BETWEEN THE LINES: State GOP Needs To Listen Up

Wednesday, February 27, 2013

If Arkansas’ Republican-led Legislature doesn’t want to follow Democratic Gov. Mike Beebe’s lead on Medicaid expansion, maybe they’ll listen to the growing number of Republican governors who have made that choice.

The count is up to seven, according to the New York Times, which reported recently some veteran foes of the Affordable Care Act, more often called Obamacare, have seen the benefits for their respective residents.

This particular element of the law will allow states to provide Medicaid coverage to a larger number of a participating state’s poor and disabled.

From 2014 through 2016, the whole cost will be on the federal government.

Later, the states are supposed to pay no more than 10 percent while the federal share continues at 90 percent.

Nationwide, Medicaid expansion could add 17 million people to the 60 million already covered.

In Arkansas, the expansion would serve something like 250,000 more people, many of them the working poor who simply can’t afford other health care.

The numbers also include people who had jobs but lost their jobs and their insurance to the recession.

So far, the New York Times reported, 22 states have decided to expand Medicaid, 17 have said they won’t and the other 11, including Arkansas, have not yet voted.

Beebe initially wanted some reassurances from the federal government before he decided to support the program. Once he had those assurances, he has strongly pitched expansion, citing fiscal considerations as well as the opportunity to serve more Arkansans. But the decision is ultimately up to state lawmakers. Three-fourths of both houses of the Legislature must agree to the expansion.

Just last week Beebe met with U.S. Health and Human Services Secretary Kathleen Sebelius about more ideas he’s heard from some of Arkansas’ lawmakers to tweak the program.

Beebe was in Washington for the National Governors Association’s winter meeting and took the opportunity to explore the state’s options, including the possibility of allowing some Medicaid-eligible people to buy private insurance instead through an exchange created under the Affordable Care Act.

That is one of the options being argued by Arkansas Republicans resistant to expanding Medicaid. Their resistance is based on a variety of factors, including campaign promises to oppose Obamacare specifically and to do what they can to hold down government spending.

Lawmakers hold sway over the state’s budget and certainly can refuse these federal dollars, but they shouldn’t. The individuals who would benefit need coverage and, again, the state government would win, too, according to the state government’s number crunchers.

Another element of concern is that somehow the feds won’t keep their promise to pay all or most of the expansion costs and states could be left with a bigger tab. Or, as Beebe first worried, the state could suffer fiscal setbacks and not be able to pay its share.

Now, he is satisfied the state has sufficient options from the feds for him to support Medicaid expansion, however, and to take this money not only to help uninsured Arkansans but to shore up health care jobs and to benefit the overall state economy as well.

Notably, others in the number-crunching business, particularly those from hospitals and elsewhere in the health care industry, have been making the same case not only in Arkansas but elsewhere.

Give them credit for turning some of these Republican governors around.

The latest to switch positions was Florida Gov.

Rick Scott, who announced last week he supports expanding Medicaid in his state. Once a fierce foe, Scott also got permission from the Obama administration for some flexibility in administering the program, much like Beebe has done.

Republican governors in Arizona, Michigan, Nevada, New Mexico, North Dakota and Ohio are also on board with Medicaid expansion.

Apparently, they’ve gotten past the anti-Obamacare political rhetoric. Maybe the Arkansas Legislature will, too.

BRENDA BLAGG IS A FREELANCE COLUMNIST AND LONGTIME JOURNALIST IN NORTHWEST ARKANSAS.

Opinion, Pages 5 on 02/27/2013