by Max Brantley
After only three months of Obamacare’s big initiatives—expanded Medicaid for the very poor and subsidized insurance for those with modest incomes—Arkansas hospitals reported that emergency-room visits were down, the number of uninsured patients treated at the hospitals was down a dramatic 24 percent and the number of uninsured people who had to be hospitalized was down an amazing 30 percent. After the original March 31 cutoff, in spite of efforts by the legislature to stop people from getting insurance, tens of thousands more enrolled in insurance plans, and by the end of 2014 the number of Arkansans without insurance and ready access to medical care will be cut in half. That will be truly historic for a state that throughout its history has ranked at the bottom of unhealthy populations.
Arkansas’s rural and regional hospitals have been saved, the charity care they had to write off or pass along to the rest of us in the form of charges and premiums sharply reduced and soon to be virtually eliminated when the rest of the working poor are insured.
It also turned out that, in spite of the insurance companies’ alarms and efforts by the Koch brothers and others to discourage young people from getting insurance, lots of them enrolled through Arkansas’s private Medicaid insurance or the subsidized exchange, which may mean that insurance premiums in the next sign-up period will not rise and may even fall.
And the nonpartisan Congressional Budget Office projected that Obamacare will cost $104 billion less over the next 10 years than originally forecast and reduce the projected federal budget deficit even more than it had figured when the Affordable Care Act passed. The CBO calculated that Obamacare would cover more people over the next 25 years—roughly 25 million—than it had first forecast.
The U. S. has never faltered on its social obligations: Social Security, Medicare, Medicaid or any the rest. The threat, such as it is, comes from the Republicans, including the whole Arkansas House delegation, who have voted to privatize Medicare and turn more of the costs over to elderly patients and to shift Medicaid to the states with declining block grants. If Republicans were to gain a big congressional majority and a cold-hearted president, the threat to the state’s budget solvency could come to pass. Otherwise, an Arkansas budget crisis will be of legislators’ own making, not Obamacare’s.