Favorite

If GOP in, Medicaid out 

A few people in the government and even a few elements of their constituencies have started to contemplate two unnerving questions.

Will Republicans take over the Arkansas legislature after the election next month, and, if they do, will they actually do what they say they will do? They say they will repeal or cut state income taxes and perhaps other taxes and curtail government medical help for the poor and disabled, those programs created in Lyndon Johnson's Great Society and expanded ever since, not just by Barack Obama but even the occasional Republican — e.g., Mike Huckabee.

The first is more than a distinct possibility; Republicans say it is a cinch. The second, that they will whack taxes and public charity, defies logic but you have to take them at their word. This is not your father's Republican Party or, for that matter, even the Republican Party of Mike Huckabee. The ranks have been cleansed of moderates and pragmatists or else they have by necessity become true believers.

Especially in the medical field, people are exploring scenarios for preserving assistance for the poor, aged, disabled and mentally ill if the Republicans gain a majority in even one house, which will give them effective control of the state budget. There are no reliable good scenarios. Taxes are off the table. Governor Beebe has the veto, but in Arkansas it is trumped by a simple majority vote in the Senate and House.

Ironically, the voters who will put them in power are the consumers of all those services that are jeopardized. They like the talk of lower taxes and smaller government. The freeloaders, Mitt Romney's 47 percent, are always someone else, although their parents and loved ones are in nursing homes or institutions and community programs for the mentally and physically disabled, the groups that consume the largest shares of Medicaid, or else Medicaid insures their children for hospital and doctor care.

Medicaid, which serves 800,000 Arkansans and affects that many more family members, faces two big questions when the legislature gathers: (1) Can the state make up a $350 million to $400 million shortfall in state Medicaid match? (2) What will happen when Republicans block the expansion of Medicaid under the Affordable Care Act, which carries some relief for the state's Medicaid crisis as well as insurance for the largest share of the state's uninsured?

Because the state has fared a little better than much of the country since 2006, lowering its poverty rate against the country as a whole, its matching share for Medicaid has risen from 25 to about 30 percent, but only theoretically. President Obama's stimulus act pumped $750 million into the state's coffers for Medicaid from 2009 through 2011, reducing the state's match to 20 percent. It produced state budget surpluses and let the state's Medicaid trust fund grow for two years. Now the trust fund is vanishing and the state will enter the 2013 fiscal year next July needing an extra $350 million or more to maintain nursing home care, the institutions and community services for disabled children and adults and hospital and physician care for low-income children.

To tea-party Republicans, like many Republicans of old, Medicaid is socialism at its worst, the giveaway established in the Medicare act of 1965 that created the "culture of dependency." Because they don't want to be seen as kicking grandma out of the nursing home, there are Republicans who defend Medicaid. Even Mitt Romney seemed to praise it in Monday night's debate although he wants to dump it on the states. But not one Republican will vote next year to levy a tax to maintain medical services, as Huckabee did 10 years when Medicaid faced a similar crisis. They will say take the money from somewhere else; the only prospect is education, and college presidents are contemplating that scenario.

The Affordable Care Act, aka Obamacare, will supply the state another $65 million a year to cover part of the shortfall, but the Republican legislators and candidates have for the most part said they would block the Medicaid option in Obamacare. Mainly, that will prevent medical insurance — fully paid for by the federal government until 2018 — for some 400,000 able-bodied adults who earn too little (up to $30,000 for a family of four) to afford even a fraction of insurance premiums. Blocking the Medicaid expansion would be an economic disaster, keeping hundreds of millions of job-creating dollars out of the state — the equivalent of halting 500 Keystone XL pipelines, a favorite trope of the Republicans.

Then consider the repeal of the income tax, although some Republicans would be satisfied with a gesture — cutting the taxes of higher-income people. A Republican champion of eliminating the tax said last week that it would require a little belt tightening here and there, eliminating the waste and fraud, you see. Some would replace the income tax with a higher sales tax, but no Republican will be caught voting for any tax next year.

The sales tax has been riddled with so many exemptions, the latest being Governor Beebe's groceries exemption, that the income tax now accounts for more than half the state's general fund, which pays for public education (including charter schools), colleges and universities, prisons, law enforcement and all the human services the state provides for the needy and the unlucky.

The good news: I am assured that there will be a half-dozen levelheaded Republicans in the new majority, enough to thwart the outright repeal of the income tax.

So never fear.

