You would figure that a legislator who voted against the “private option” legislation expanding healthcare coverage would be happy if that law was never enacted, or was stopped. But if you so figured, you do not know the mind of Rep. David Meeks.
At the joint committee hearing on the "private option" plan for healthcare expansion yesterday, Meeks asked about a Plan B. "Are we anticipating what we would do if something happens and we don’t get the private option?"
This is a question we certainly ought to think about because the plan is dependent on federal approval of a waiver. The law was designed as a take-it-leave-it offer to the feds and has various triggers in place to halt the legislation if the feds don't hold up their end of the bargain. In other words, Plan B is nothing.
Because of the way current law is structured here's what that means: 1) People between 100-138 percent of the federal poverty level would have to pay a little out of pocket on premiums but they would be eligible for heavily subsidized insurance on the exchange. 2) But uninsured people under 100 percent would be out of luck — without expansion, there isn't a backup. If you're worried about low-income people not having health insurance, Plan B is awful.
But Plan B — do nothing — is exactly what Meeks voted for. It's what he argued for on the House floor and elsewhere, as a vigorous opponent of both traditional Medicaid expansion and the "private option." Does Meeks realize this? Unclear, because he asked that they consider "what can we do with the [uninsured below 100 percent*] so they're not just kinda left out there."
Again, just kinda leaving them out there is indeed the result if expansion doesn't happen — and Meeks voted against expansion.
Meeks continued: "Is there any talk about what to do with the [uninsured below 100 percent] if in fact the private option goes away? I would like to encourage folks to come up with a Plan B for them. I know that you have a lot on your plate with just going forward and doing what you’re doing, and that may be something us as legislators that maybe we need to discuss."
Yeah, maybe so! Of course we just had that discussion, and this particular issue escaped Meeks's attention at the time. If you've been following the healthcare debate in Arkansas, you'll want to pick your jaw up off the floor. Well, Meeks contains multitudes.
Rep. Kim Hammer made sure to join in the lunacy, asking "if Plan A goes away, the federal government doesn’t cover the [uninsured below 100 percent], they’re just hung out to dry?" You guessed it: Hammer voted against Plan A, leaving those folks "hung out to dry."
Rep. John Burris said he was "confident in Plan A" but noted that if it fell through, the state would revert to "the default position that would have happened otherwise." Burris did not mention that this was the default position that, just a month ago, Meeks and Hammer said they wanted.
*Meeks and Hammer actually referred to this group as “the 18-100s” because parents below 18 percent are already eligible under the traditional Medicaid program. For childless adults, without expansion, 0-100 would be uncovered.