Columns » Ernest Dumas

Hutchinson won't stop private option insurance

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Asa Hutchinson would politely decline my help if he were given a choice, and because he holds a tiny lead in the governor's race he may not need it, but it is one of the encyclopedic services a columnist ought to provide.

Here is Hutchinson's dilemma: His case against Mike Ross is chiefly that the president and a Democratic Congress enacted the despised "Obamacare," a.k.a. the Affordable Care Act, while Ross was a member, although Ross voted against its passage and sided with Republicans afterward on repealing it even while occasionally acting like the insurance reform was not altogether a bad thing. But on the only part of Obamacare that has had a big impact in Arkansas, Hutchinson steadfastly refuses to take a stand. That is "the private option," the euphemism that masks the fact that expanding Medicaid to insure poor childless adults is a central feature of Obamacare.

If he were forced to take a stand Hutchins on would have to say that he would keep the Medicaid expansion because scrapping it would wreck the state budget, end medical coverage for more than 200,000 of the state's neediest citizens, imperil community hospitals, disappoint doctors who have begun to accept poor adults as patients because they now can pay, and end a big economic stimulus for businesses in every community. But openly embracing Obamacare like that could stifle his campaign to characterize Ross as a pawn of the evil people who saddled Arkansas with Obamacare.

Ross promises to keep the private option and hammers Hutchinson for his fence-straddling. Ross's boldness could be riskier than Hutchinson's quailing because while 40 percent of Arkansans already have enjoyed the benefits of the Affordable Care Act and few, if any, suffered any discernible harm, Obamacare is still a word that strikes fear in most people's hearts.

Hutchinson must have discovered that the hardest thing about running for office is to get elected without proving that you are unworthy of it or without rendering governance impossible once you get the reins. Courage is a virtue and faintheartedness a weakness, but sometimes it's the only thing that keeps you in the game.

Here's my assist to the Hutchinson campaign. He can't tell you that he would keep insuring all those poor working people, but I can. That is what will happen and the private option will continue in virtually its present form long after either he or Ross takes office. And it doesn't matter if the Tea Party folks get 26 of the 100 House members or nine of the 35 senators in the fall election. They won't stop Medicaid.

So if that's your hang-up, move on. If Hutchinson keeps fudging until election day, let him be. See what else he and Mike Ross have to say because the private option is settled.

Why am I so certain?

If the state scraps the private option, it will have to once again shoulder Medicaid costs that were shifted to Washington last winter as part of the Obamacare bargain with the states. After seeing the big budget savings from the Obamacare shift, the legislature decided it could cut taxes last year. Hutchinson and Ross both promise more tax cuts next year, but ending the private option would make that as fiscally reckless as it proved to be in Kansas.

A total of 185,000 persons have enrolled in expanded Medicaid and another 40,000 have bought insurance in the Obamacare exchange — together nearly half of all the previously uninsured citizens in Arkansas. When the new governor takes office, some 215,000 will be enrolled in expanded Medicaid alone. Will Hutchinson and, indeed, most Republican legislators want to end medical coverage for so many of their neighbors and constituents? It was an easy vote for some Republicans last year because they viewed Medicaid, except for nursing home care, as welfare for all those black people in the Delta and south-central Arkansas. But they are learning that it is mostly a program for white working people and their children.

Compare the private option enrollment in the six prosperous counties of the northwest corner (Benton, Washington, Crawford, Boone, Carroll and Madison) with enrollment in the 11 counties down the length of the Delta. The black ratio in the mountain counties ranges from a high of 3 percent in Washington County to two-tenths of 1 percent in four of them. Most of the Delta counties are higher than 50 percent with only Craighead (13 percent) and Poinsett (7.2 percent) having relatively small African-American cohorts.

But by July 1 the six northwest counties had enrolled 27,213 in the private option and the vast Delta region almost the same number, 27,871. The handful of northwest legislators who fought the private option last year and in February may take another reading.

And a fourth of the members of one or the other house can't kill it by voting against the appropriation, if the governor and legislative leaders don't want them to. An appropriation of federal money needs only a majority. Also, the Arkansas Supreme Court has held that once you create a program or an entitlement the mere failure of the legislature to pass an appropriation doesn't kill it.

So let Asa be Asa, a fence straddler, and see what else he has to offer.

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