it has been perhaps the state’s most debated issue since secession. That was laying it on a little thick, but not that much.

Two things happened, the most important being that for the first time since shortly after the Civil War, Republicans control the Legislature and the governor’s office, and they do not want to give their party’s leader a hard time. One of the private option’s most influential opponents, Senate Majority Leader Jim Hendren, R-Sulphur Springs, is Hutchinson’s nephew and wanted to find a way forward. It’s not Mike Ross’ fault, but if a Democratic governor had been elected with a Republican Legislature, the debate over the private option would be deadlocked at this point.

The other thing that happened was that Hutchinson smartly took the issue off the table by proposing to fund it for two years while a task force studies overall health care reform, including changing the private option into something else. The proposal, sponsored by Hendren, gave opponents a reason to vote yes in hopes of ending the program at the end of 2016. Legislative Democrats knew there is a time to fight and a time to make peace, and this was not the time to fight. It not only passed, but it passed easily.

The rest of Hutchinson’s agenda is sailing through the Legislature. He’s already signed into law the middle class tax cut that was the centerpiece of his campaign. His budget has been meeting little resistance. His bill to require all high schools to offer computer science will have no problem passing.

He should not get used to this. Some of the legislators who campaigned against the private option but then voted for Hutchinson’s proposal could face primary opponents in the next election because they didn’t vote “no” enough. The task force will recommend significant changes and will no doubt want to change the private option’s name, but it won’t simply recommend ending it. That means the debate we’ve had the past three sessions will resurface in 2017, if it doesn’t do so earlier. The 2017 legislative session will not be the first in 150 years that Republicans control both the Legislature and the governor’s office. By then, it will be the norm. Factions will develop, and dissidents will be emboldened.

In other words, Republicans soon will start looking a lot like Democrats always looked when they were the undisputed majority party.

Earlier in his career, Hutchinson was a Republican candidate when being a Republican candidate wasn’t cool. Now, he’s a Republican governor when being a Republican governor may not again be this easy.

That’s not to discredit his accomplishments, because he ran a great campaign, transitioned well, and has performed effectively during his first month in office. His leadership has been thoughtful, measured and fair. A lesser governor with fewer political skills would not be this successful, regardless of what historical winds were at his or her back.

He’ll need those skills in the future when those winds start to swirl. They always do.

Voters should select, not elect, judges

By Steve Brawner
© 2015 by Steve Brawner Communications, Inc.

The recent admission of bribery by former circuit judge Michael Maggio is an example of why Arkansas should consider changing the way it fills judicial offices – still relying on average citizens, but not by using elections.

Maggio pleaded guilty Jan. 9 to a felony bribery charge and now probably is on his way to prison. He had reduced a jury verdict against a nursing home operator from $5.2 million to $1 million two days after receiving large campaign donations from the operator.

Clear-cut justice-for-sale cases like this are relatively rare, so let’s not overreact. The corrupt official was caught, so you might say the system worked.

The problem, however, isn’t so much the obvious cases of bribery that can be prosecuted. The problem is when judges are merely influenced. Who donates to judicial campaigns? Often, those who have an interest in the outcomes of judicial decisions in general, such as attorneys and nursing home operators.

Elections of judges and justices has always been the least democratic of all ballot races. Candidates aren’t supposed to discuss how they would rule on specific cases because a judge should remain impartial until hearing the evidence. Meanwhile, they aren’t allowed to run under party labels, which at least would give voters a sense of where they stand. Many voters are just guessing.

In the future, the problem may go from voters having no information to them having a lot of bad information. More and more, the waves of campaign dollars swamping the executive and legislative branches is engulfing judicial races. In some other states, ads by outside groups in judicial races are as nasty as the ads for other offices. It hasn’t really come to Arkansas yet, but when it does, it will change not only judicial campaigns but also the administration of justice.

Solutions? One would be for the governor to appoint justices and judges the way the president does at the federal level, subject to legislative confirmation. That kind of power bestowed on the governor might make some people uncomfortable, but remember that he or she would be held accountable by the voters. A personal example: In 2000, enthusiastic about no candidate, I decided while driving to the polls to vote for soon-to-be President Bush solely because I preferred the justices he would appoint over Vice President Gore’s likely selections.

There is another model. In American democracy, where do registered voters best collect adequate information in a deliberative fashion before making an important decision? Juries.

So let’s have “voter duty” where 100 (or some other number of) Arkansas voters are randomly selected, summoned to a location, and given two days to interview judicial candidates and study their records. The names of the voters would be withheld so the candidates couldn’t influence them beforehand. At the end of two days, the voters would select the officeholders and go home.

We trust jury members to make life-or-death decisions in capital murder cases. Why not trust registered voters to appoint judges, which they do now anyway through the ballot box? Wouldn’t 100 informed and focused average Arkansans do a better job than 1 million scrolling through a list of names on the ballot that they recognize only through campaign attack ads? Best of all, judicial candidates could avoid having to raise money from shady donors who want something in return.

