I breezed over to the state Capitol
on Tuesday morning and came up
with what I believe to be the latest, or near-latest, on Medicaid expansion and tax cuts.
Those are the big issues amid all the horrible small ones.
The first thing is that two leading Republican planners on this pending and nationally innovative private variety of Medicaid expansion-Sen. David Sanders of Little Rock and Rep. John Burris of Harrison-have become maybe a tad deluded with youthful grandeur.
Sanders was quoted Tuesday as saying he and his like-minded colleagues were using this private option for nothing less than the rewriting of Obamacare.
Well, not quite.
Burris was quoted as saying there would not be any bill in Arkansas that’s not fully detailed. It won’t be like the federal health-reform bill that had reams of verbiage that Nancy Pelosi said everyone could figure out later.
Well, maybe and maybe not.
Sanders and Burris want provisions for medical savings accounts for poor people and deductibles and co-payments and bare-bones insurance options backstopped by some kind of catastrophic pool.
At least I think that’s what they want.
None of that is as-yet specifically sanctioned by the federal Health and Human Services Department.
So this is the key new development: Sanders and Burris have been advised to keep working on all that, but that this expansion needs to go forward concurrent with their labors.
That is to say that Gov. Mike Beebe, House Speaker Davy Carter and Senate President Pro Tem Michael Lamoureux want actual wording placed in bills, or in three or four bills,for the health committees to begin examining.
And they want that done by the end of this week or the start of next week.
Sen. Jonathan Dismang told me that the emerging consensus is that the Legislature needs to proceed immediately with short-term authority for this private-option expansion that stipulates strict legislative oversight. Then it needs to continue working on longer-term policy development in the way that Sanders and Burris and others desire.
The real story shouldn’t be missed. This private-option expansion can pass. Or might well pass. And that’s huge.
And credit goes to Republicans who have leveraged it.
They could simply have said no. Of course, they simply could have said yes to Medicaid expansion.
But they don’t believe in government, only in government subsidies of the private sector. Andthey don’t believe in going along with Barack Obama, only in telling the voters that they stood up to him.
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On tax cuts, Beebe has met with Republican legislative leaders and told them that, yes, if we do this variety of Medicaid expansion, there will be new general-revenue savings.
They will come from new insurance coverage for previously uncompensated care and through people moving from Medicaid to private insurance.
And yes, in that event, he says, he could go along with some measure of tax cuts.
The governor told me in a Capitol corridor ambush-mine of him, of course-that he hadn’t set any dollar amount. And he said legislative leaders need to understand that budget savings would mostly occur not in 2013-14, but 2014-15.
So I asked of this tax cutting: “It won’t be any $100 million to $150 million?”
Beebe said: “Certainly not any $150 million.”
So I said: “So you can go along with a hundred million?”
Beebe said: “I did not say that.”
I think he was previously prepared to live with $60 million in cuts, and that, if there are new Medicaid savings, he could go up a little from there. State Rep. Charlie Collins of Fayetteville is apparently going to be obliged on raising the threshold for application of the top state income bracket, then lowering that rate by an eighth of a percent.
It’s a few tens of millions going mostly to the richest people, this to serve supply-side economics and compensate these richer people for subsidizing the health care of all those undesirables. I guess.
And Speaker Carter wants to cut those higher-income people’s capital gains taxes, too.
Those would be outrages in another session, on another day, at another time.
They’re positively moderate actions here in contemporary Oklabama.
John Brummett’s column appears regularly in the Arkansas Democrat-Gazette. Email him at [email protected]. Read his blog at brummett.arkansasonline.com, or his @johnbrummett Twitter feed.
Editorial, Pages 15 on 03/21/2013