Commentary: The 'bad news' nine

Despite popularity of specifics, Private Option’s future threatened

I've got good news and I've got bad news.

The bad news: Obamacare appears to be an utter failure.

The good news: The Affordable Care Act is a stupendous success.

The irony? They are the same thing.

More good news: Arkansas' Private Option generated more than $990 million of economic impact in 2014, cut uninsured adult rates from 22.5 to 9.1 percent, and will save the state budget at least $438 million in the next five years.

More bad news: Nine mathematically challenged state senators could kill the goose that lays the golden eggs.

Our state Constitution has an unfortunate provision requiring a three-fourths vote to pass appropriation bills (except for sales taxes that disproportionately hit the poor and can be passed by simple majority). That means nine senators out of 36 can kill our successful health care expansion. A legislative special session is expected to meet to decide about that funding next month.

Here's our Arkansas situation. In 2013 by a bipartisan act, Arkansas changed Obamacare, creating the Private Option to expand health care coverage by using federal dollars to cover the costs of private insurance plans. The Legislature meets next month to re-invent and (hopefully) fund the plan, recast under Gov. Asa Hutchinson as Arkansas Works. By all accounts, the plan has worked.

In 2013, one out of four of your neighbors did not have health insurance. The good news: That's been cut in half, with more than 240,000 people now approved for coverage; 30,000 more children are covered. For 40 percent of these neighbors, it was the first health care coverage in their lives. The bad news: We still don't have universal coverage.

This August, the Arkansas Hospital Association published a report examining the total economic impact of expanding Medicaid. In 2014 the new coverage brought in nearly $1 billion in economic energy. Extraordinary! The study expects those economic benefits to grow even larger each future year. (See http://is.gd/ARbenefits)

In the old days, hospitals were swamped with uncompensated care and emergency rooms were troubled by visits from people who had no other access to care. Thanks to the Private Option, Arkansas hospitals have cut their uncompensated costs and emergency visits by uninsured patients by half. Many rural hospitals that were threatened with bankruptcy are now solvent. That's especially important in small towns where the hospital is often the largest employer.

We are enjoying an historic slowdown in health care costs. Increases in insurance premiums across the board have slowed.

The percentage of premature babies is at a nationwide all-time low. Greater access to mental health care and substance abuse treatment promises huge savings to health care and criminal justice systems.

Every one of these statistics concerns real human beings and their families, relieving them from suffering and anxiety. That's the moral-ethical motive. That's priceless.

But the smear campaign directed at "Obamacare" has left millions of Americans and quite a few politicians with reactive opinions against it. However, when you ask people their opinions about the specific characteristics of the health care act, they support it. Comedian Jimmy Kimmel had fun with this irony. He did man-on-the-street interviews asking, "Which is better? The Affordable Care Act or Obamacare?" Pedestrians trashed Obamacare and praised the Affordable Care Act. And then were embarrassed to learn that they are the same thing.

Unfortunately health care became a partisan political football. The Kaiser Family Foundation found that no single characteristic better predicts how a person feels about the health care law than his or her partisan affiliation. Yet even Republicans who "loathe" Obamacare overwhelmingly support most of its key provisions.

Eighty percent of Republicans favor "creating an insurance pool where small businesses and uninsured have access to insurance exchanges to take advantage of large group pricing benefits." Seventy-eight percent support "banning insurance companies from denying coverage for pre-existing conditions," and 86 percent favor "banning insurance companies from cancelling policies because a person becomes ill." Fifty-seven percent of Republicans support "providing subsidies on a sliding scale to aid individuals and families who cannot afford health insurance. Fifty-four percent favor "requiring companies with more than 50 employees to provide insurance for their employers," and 52 percent favor "allowing children to stay on parent's insurance until age 26."

Independents and Democrats are even more supportive of these aspects of the Affordable Care Act.

So there is the moral imperative -- insurance is good for our neighbors -- and the economic imperative -- the dollars add up.

If so many uninsured Arkansans now have coverage, and the vast majority of people favor the new provisions, and it is an economic bonanza, who could be against this?

Unfortunately it only takes nine people.

Commentary on 03/29/2016

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