So let’s have a selection process instead of an election process for judicial offices. Elections are a means to an end, not the end itself. The ultimate goal is a just, democratic society ruled by the people. To keep justice from being for sale, 100 people might accomplish that goal better than 1 million of them.

Here’s some hopeful news on the national debt

By Steve Brawner
© 2015 by Steve Brawner Communications, Inc.

If you’re a person who reads this newspaper section or clicks on this column online, you’re probably aware of the national debt and maybe a little concerned, but you’re not crazy about reading 700 words about it.

I get it. The numbers are mind-boggling and the terms confusing. Could there be any more boring words than “federal budget” and “fiscal responsibility”? We’ve been hearing about this bear in the woods for decades, but he never seems to attack.

But a couple of important things happened this past week – one hopeful, one less so – that are worth noting, so let’s cover them. Bear with me. We’re already at 110 words.

Let’s start with the less hopeful news. The Congressional Budget Office (CBO) released its 10-year projections Monday, which told us what we already knew, which is that the debt is growing unsustainably. Already $18 trillion ($57,000 for every American), the debt is expected to grow to $27.3 trillion by 2025.

Each year, the government runs a deficit that adds more to the debt –about $1 trillion every year during the recession, less so in recent years. In 2014, the government added “only” $483 billon to the debt, and the next three years will be about the same. But then the deficit starts rising. By 2025, the government again will spend more than $1 trillion over what it collects that year.

The CBO reports are typically a good information source, but they are based on some rosy scenarios – for example, that Congress won’t extend tax loopholes that it always extends. Forecasters assume there won’t be a terrorist attack, a natural disaster, or a significant economic downturn between now and 2025. On the other hand, unexpected good things can happen as well, such as the United States’ increasing energy independence.

The CBO projections stop at 2025. The picture does not improve moving forward as the baby boomers age and as spending increases for Social Security and Medicare.

And Medicare is where we get to the hopeful news. The federal Department of Health and Human Services announced this week that it will rely less on the “fee for service” model that has helped create runaway health care costs. Under that model, doctors and hospitals are paid for whatever services they render. They bill, and taxpayers pay, few questions asked, creating an incentive for unnecessary tests and procedures.

In the future, alternative models more often will pay medical providers based on quality of care. This is very hard to do, but it has been tested. Little Rock’s CHI-St. Vincent has been involved in a Medicare pilot program where the hospital and doctors were paid a set amount for joint replacement procedures, and it was up to them to control costs to make a profit. I know we don’t like to think of health care in terms of profits, but the alternative is a government bureaucracy. The result of the pilot program was that patient hospital readmissions after those procedures were reduced by two-thirds. When I asked the hospital’s reform-minded CEO, Peter Banko, why the changes had not been made earlier, he said, honestly defining the problem, “There was no financial incentive to.”

“Until you change how we’re being paid, you’re not going to see changes in the system,” he also said.

At the state level, Arkansas has been involved in a similar effort, the Arkansas Health Care Payment Improvement Initiative, which involves Medicaid, insurance companies and others. As part of the initiative, medical providers have financial incentives to keep costs at certain levels for particular “episodes of care.” One result, according to the Arkansas Center for Health Improvement, is that unnecessary antibiotic prescriptions for certain respiratory infections have decreased 17 percent. Doctors now have a financial incentive not to prescribe medicines that serve no purpose other than making patients feel like something is being done.

These are not perfect solutions. They’re very top-down in a health system that has been becoming increasingly top-down for decades.

But they are hopeful. It is impossible to balance the budget without controlling health care costs. If that could happen, it would be one of those unexpected good things that might mess up CBO’s numbers, in a good way.

Asa’s state of the private option address

By Steve Brawner
© 2015 by Steve Brawner Communications, Inc.

Gov. Asa Hutchinson’s health care reform speech last Thursday was what the State of the Union address ought to be but rarely is – an accurate definition of a problem respecting both sides, followed by a solution that actually has a chance of being enacted.

Hutchinson spoke last week at UAMS before an auditorium full of legislators, health care policymakers, and other interested listeners. The atmosphere was serious and expectant.

Hutchinson started his speech with a history lesson. One of the provisions of the Affordable Care Act (Obamacare) expanded Medicaid in the states, but the Supreme Court had made that provision optional. Arkansas had created what Hutchinson called an “innovative” approach: using federal dollars to buy private health insurance instead of just pouring more money into Medicaid.

Hutchinson then accurately defined the two opposing viewpoints on the issue. Because of the private option, 200,000 Arkansans have health insurance, and hospitals are providing far less uncompensated care. However, the state will soon be responsible for up to 10 percent of the costs, which could equal $200 million by 2021. Opponents, he said, are “wise” to be concerned about this.

As he pointed out, the private option has paralyzed Arkansas politics. The votes in the two previous legislative sessions have been close enough that health care providers can’t completely rely on it. So many legislators campaigned this past election on ending the private option that its future is very much in doubt, but what about the 200,000 people?

