Though the Washington Post is under the impression that Arkansas has already said yes, things in fact remain dicey for Medicaid expansion. Republicans, led by House Public Health Chairman Rep. John Burris, are now promoting the idea of waiting to make the decision until the fiscal session next year. From a fiscal point of view, this is insane: The 100 percent match rate between 2014 and 2016 is the part of Medicaid expansion that no one denies is a good deal for the state. Waiting until the fiscal session would mean the state couldn’t start expansion until July 2014, leaving six months of money on the table. Burris is no fool, so this instead has the stench of a delay tactic. If Arkansas wants to say yes, they would do so this year.
Meanwhile, Republicans continued trying to change the subject to their preferred topic: Waste! Fraud! Abuse! “We keep hearing stories of…” is their opening line, which we guess means that some people really like gossiping (or fantasizing?) about Cadillac-driving Medicaid recipients, “crazy check” scammers, and housecleaners who don’t work enough days. Rep. Bruce Westerman, captain of The Waste Wing team, filed a bill along with Sen. David Sanders to institute a costly system of biometric smart cards for Medicaid recipients — sort of like the Voter ID of health care. Experience in other states suggests that this will harass some eligible folks out of the program while doing nothing about fraud. Westerman also filed a shell bill that looks like an effort to codify Medicaid-attacking hijinks from Legislative Audit.
As for the much-hyped audit of the Medicaid program, the release was delayed until today to foster cooperation between Leg. Audit and DHS. The results were much ado about nothing. Bummer for the Waste Wing. Meanwhile, the Medicaid program itself shows early signs of curtailing cost growth.
There was some other good news for expansion proponents. Two more Republican governors came out for Medicaid expansion; despite hating Obamacare, that's now six that have concluded that expansion is too good of a deal to pass up. (Still no movement from our Dixie neighbors; Tennessee is probably the real bellwether and there's a little hope there.) Here at home, Gov. Beebe has floated another compromise idea and gotten a maybe from the feds.
Still, none of these developments make a lick of difference if the Republican leadership is determined to run a delay game. For the third straight week, the Expand-o-meter is dipping down.