GOP UNMOVED: Lt. Gov. Mark Darr and legislators vow continued resistance to federal health care law. Brian Chilson

GOP UNMOVED: Lt. Gov. Mark Darr and legislators vow continued resistance to federal health care law.

  • Brian Chilson
  • GOP UNMOVED: Lt. Gov. Mark Darr and legislators vow continued resistance to federal health care law.

The Supreme Court ruling on federal health care law set the stage at the Arkansas Capitol today for more health discussions.

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A group of Republicans — legislators and Lt. Gov. Mark Darr, who’d personally intervened in the case —called an afternoon news conference to blast the decision and promise all possible resistance.

Elsewhere, officials of the Beebe administration held a session to explain their plans to reshape Medicaid in a way that they hope will save money in the billion-dollar program about 70 percent paid in federal dollars.

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Darr led the way at the Republican news conference. He said the state should hold off on implementing any part of Obamacare for as long as possible. Nor does he think Arkansas should expand Medicaid, as the law anticipates.

Both Darr and Sen. Jeremy Hutchinson asked what will happen to uninsured citizens in states that choose not to expand Medicaid. “I know there are reports from governors all over the country that say they’re not going to voluntarily expand their Medicaid program. What happens if the majority of the states don’t do it? Are those people taxed because they don’t have insurance? Are they given a rebate? Where does the money come from to rebate all these people? It opens up a whole lot of questions that we as legislators need to get the answer to before we move forward. I know we’ve had reports from state agency heads that say onward and forward, but I think that’s the wrong approach. I think there are more questions to be answered now than before today’s rulings…I think it’s important to wait and see what other states do. We don’t want to be the only state that voluntarily agrees to Medicaid expansion,” Hutchinson said.

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Hutchinson joined a Republican messaging point that became ubquitous as the day wore on. Obama had campaigned against raising any sort of tax on lower income Americans, but carried the day in the Supreme Court because the mandate was construed to be a tax.

“Despite the Administration campaigning for this legislation on the grounds that it’s not a tax, today they embrace it as a tax…the frustrating thing is, this tax, unlike any other tax in American history, most taxes, you’re taxed because of income, or because you decide to purchase something…this tax is not broadbased. It is not spread out across the population as a whole. It selects a few people and taxes them for their mere existence. They’ve done nothing, they chose to participate in nothing, they’re not participating in a commerce, they’re taxed because they exist,” he added.

Talking Points Memo offers a more nuanced discussion of this. It’s not as simple as Hutchinson suggests. The mandate, plus a variety of health insurance options, exists regardless of how far states go in expanding Medicaid for the poor.

TPM also notes that the call by Republicans to refuse to set up state health exchanges — nullification in other words — is empty talk because the feds will do it if the states won’t.

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Darr’s full statement and some video after the jump. But first, Leslie Newell Peacock’s coverage of the state’s explanation of coming Medicaid changes:

The state is going to change the way it reimburses medical providers with a “medical home” strategy that substitutes for the fee-for-service model by gearing payments to episodes of illness, rather than doctor visits. The system also appoints a “principal accountable provider” to coordinate patient care between hospital and doctor’s office.

State Department of Human Services Director John Selig, Medicaid director Andy Allison, Medicaid medical director Dr. William Golden and the medical directors and administrators of insurers Qual Choice and Blue Cross and Blue Shield talked about the changes, which go into effect Oct. 12, in a press briefing today.

Selig also fielded questions about the Supreme Court decision on the Affordable Health Care Act, which would allow states to opt out of Medicaid expansion. “We’ve been planning to do the expansion all along,” Selig said. It will cost along the lines of $1 billion a year; the federal government will pay the first three years.