“We’re not going to put more than 250,000 people on our Medicaid rolls, then pull them off,” Sen. Cecile Bledsoe said once upon a time.
Curiously, the very folks, like Bledsoe, who said the state would never, ever give people health coverage and then take it away — indeed, some even claimed that would be wrong to do — now propose to take away health coverage from 100,000 (and counting) Arkansans. (Bledsoe is one of the nine senators promising to block the appropriation that includes the private option.)
Back when the debate over Medicaid expansion was first raging, Bledsoe often said her concern was about the feds not maintaining the match rates in the Affordable Care Act to help fund expansion down the road. When I mentioned various ways that Arkansas might back out of the policy if problems emerged, she responded, “Does that mean people on the program would be kicked off?” That, she said, would be a “travesty.”
This basic argument — that it’s better for people to get no coverage than to get it and possibly, some day in the future, lose it — was a popular Bledsoe line. Rep. David Meeks made the same argument when the private option emerged as a new approach to Medicaid expansion.
Later, after the private option passed, Meeks was suddenly worried about what would happen to beneficiaries if the private option went away, the result that Meeks himself wanted.
“Is there any talk about what to do with the [uninsured below 100 percent] if in fact the private option goes away?” he asked in a legislative hearing. “I would like to encourage folks to come up with a Plan B for them. I know that you have a lot on your plate with just going forward and doing what you’re doing, and that may be something us as legislators that maybe we need to discuss.”
In fact, Plan B is simply that Arkansas would return to being one of the stingiest Medicaid states in the nation and more than 200,000 Arkansans eligible to gain coverage under the private option would instead go without. Plan B is exactly what Meeks voted for! He asked, “what can we do with the [uninsured below 100 percent*] so they’re not just kinda left out there?” — even though just kinda leaving them out there is precisely what would happen if the private option is defunded.
Rep. Kim Hammer joined Meeks through the looking glass. “If Plan A goes away, the federal government doesn’t cover the [uninsured below 100 percent], they’re just hung out to dry?” Hammer asked. Correct! Of course, Hammer voted against Plan A (the private option) and seems to be leaning toward defunding it, which would…leave those folks “hung out to dry.”
For his part, Rep. Justin Harris has been vigorously fighting to defund the private option, but he still uses the Bledsoe line on expansion, tweeting, “We hurt people when we give something then taketh away.”
When I spoke with Meeks last month, he told me that he opposed the private option but “those folks right now that have insurance, you don’t want to just cut them off if at all possible…[we want to] continue to cover Arkansas, those folks that are under [the poverty line], to make sure they have the health care.”
I don’t doubt the sincerity of legislators’ concerns about what happens to 100,000+ Arkansans if they get kicked off of coverage. But voting to defund the private option — and kicking them off of coverage — is an odd way to show it.