Should a lawmaker who has received a lot of needed government assistance vote to extend government assistance to others? That’s a question Rep. Josh Miller, R-Heber Springs, has had to answer recently.

Miller, 32, has been a consistent opponent of the private option, which uses Medicaid dollars to buy private insurance for lower-income Arkansans. It was created mostly by Republicans in the Legislature who were trying to make the best of Obamcare. Other Republicans oppose it, just as they oppose Obamacare itself. It passed in 2013 and then was extended this year after one heck of a debate.

Why is Miller’s vote worth more attention than the 23 other House members who voted against it on the final vote?

A broken neck changed Miller’s life

A decade ago when he was 22, Miller was drinking with a buddy, climbed into his pickup truck and, minutes later, careened off the side of the road and into a ravine. He does not remember who was driving. He remembers his father, Larry, telling him in a hospital weeks after the accident that he had broken his neck but that the Lord had spared his life so far and things would be OK. Larry was a credible source of comfort considering he has been in a wheelchair as a result of a muscular condition all of Miller’s life.

The accident left Miller paralyzed from the neck down, though he has some use of his arms. Because he did not have insurance, Medicaid paid for hundreds of thousands of dollars of his medical care. He and his family also paid a share of the medical bills. Medicaid and Medicare have since paid for other care, including ongoing help from a personal assistant.

Today, Miller is the manager of a family-owned rental property business. He was married in 2010 and elected to the Legislature in 2012. He is a contributing member of society because of his work ethic, his family’s support, and his faith. But the government health care he has received has certainly helped.

He accepts responsibility for his situation and acknowledges that his own choices put him in need of ongoing government assistance. He didn’t buy insurance even though he probably could have afforded it. He drank too much that night. He got in the truck.

That leads to the question, asked by some in the media during the recent private option debate, why he was opposing government assistance for others.

When I asked him the same question, Miller said that traditional Medicaid, which he received and continues to receive, is meant as a safety net for society’s most vulnerable people, and he’s not trying to cut that. The private option, however, is a new government benefit that he doesn’t believe is affordable unless something else is cut or taxes are raised.

“It’s not because I feel like people are undeserving of health care,” he said. “It’s not because I’m trying to take away any health care benefits from someone else potentially who might be in the same situation I was in. If anything, I’m trying to make sure that those stay intact for folks who do have catastrophic incidents.”

Doesn’t feel hypocritical

He never felt like he was being personally hypocritically in his stance, but, like a lot of legislators, he wrestled with his votes on a policy level. The administrator of the Baptist Health Medical Center in Heber Springs, a personal friend, asked him to vote yes. The state’s hospitals, particularly the small, rural ones, say they really need the money the private option provides. Miller just didn’t think the money was there.

“In a perfect world, Josh Miller supports universal health care 110 percent if it’s affordable, and in this case right now, it’s not affordable,” he said.

So should a lawmaker who received a lot of government assistance vote against extending government assistance to others? To Miller, it’s not particularly relevant either way. These days, he said, it would be hard to find any legislator who hasn’t benefitted from a government program.

“I think a legislator’s moral obligation is to make the best decision based on what the facts are, based on what his constituents want to see done,” he said. “I think a legislator has to make the best decision about how the state or the country moves forward regardless of if they have personally benefitted from something in the past or not.”

By Steve Brawner