Arkansas is the perfect place to try out this new health trend. Read all about the what, why, where and how here.
Is there greater conservative virtue in opposing federal health reform, period, or in saying it ought to be implemented locally instead of from Washington in the event we are unavoidably laden with it?
That is to ask: Is the greater conservatism in obstruction or pragmatism?
I think national Republicans answered that already in the debt-ceiling fiasco. And the question seems not to give the least pause to Arkansas Republican legislators, and they, after all, know the right wing best.
They choose the option I wouldn't — obstruction — but, then, I didn't sweep into office in a Tea Party revolt last year based mostly on fear of this health care reform law.
Their choice is to oppose federal health care reform at all cost, period, across the board, even if that effectively cedes to the federal government an eventual authority that could have been the state's.
Gov. Mike Beebe is a consummately moderate Democrat worried about some elements of the federal health care law but favorable to having the state run whatever part it may. And he got his back up over this last week.
He decided to let the Republicans have it their superficial and obstructive way.
Beebe said he would not exercise his executive authority to seek and receive $3.8 million in federal aid so the state Insurance Department could plan for state-created health insurance exchanges as mandated by 2014 in the new law.
If states don't exercise the option, the federal government will design and install these exchanges containing private health insurance plans under government parameters that would augment the usual choices in the private sector.
Leading Arkansas health insurers like Blue Cross-Blue Shield and Delta Dental had called on the governor to secure the planning money. They like the profitability possibilities of participating in the exchange but would rather deal with state politicians close to home instead of the federal government. They think it's high time to plan what will be a complicated undertaking.
Beebe balked after several Republican legislators sent him a letter saying they were against receiving this federal grant because there was no urgency and, anyway, what they call "Obamacare" may be thrown out by the courts.
Even so, they wrote, the federal government will give the exchange to the states after a year.
Maybe, the governor's people say, but only by federal rules and probably with some cost to the state.
I'm told that Beebe believes the politics of all this could play to the benefit of Democrats and to the detriment of Republicans.
He thinks "local control" could resonate, especially when sought by the relevant and affected private sector, including, tentatively, the powerful lobby known as the Arkansas State Chamber of Commerce.
The chamber president, Randy Zook, told me last Thursday that the chamber isn't certain there is an urgent need to take planning money right now. But he said that, in the larger picture, the chamber wants any newly mandated health care exchange to be designed by the state, not federally.
Zook may be right about the timing and Beebe wrong about the politics.
As Zook indicates, the state could still pursue federal planning money in December and the "drop-dead date," a state insurance official told me last week, is not actually until June. Beebe's decision last week was not the end of it.
Beebe's calculation that the state's voters might rise up against Republican obstruction of local control assumes — incorrectly, I regretfully suspect — that wide and superficial fear of federal health care reform won't continue to prove more powerful.
For all his job approval, Beebe remains an agent of effective government in an era when people don't seem to be believe in such a thing.
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