Central Arkansas venues have a full week of commemorative events planned
That’s good news for those states' poorer residents, who have been left to fend for themselves while state legislatures offer massive resistance to Obamacare. In practice, however, crafting plans that are ostensibly more conservative has tended to add layers of bureaucracy and administrative complexity. The Republicanized versions of Medicaid thus far have ended up more complicated, confusing, and possibly costlier than the program Republicans refused to expand in the first place.
Take, for example, Arkansas—the state that got the ball rolling for red states seeking GOP twists on Medicaid expansion with its privatized version known as the “private option.” Last month the state got approval for a byzantine new program, called Health Independence Accounts, that imposes co-pays on some beneficiaries unless they pay a small monthly fee. Those who have paid their fees are eligible, under certain conditions, for up to $200 to pay for the costs of private health insurance if their income goes up and they transition off of Medicaid. To run the program, the state will pay a third-party administrator about $15 million annually (covered by the feds as part of the cost of expansion).
More complex programs can also be more confusing for beneficiaries. State officials in Arkansas have suggested that the Health Independence Accounts would serve as an educational tool, modeling how to be consumers of private insurance, but it's just as likely that beneficiaries will simply be baffled by the genuinely confusing structure and rules. Trying to latch GOP hobby horses onto Medicaid and low-income beneficiaries can make for an awkward fit—in practice, the HIAs aren’t much like private insurance, aren’t much like Health Savings Accounts, and don’t clearly incentivize the most cost-effective ways of using the health care system. To make matters worse, state Republicans have banned state-appropriated outreach funds to help eligible beneficiaries enroll in the private option and navigate the system
Small-town hospital administrators all over Arkansas are quaking in their boots.
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