by Max Brantley
Sen. Michael Lamoureux, who'll lead the Senate under a GOP majority, gives every indication of a willingness to impose a blockade of things he doesn't like even without a majority. The Arkansas Constitution bestows that power on a minority because of the 75 percent vote requirement for most spending legislation.
The Republicans want co-pays from poor working people who get added to Medicaid. Even Democrats are looking kindly at the idea of sticking impoverished working people who've contributed toward medical care through payroll taxes. It may be a political necessity. It proved so in ARKids.
Co-pays will, of course, discourage access to the system by poor people. Which will mean some illnesses will go untreated. Which will ultimately mean more costs for somebody — more severe illness, death, unpaid emergency medical bills and all the rest. Republicans simply intend to fight universal health care, an accepted part of society in rest of the western world, to the dying breaths of the uncovered poor.
But it's worse than co-pays.
Lamoureux and the Republicans won't let go of drug-testing. The Florida experience has already proved that it's another red herring. Medical professionals are more likely to be drug abusers than poor folks seeking health care.
Lamoureux throws out the old "root out fraud and abuse" line. I'll believe he's serious when he demonstrates that he understands the vast majority of Medicaid fraud is not by poor sick people but by drug companies, insurance companies, hospitals and doctors gaming or directly cheating the system. Trust me. That's not who the teabaggers see as the enemy. It's the moochers they're after, the 47 percent.
Lamoureux wants greater eligibility verification. What? Photo ID? Of course people should be income-eligible. Is there evidence of many people with sufficient income lining up for Medicaid? I'd be interested to see it. (There is some evidence of middle class people trying to hide granny's assets to qualify for nursing home coverage.)
Finally, the money quote:
A “small amount” of expansion might be do-able if “all our reforms are implemented,” said Lamoureux, referring to the July letter. “But it wouldn’t be 250,000. If they’re not interested in compromise, then we’re not either. They’re not going to be telling us what the expansion is going to be.”
Republican compromise: Do it the way we say. Accept all our conditions or go to hell. We'll decide what federal law provides.
What you have here is part of the Southern massive resistance movement to President Obama's health care law. Much of it is non-negotiable, despite what Lamoureux wants to suggest. The state can take it — and help a quarter of a million people — or, for the most part, it need not. The Arkansas legislature doesn't write the federal health care law. Texas here we come. It's going to be a meaner place, this so-called Land of Opportunity. The feds have said states can participate or not — or drop out entirely if money runs short in the future — but they've said so far that incremental participation is not part of the states' options.
PS — If Lamoureux and the rest of Koch Inc. block Medicaid expansion, it will cut off the federal money that could otherwise correct a $350 million gap in state support for the existing Medicaid program. Think schools, prisons, colleges, along with throwing poor people out of nursing homes and hospitals.
PPS — We are not alone in this lunacy. From Forbes:
The nation’s state and local public hospitals may face an increase of more than $50 billion in the costs of uncompensated care by 2019 if states decide against participating in an expansion of the Medicaid health insurance program for the poor.
The giant price tag to safety net hospitals for patients who are unable to pay their medical bills comes from a new analysis from the National Association of Public Hospitals and Health Systems. The association said the study puts “a dollar figure” on the additional cost of uncompensated care following the U.S. Supreme Court ruling in June on the constitutionality of the Affordable Care Act.
By the way, Sen. Lamoureux: When you cut this spending to UAMS and Children's Hospital and other community hospitals, it's not just sick people who suffer. It's all those jobs that will be lost with no money coming in. Thanks, sir. May I have another?