Now for the solution. Hutchinson asked legislators to broaden the debate. Pointing to a single chart beside him, he said most Medicaid spending has nothing to do with the private option, so why argue over one slice of the pie? He asked legislators to approve the private option for two years, and to create a task force that will study health care reform in general for one year. The task force will produce recommendations based on principles such as minimizing the need for more revenues and increasing recipients’ accountability and work requirements.

It will be interesting where this goes. Arkansas is already involved in a promising health care reform process, the Arkansas Health Care Payment Improvement Initiative. Will the task force build on that, produce a different idea, or just tie a pretty ribbon on the private option and rename it so certain legislators can vote yes? We’ll know in a year, assuming the Legislature passes the bill that would create it.

At the end of the speech, Hutchinson remarked good-naturedly that he had not been interrupted by applause, so the audience clapped. The reason that had been the case was that audience members were listening intently – in order to learn important information, not for cues that would tell them to stand or sit in order to make a political point.

Contrast that with the State of the Union address, delivered two days earlier. President Obama’s speech had some good points in that it had a clear theme (middle-class economics) and a call for civil debate. But as is usually the case, it was marked by a list of proposals that had little chance of being enacted. Members of Congress played their expected parts. It was theater, not policymaking. Much of it will be ignored.

Not that there wasn’t some theater in the UAMS auditorium. Part of what Hutchinson was doing was buying time. He’s willing to change the private option, even significantly. But he wants neither to take health insurance from 200,000 people, nor to turn away the $1.3 billion in federal funds the private option will provide the state this fiscal year. After the speech, some legislators opposed to the private option expressed at least mild support because they said Hutchinson’s plan would end the private option in two years. That was not what he said.

But all that’s to be expected. This is politics. Hutchinson’s address changed the tone of the debate and offered a way forward. The legislation to create the task force has been filed, and there are good reasons for it to pass: Supporters don’t want the private option to fail, and Republicans opposed to the private option want their party’s governor to succeed.

Some still will oppose the plan, but what Hutchinson said won’t be ignored. Good speech.

Can states fix what Congress messed up?

By Steve Brawner
© 2015 by Steve Brawner Communications, Inc.

Can the usual processes that created the $18 trillion national debt – now more than $57,000 for every American man, woman and child – also be used to pay it down?

If your answer is yes, then I encourage you to check the history books. Almost ever year since the nation was founded, the federal government has added to the national debt, and under current projections, the debt will grow bigger each year, year after year, as far as the eye can see.

It should be clear by now that our nation’s capital will not suddenly see the light of fiscal responsibility, so can anything be done to reverse the slide? Apparently not by Congress, so two separate national movements are attempting to amend the Constitution by employing a never-before-used process led by the states. Under Article 5 of the Constitution, 34 states can call a convention, which would then propose amendments that must be ratified by 38 of them.

One of those efforts, the Convention of the States, proposes an open-ended convention tasked with limiting the powers of the federal government, with suggested amendments that would require a balanced budget, enact term limits, redefine the Constitution’s Commerce Clause, etc. In Arkansas, supporters are considering two versions, according to one of its supporters, Rep. Bob Ballinger, R-Hindsville. He believes at least one will pass.

Nationwide, the effort faces a much steeper climb. The Convention of the States’ goals and its rhetoric are so conservative that it will have a tough time reaching 34 states, let alone 38. Also, the delegates would be free to propose whatever amendments they want, leading to fears of a “runaway convention.” Those fears are unfounded, because any proposed amendments still would require approval by 38 states. But the fear that something crazy might happen has cost the movement some allies.

The other effort, the Compact for a Balanced Budget, also is a long shot but would seem to have a better chance. Unlike the Convention of the States, the Compact proposes a single amendment. The amendment states that the government cannot spend more than it collects unless it borrows under a debt limit that can be increased only with approval by a majority of state legislatures. Also, all future tax increases would have to be passed by a two-thirds vote of Congress, though a majority vote could close loopholes or replace the income tax with a national sales tax.

With the Compact for a Balanced Budget, we know what we’re getting. The states that sign up agree to the wording upfront. The delegates would assemble, vote yes and go home.

Alaska and Georgia have already signed on as members of the Compact. Organizers see Arkansas as one of 30 other states they must have. Then they would have to sway six other states where passage would be harder.

In Arkansas, Rep. Nate Bell, R-Mena, pre-filed a Compact for a Balanced Budget bill before the legislative session began. He was one of the early supporters of the Convention of the States, and although he still favors it, he thinks this is a better way.

I like it, too, and not just because it has a better chance of passing. It creates a mechanism that helps Congress be more fiscally responsible. It gives states the ability to rein in Washington. It makes it hard for Congress to raise taxes, but not impossible, particularly not by closing some of the loopholes that riddle the tax code.

Bell, who is on the Compact for a Balanced Budget’s national board, plans to push his bill, HB1006, later in the session. Will it pass? It depends on a lot of factors. Legislators, including Bell and Ballinger, have a lot on their plates as they consider thousands of bills in three months’ time.

One of those is the Revenue Stabilization Act, passed each session since 1945. Because of that act, Arkansas has a mechanism in place to produce a balanced budget – which is one of the main reasons the state, unlike the federal government, always has one.