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Wednesday, July 18, 2012

Republicans struggle for talking points

Posted By on Wed, Jul 18, 2012 at 6:57 AM

The Twittersphere indicates that Republicans are having a hard time coming up with talking points to potshot the bombshell news that it won't cost Arkansas any money to expand Medicaid, that it will actually save Arkansas money — more than $300 million over the next seven years.

Early efforts at counter-messaging (Arkansas Republicans clearly don't have a Frank Luntz among them):

* Why didn't they tell me first? Repubs are steamed that the press released the numbers before they could pre-spin it. I can only speak for myself. I requested these numbers from the state last week when it became clear little attention was being given to the gains available to Arkansas in a more advantageous federal Medicaid match and additional health care spending in the state. I believe other reporters requested the same information. When the information was finally compiled, it seems to have been released to those who requested it.

* You can't pay less for more coverage. That's a misstatement of what the figures show. Expanding Medicaid will cost more gross dollars, no doubt about it. But most of them will flow from the federal government. And this direct new spending in Arkansas will have an economic benefit, conservatively estimated at 4 percent of the spending in tax revenue.

* It can't be true. It just can't be. These are faith-based, not fact-based legislators, remember.

* Nothing's free. This is true. Of course federal Medicaid dollars derive from tax payments. Should one of the country's poorest states turn down the opportunity to cover its working poor and its sick children at a reimbursement rate disproportionately favorable compared with what we pay into the system? That IS the question. Make a good deal to insure a healthier Arkansans, with all the benefits that accrue to school kids and workers and their employers from being healthy? Or screw 'em? Republicans choose Door #2.

* This is numbers funny business. Much howling is underway because DF&A always disputes the wild exaggerations from Republicans about the economic benefits of tax cuts. (With good reason. See the decade of Bush tax cuts for conclusive proof of that particular Republican fallacy, particularly when it comes to the supposed economic benefits of letting rich people hang onto more of their unearned income from so-called capital gains.) But this is not about imaginary numbers. More federal dollars will be received in Arkansas and spent here. The state match will be reduced. The cost of uncompensated care will be reduced. It is easy to compute the direct impact of NEW federal dollars spent in Arkansas. It is not a fictional number that depends on the hope that a wealthy person will put his dividend income into something in Arkansas rather than more offshore investments. Nurses, doctors, nursing homes and lots more will be employed here.

UPDATE: Good Q&A by Roby Brock with Medicaid director Andy Allison on how the figures were reached.

UPDATE II: Gov. Mike Beebe today — still leaning toward the Medicaid expansion — notes to reporters something I've been writing for days. Under Arkansas law, a small minority of the legislature can prevent spending the money on sick people. By all indications, Republicans are prepared to do just that.

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