by Max Brantley
Ernest Dumas this week says that, despite the Tea Party noise, there's little chance Congress will repeal Obamacare, no matter how often Tom Cotton and his Republican House colleagues vote to do so.
But it's worth considering what would happen if they really did, specifically in Arkansas. And to make the politicians explain how they defend the draconian impact that would result. Important stuff:
The obvious big result is what won’t happen. Some 250,000 Arkansans, mostly working adults and their families whose incomes fall below 138 percent of the poverty line, would not get health insurance wholly subsidized by the government except for some out-of-pocket expenses.
About that many more people who make more than 138 percent of poverty but are uninsured could not buy an affordable policy in the new private market set up by the Affordable Care Act. Most of them stand to get government help paying the premiums. That option would disappear.
Hundreds of thousands of other Arkansans would suddenly lose benefits from their private or government health insurance that they already have gained from the Affordable Care Act, although most of them are not aware that they have the hated Obamacare to thank.
The immediate crisis would belong to the Republican-controlled Arkansas legislature, which will convene in January to adopt a state budget for fiscal 2015, and, of course, to Governor Beebe. As a result of losing the Medicaid changes in Obamacare, Arkansas’s budget for this fiscal year would suddenly be in arrears, and the budgets for the next four years would be about $550 million short.
Remember that Republican lawmakers jumped on the Medicaid expansion in Obamacare, which not only would insure 250,000 of the working poor but save the state’s taxpayers hundreds of millions of dollars over the next few years. Obamacare will shift much of the state’s share of Medicaid to the federal government and also save the state-supported hospitals tens of millions of dollars a year in charity care. Anticipating the savings, the legislature last spring reduced funding for the University of Arkansas medical center, prisons, the Medicaid division and the Health
Department and Human Services Department, which help fund community mental health centers.
Then to soak up the budget savings, the legislature enacted Republican-sponsored tax cuts for the rich and manufacturers. So with all the Medicaid savings suddenly lost with Obamacare’s repeal, would the legislature repeal the tax cuts? Not likely, but it would have to raise taxes elsewhere (on working folks) or else make huge program reductions at prisons and colleges or Medicaid programs like nursing homes and children’s health care—some $550 million over the next four years alone.
That sum represents the loss of Obamacare’s state savings on Medicaid, the loss of insurance payments to hospitals for indigents and the loss of tax revenue from premium taxes and income taxes that are to flow into the treasury as a result of Obamacare.
But back to repeal’s impact on people other than the 500,000 who wouldn’t get access to insurance.
About 31,500 Arkansans on Medicare have saved $42.9 million on their prescription drugs since 2011 as a result of the discounts ordered by Obamacare, and the numbers will grow much larger until the infamous “donut hole” is closed in 2020. If the law were repealed, seniors would see big increases in their drug bills.
About 120,000 Arkansans have gotten rebates from their insurance companies totaling $11.3 million for premium overcharges. They may have thanked the thoughtful insurance companies, which are ordered by Obamacare to do it every year.
Thirty-five thousand men and women ages 19 to 26 got back on their parents’ policies as a result of Obamacare. The insurers could cut them off if the law were repealed.
About 1 million insured Arkansans, principally women and the elderly, can get cancer screenings and preventive care free of copays, thanks to Obamacare, but no longer if it were repealed.
Firm numbers aren’t available, but up to 170,000 Arkansas children with chronic health problems can no longer be denied insurance coverage on their family’s policies. Repeal would end that protection. Adults with preexisting conditions wouldn’t get insured again come Jan. 1.
Obamacare has lifted the lifetime caps on benefits from the policies of a million Arkansans, and it will remove the annual caps on Jan. 1—unless it is repealed.
Surely, at some point, Cotton and the others will tell people that these are the horrors they are intent on protecting them from.