by Gwen Moritz
Posted 7/1/2013 12:00 am
Updated 9 months ago
The Patient Protection & Affordable Care Act is not at all the sort of universal health care system that I wanted to see — not because of the completely logical individual mandate but because it binds tighter than ever the artificial connection between the workplace and health insurance. It’s going to be a nightmare.
But I firmly believe that it will be far better than continuing the death spiral of our current patchwork of health insurance, which delivers mediocre outcomes at the world’s highest prices while leaving millions of Americans one illness or injury away from bankruptcy.
I thought simply expanding Medicaid was more logical than the “private option” that ultimately came out of the Arkansas Legislature. But the private option is infinitely better than turning down hundreds of millions of federal taxpayer dollars every year, as some other states are doing.
Leaving a quarter-million Arkansans uninsured and pushing health care providers to the wall simply to make a point would have been the textbook definition of cutting off one’s nose to spite one’s face. (And throwing the baby out with the bathwater, if I may be allowed two clichés in a row.) I’m just so grateful that, when it really mattered, a supermajority of Arkansas lawmakers put people above ideology.
In between the passage of the ACA in Washington and the adoption of the private option in Little Rock, the demonization of “Obamacare” has been so thorough and unrelenting that I’m afraid that even people who will benefit from the private option could be persuaded to vote against it. And they may have that chance if a group called Arkansans Against Big Government can collect the 47,000 voter signatures needed to get their repeal initiative onto the 2014 general election ballot.
My friend Andrew DeMillo, a political reporter for The Associated Press in Little Rock, wrote an analysis suggesting that time is not on the AABG’s side: Enough signatures have to be collected in at least 15 counties, and it all has to be done by Aug. 15. “Long odds and a tight deadline,” DeMillo wrote.
But I won’t rest easy until that deadline passes unfulfilled, because if the repeal initiative gets on the ballot, getting Arkansas voters to strike a blow against Obamacare will be like shooting fish in a barrel. Even if it is a futile gesture and worse than an empty one. Even if it doesn’t do anything at all to the federal law, the individual mandate or new employer requirements.
A bunch of Arkansans might vote for the repeal even if it would only hurt low-income families and could well shut the doors of small but vital hospitals around the state and prompt more doctors to stop accepting Medicare and Medicaid patients.
Back in 2010, David Frum, the conservative commentator and former speechwriter for President George W. Bush, scolded Republicans for letting demonization of health care reform prevent them from negotiating a better solution than the one the Democrats ultimately passed all by themselves.
“There were [Republican] leaders who knew better, who would have liked to deal,” Frum wrote. “But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or — more exactly — with somebody whom your voters have been persuaded to believe wants to murder their grandmother?”
Many of the Republicans who ran for office in Arkansas on a platform of rabid opposition to Obamacare — as if they would have any power over the federal government — came around to the pragmatic realization that just saying no to Medicaid expansion would be foolish. Unlike the Republicans in Washington, they made a deal they could live with. (Some, of course, never have come around.)
But if repeal of the private option does make it to the ballot, will one year be enough time to get voters to reconsider the idea that anything and everything associated with Obama’s health care reform should be torn out by the roots and burned?
I comfort myself with the memories of very bad ballot items that Arkansas voters have rejected, like the amendment that would have written a casino monopoly for a Texas company into our state’s constitution and the amendment that would have removed the sales tax on groceries in one fell swoop with no plan for replacing the revenue.
But then I remember that the same electorate, by a hefty margin, doubled the number of legislative sessions. You’ll never convince me that the majority knew what they were voting for that time.
Gwen Moritz is editor of Arkansas Business. Email her at GMoritz@ABPG.com.