One problem with blind partisanship is that it can lead you to betray your own principles and the well-being of the people you represent.
So it is with the invigorated Republican minority in the Arkansas legislature and the national health-insurance reform law. The Republicans are intent on stymieing anything that is associated with the new federal law, which they always call "Obamacare," no matter if it is something they might otherwise support.
The part of the law they commonly attack is the part borrowed from old Republican health plans, requiring sizable employers and individuals who are uninsured to either buy health insurance or pay a tax to support health services for the uninsured. The Patient Protection and Affordable Care Act will create exchanges supervised by the federal Department of Health and Human Services, where employers and individuals starting in 2014 can shop for a private health plan that suits them and is affordable.
As a sop to conservatives, Congress gave states the option of skipping the national exchange and setting up the exchanges themselves and regulating the companies and agents, as the states do already for existing health insurance and other forms of insurance. If a state chooses not to establish its own market for individual and small-group insurance, then people in that state will purchase a plan through the national market. The premium rates and conditions and the servicing of complaints then would be handled in Washington as well.
It makes sense for a state like Arkansas to run the market instead of letting Washington do it. As a relatively low-cost state for medical care, Arkansas ought to get cheaper premiums and better conditions for employers and individuals than the national exchange likely will offer. New York might want to let the feds do it.
So Gov. Beebe, no fan of the federal law (he worries that it will impose higher Medicaid costs on the state government in about 2019), wants the state to do the job, if the law stands up in the courts, as it almost certainly will. A bill would give the state Insurance Department the authority to avoid the national exchange and create the private insurance market for Arkansas employers and individuals, set the terms and regulate the insurance companies that offer the plans and the agents who sell them.
You would think the Republicans would be clamoring to sign up. "We, not Washington, will run our business in Arkansas, thank you."
But they have blocked the bill in the House Insurance and Commerce Committee, with the help of weak-kneed Democrats who worry that they might be seen as siding on something with the black president with the Asian-sounding name. I don't know, but I would guess that President Obama would be more than happy for Arkansas to let Washington manage the new health insurance market for Arkansans.
The Republicans seem to think that if the legislature does not enact the insurance-exchange bill then the federal law would never be implemented in Arkansas even if the U. S. Supreme Court declares every bit of the law constitutional. That bit of ignorance is not surprising. The Republican critics have never evinced any grasp of the law, relying instead on the talking points that were drafted before the legislation was written.
Sen. Gilbert Baker, the Republican leader, said last week: "We are not going to be implementing the federal health-care law. There is no strength in the Arkansas Legislature to enact Obamacare." He said it was debatable whether the law could be implemented in Arkansas if the legislature doesn't adopt the legislation.
Utter nonsense. The exchange bill merely exercises Arkansas's option to run the insurance market itself rather than the federal government, if and when the law is ruled constitutional.
Its defeat will accomplish only one thing: Arkansas businesses and individuals will be buying health insurance through the federal exchange supervised by the U.S. Department of Health and Human Services rather than from the locally devised and regulated market.
Those who favored a centrally controlled health insurance system and wanted a public option (they are a good part of the polling majority opposing "Obamacare") may side with the Republicans on this one. States generally have a poor record of regulating the insurance industry although Arkansas, at least in the past several years, is an exception.
The Republicans and timorous Democrats will likely kill the exchange bill, thus significantly magnifying the federal government's hand in health care delivery in Arkansas, but if you like the idea of universal health insurance this will not be a real setback. Yes, insurance may prove a trifle costlier for employers and individuals and more onerous for the industry and consumers than if the state were running the show, but this is tea-party government. We have to get used to it.