Posted 3/11/2013 12:00 am
That was some fascinating story in the Arkansas Democrat-Gazette last week, in which reporter Charlie Frago plowed through emails between legislators and bureaucrats to track the political evolution of the idea of expanding insurance coverage to the working poor by using the new health care exchange rather than through the traditional Medicaid program.
To reiterate our editorial position on this: If that’s the only political path to capturing the hundreds of millions of dollars offered to Arkansas by the federal government and to provide coverage for as many as 250,000 Arkansans, we’re for it. We were for the expansion of Medicaid to Arkansans earning up to 138 percent of the poverty level when we thought it was the law, and we were for it even after the U.S. Supreme Court determined that it was optional rather than mandatory.
And we’re still for it, even in this “privatized” form, because moving toward universal coverage is a good thing for individuals, families, employers, providers and our state government’s budget. We have never agreed that the working poor of Arkansas should pay for a minuscule gesture toward balancing the federal government’s budget deficit.
But the question of cost is an excellent one, which the Democrat-Gazette’s story touched on.
“We do expect the gross costs to be higher than expanding traditional Medicaid in the first years of the expansion,” state Medicaid Director Andy Allison wrote in one of the emails. “However, it isn’t clear that those higher costs mean that expansion turns from being a net saver to a net coster for the state in the out years (2017 and beyond) ...”
If the goal is saving money, this option doesn’t do it. But it does have the attractive advantage of not being a direct expansion of the state government’s role.
We also learned that Dr. Joe Thompson, the state surgeon general, calls our governor “Beebelieber.” We’re not even sure how to pronounce that.