Arkansas is the perfect place to try out this new health trend. Read all about the what, why, where and how here.
At press time, a Senate vote was still up in the air, but the thinking was that senators would join the House in its momentous approval Tuesday of Medicaid expansion by a 77-23 vote.
The vote passed a $5 billion appropriation bill for the Department of Human Services, a good billion of it in the form of extra money provided by the Obama administration's Affordable Care Act for states willing to expand the pool of people covered by Medicaid. Obamacare, in other words.
What's that I say? The new Republican legislative majority, most of them elected on a platform of revulsion toward the president and Obamacare, voted to accept Obamacare? Yes they did, as many in the holdout group of 23 Republican opponents took pains to point out.
Some pragmatic Republicans took the lead in shaping a Medicaid expansion pitched as a far superior "private option." Arkansas will privatize Medicaid expansion, using federal money to buy health insurance from private insurance companies. The remnant core Medicaid program for the elderly and disabled will be cut back. Various bits of complementary legislation will advance the (largely unsupported) Republican belief that the medical program for the poor is wastefully run and rife with fraud.
If the federal government can't sustain the money to continue its support of this state expansion, Arkansas can drop out. It will be left with a residual Medicaid program even less sufficient for the needs of the working poor than it already was. Thus this legislation is a win/win for Republicans, except to those principled teabagger holdouts who simply don't want to expand government programs, whether the feds are paying or not, whether it's good for people or not.
The political fallout is all good for Republicans. They get all the federal money with none of the guilt because they can claim they made a bad proposition better. The money will free hundreds of millions in Arkansas revenue for other state purposes, first among them a tax cut mostly of benefit to rich people.
Though the measure couldn't pass without the 49 Democrat/Green votes, it looks for all the world like a Republican victory. Which it was. Democrats (and liberal columnists) were instructed to shut up, lest their enthusiasm discourage Republican votes. Gov. Mike Beebe agreed to anything that Republicans like Rep. John Burris and Speaker Davy Carter wanted.
Davy Carter? It was a huge victory for the speaker, who used all the Democrats, Burris and a handful of Republicans to be elected speaker over the expected coronation of Rep. Terry Rice. His effective, determined leadership makes his rumored plans to run for governor all the more real. Use Obamacare against him? With 28 of 51 House Republicans on his side? They also happened to be the most intelligent and effective of the Republican caucus. Conservative to a lamentable fault, yes, but generally not the type searching the sky for black helicopters to potshot with their openly carried shooting irons.
Carter can run as a guy who gets things done. He'll face some grumbling from the hard right in a Republican primary against Asa Hutchinson. But Hutchinson, three times a loser in statewide races, is old news. Also, he is often confused with a brother who lost a U.S. Senate race amid a messy personal life, not to mention a nephew with a recent girlfriend problem. He is the NRA poster boy for more guns in schools. But will the Republican primary really be about guns? This legislature, under Carter's leadership, has passed just about every gun-friendly piece of legislation imaginable.
Who'd have thought Davy Carter, and several other Republicans, would go into an election cycle claiming credit for an unprecedented expansion of a government entitlement program? I bet they won't call it Obamacare.
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