As promised, Gov. Asa Hutchinson has formalized his request to extend Arkansas’s use of Obamacare money for the private option version of Medicaid expansion, but with changes to make it more palatable to conservative Republicans.

Most of the Asacare add-ons are cosmetic or mildly harmful and the feds will reject several. New bureaucracy for various requirements ladled on the working poor would be expensive.  An asset test, even if approved, would touch a bare handful of people. Some co-pay requirements — though they’ll place legislators who themselves enjoy Cadillac health plans courtesy of taxpayers — might deter some very poor from needed treatment.

But here’s the main point of all this, which David Ramsey has detailed at length: Various news accounts say Hutchinson is attempting to pare costs so as to meet the small future state match required to continue Obamacare billions, currently fully funded by the federal government.  This is simply inaccurate — administration spin swallowed whole. The impact of the Obamacare money — both through rollover effect of the money in the economy, new insurance fees and the savings elsewhere in the state budget from the infusion — is a net plus, even when a 5 to 10 percent match kicks in.

Also subject to question are the imagined savings on proposed spending cuts in services to the elderly and disabled. These are primarily being offered just because. If they encourage some cheaper and preferable home care over institutional settings, that would be a good thing. But, as yet, we have no showing that the nursing home industry can come up with voluntary cost-cutting plans that make givebacks more from their profits than from patient care.


As David summarized  about all this:

In fact, the [consultant] Stephen Group found that the private option saves money for the state on net, even when the state has to start paying its full 10 percent share. Hutchinson is plowing the current savings into tax cuts, without a thought to the state’s share of private option costs down the road. The truth is that the governor wants to achieve savings in the traditional Medicaid program because he wants to achieve savings in the traditional Medicaid program. It has nothing to do with whether the state continues the private option or not.

Let the dickering begin. And may the governor go to sleep at night praying his Republican colleagues from Arkansas in Congress not succeed in their eternal vow to kill Obamacare.