It’s getting down to the wire and the Expand-o-meter remains bullish. The big news this week: a new DHS study suggesting that the additional cost to the feds of the “private option” could be much lower than anticipated. According to DHS, it could represent no additional cost at all compared with traditional Medicaid expansion. Given that the biggest critique of the “private option” was a higher federal price tag, this could help seal the deal — particularly for wobbly Republicans worried about federal spending.
So far DHS has offered assertions without hard numbers and critics from the right, left, and wonky middle have viewed the findings with a bit of skepticism until we see more. But with Republican lawmakers mostly showing (newfound) faith in DHS reports, their conclusions represent very good news for expansion proponents.
So is expansion a slam dunk? Not just yet. Getting to 75 percent is still a steep climb given the conservative, Obamacare-phobic makeup of the General Assembly. Thus far, there has been very little public criticism of the “private option” from the right. We got our first real dose this week when the Cato Institute’s Michael Cannon came to town. Cannon was invited to testify against state-run exchanges, which mostly fell on deaf ears (it goes to show how much of a difference the "private option" has made that Sen. Jason Rapert, once a vehement opponent of state-run exchanges, shrugged Cannon off).
However, Americans for Prosperity invited Cannon to be the guest speaker at their Conservative Caucus Luncheon, where much of his talk focused on attacking the “private option” (or “the Beebe proposal” as he called it). Cannon called it crony capitalism that was even worse than Medicaid expansion and represented an effort to trick Republicans into capitulating on Obamacare.
Will we start to hear attacks like that from conservatives in the state? That remains the possible fly in the ointment. One Tea Partier at the Capitol to see Cannon called the “private option” lipstick on a pig. Rapert tweeted yesterday that he was “growing tired of the waiting game…and I have said so internally. Time is up and no one has presented details.” As for AFP — one of the biggest spenders in the state on legislative races and a key gatekeeper on the GOP’s right flank — they have been cagey and noticeably quiet so far. Cannon clearly fired them up, as the AFP Arkansas twitter account sent out a clear rejection of the “private option,” only to have AFP Regional Director Teresa Oelke quickly get online to walk it back. They’re still “waiting on details,” she tweeted. What position (if any) they decide to take looms large.
That said, the overwhelming majority of public comments from Republican lawmakers have been positive. House Speaker Davy Carter has been asking this week for some form of legislation to begin moving through the process. The Expand-o-meter keeps on heating up, shooting north of 80 percent for the first time.