Favorite

Comments (2)

Showing 1-2 of 2

Add a comment

 
Subscribe to this thread:
Showing 1-2 of 2

Add a comment

More by Ernest Dumas

  • Fake news

    So fed up was young Edgar Welch of Salisbury, N.C., that Hillary Clinton was getting away with running a child-sex ring that he grabbed a couple of guns last Sunday, drove 360 miles to the Comet Ping Pong pizzeria in Washington, D.C., where Clinton was supposed to be holding the kids as sex slaves, and fired his AR-15 into the floor to clear the joint of pizza cravers and conduct his own investigation of the pedophilia syndicate of the former first lady, U.S. senator and secretary of state.
    • Dec 8, 2016
  • Fake economics

    Fake news is a new phenomenon in the world of politics and policy, but hokey economic scholarship has been around as long as Form 1040 and is about as reliable as the news hoaxes that enlivened the presidential campaign.
    • Dec 1, 2016
  • China in charge

    Let's turn to foreign affairs to see how we might calm the flood of anxieties over the coming Donald Trump presidency.
    • Nov 24, 2016
  • More »

Readers also liked…

  • Religion as excuse upends Constitution

    Tirades over religious liberty since the U.S. Supreme Court legalized same-sex marriages nationwide have awakened the ghost of James Madison, the author of the constitutional doctrine on the matter, and it isn't happy that his effort to protect religious inquiry in America is being corrupted.
    • Jul 9, 2015
  • Guns, God and gays

    Many more mass shootings like the one last week in Roseburg, Ore., will stain the future and no law will pass that might reduce the carnage. That is not a prediction but a fact of life that is immune even to Hillary Clinton.
    • Oct 8, 2015
  • AEC dumps ALEC

    No matter which side of the battle over global warming you're on, that was blockbuster news last week. No, not the signing of the climate-change treaty that commits all of Earth's 195 nations to lowering their greenhouse-gas emissions and slowing the heating of the planet, but American Electric Power's announcement that it would no longer underwrite efforts to block renewable energy or federal smokestack controls in the United States.
    • Dec 17, 2015

Most Shared

  • World leaders set to meet in Little Rock on resource access and sustainable development

    Next week a series of meetings on the use of technology to tackle global problems will be held in Little Rock by Club de Madrid — a coalition of more than 100 former democratic former presidents and prime ministers from around the world — and the P80 Group, a coalition of large public pension and sovereign wealth funds founded by Prince Charles to combat climate change. The conference will discuss deploying existing technologies to increase access to food, water, energy, clean environment, and medical care.
  • Tomb to table: a Christmas feast offered by the residents of Mount Holly and other folk

    Plus, recipes from the Times staff.
  • Fake news

    So fed up was young Edgar Welch of Salisbury, N.C., that Hillary Clinton was getting away with running a child-sex ring that he grabbed a couple of guns last Sunday, drove 360 miles to the Comet Ping Pong pizzeria in Washington, D.C., where Clinton was supposed to be holding the kids as sex slaves, and fired his AR-15 into the floor to clear the joint of pizza cravers and conduct his own investigation of the pedophilia syndicate of the former first lady, U.S. senator and secretary of state.
  • Reality TV prez

    There is almost nothing real about "reality TV." All but the dullest viewers understand that the dramatic twists and turns on shows like "The Bachelor" or "Celebrity Apprentice" are scripted in advance. More or less like professional wrestling, Donald Trump's previous claim to fame.
  • Arkansas archeologist does his job, is asked to leave

    Amid Department of Arkansas Heritage project.

Latest in Ernest Dumas

  • Fake news

    So fed up was young Edgar Welch of Salisbury, N.C., that Hillary Clinton was getting away with running a child-sex ring that he grabbed a couple of guns last Sunday, drove 360 miles to the Comet Ping Pong pizzeria in Washington, D.C., where Clinton was supposed to be holding the kids as sex slaves, and fired his AR-15 into the floor to clear the joint of pizza cravers and conduct his own investigation of the pedophilia syndicate of the former first lady, U.S. senator and secretary of state.
    • Dec 8, 2016
  • Fake economics

    Fake news is a new phenomenon in the world of politics and policy, but hokey economic scholarship has been around as long as Form 1040 and is about as reliable as the news hoaxes that enlivened the presidential campaign.
    • Dec 1, 2016
  • China in charge

    Let's turn to foreign affairs to see how we might calm the flood of anxieties over the coming Donald Trump presidency.
    • Nov 24, 2016
  • More »

Visit Arkansas

View Trumpeter Swans in Heber Springs

View Trumpeter Swans in Heber Springs

Magness Lake, in Heber Springs, is a magnet for swans

Event Calendar

« »

December

S M T W T F S
  1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30 31

Most Recent Comments

  • Re: Reality TV prez

    • And while we're at it, Runner, the Wisconsin recount isn't finished yet, but as of…

    • on December 9, 2016
  • Re: Reality TV prez

    • In fact, Runner, Hillary Clinton won the popular vote by 2.7 million and counting, just…

    • on December 9, 2016
  • Re: Stay the course

    • Thank you Autumn. I agree that we can not compromise an inch on the value…

    • on December 9, 2016
 

© 2016 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation