State to misleadingly tell poor Arkansans their health coverage is going away, but that's probably not true | Arkansas Blog

Wednesday, March 25, 2015

State to misleadingly tell poor Arkansans their health coverage is going away, but that's probably not true

Posted By on Wed, Mar 25, 2015 at 10:16 AM

COPELAND: Passes bill to send misleading letter to poor Arkansans.
  • COPELAND: Passes bill to send misleading letter to poor Arkansans.
I wrote yesterday about Rep. Donnie Copeland's silly, cruel, pointless, mean-spirited, misguided bill to send a letter to private option beneficiaries telling them that their health coverage is ending Dec. 31, 2016. Has there ever been a more perfect example of lawmakers' yen for meaningless posturing over sensible policymaking? Well, no surprise, it passed the House yesterday 81-19. It's on to the governor, who will sign it into law. 

As I explained yesterday, it makes no sense at all to send a letter telling folks that their coverage is going to end before the first meeting of a Task Force specifically tasked with coming up with a plan to continue coverage. The notion that this is going to help anyone "prepare," as the governor's spokesman suggested, is nonsensical. We don't yet know what the options will be! (And in a scenario in which people's coverage is snatched away and no options are offered, I'm not sure what poor Arkansans are supposed to do to prepare — they'll lose their insurance and the state's uninsured rate will double overnight).  

One point worth elaborating on is that in fact it's highly unlikely that Copeland's threat will come to pass. Leave aside that newly elected Gov. Asa Hutchinson and the overwhelming GOP legislative majority could have ended the private option's coverage expansion and chose not to. Leave aside that Hutchinson's proposal for the future and the legislation that enacted it both explicitly state that the goal is to maintain coverage. Just think about the politics for a moment. By 2016, there will almost certainly be significantly more than 250,000 Arkansans with health insurance via the private option. Perhaps more than 300,000. By that point, hospitals will have saved hundreds of millions in uncompensated care. Taking that away isn't going to get easier, it's going to get harder.

The Task Force is aiming to make recommendations by the end of this year. Presumably, any significant changes (whether repeal or replace) would require a legislative special session in 2016. Copeland's plan is to send absolutely meaningless and confusing letters now, okay. But if the legislature actually ends the coverage expansion, hundreds of thousands of letters would go out in October of 2016, an election year, canceling people's plans. Read that last sentence again. Does that seem like an outcome skittish politicians are likely to enact?

It's also worth noting that while hardcore Tea Party activists and their stalwarts in the legislature simply want to end coverage — they have a philosophical opposition to government spending on safety net programs for the poor — plenty of anti-private-option GOPs have stated that they want to establish a policy that will cover these folks, just not the private option. Lawmakers such as Sen. Jim Hendren, Rep. David Meeks, Rep. Joe Farrer, and Rep. Bob Ballinger have publicly and vociferously claimed that their aim is to develop an alternative that won't leave current beneficiaries out in the cold. Farrer has stated numerous times over the last two years that he is developing an alternative plan (it never arrived) and when I specifically asked him whether this alternative would cover everyone covered by the private option, he said yes.  

Now, obviously, the fact that the magical alternative plan to cover everyone never, ever arrived is telling. They'll have their chance with the Task Force, with a deadline fast approaching, and we'll see what happens. But the thing I want to highlight is that their rhetoric is different from some of their fellow aginners. Sen. Bryan King, for example, and the activist base hollering on social media, want to kill the private option because they want to end the coverage expansion. They sneer at the notion of, as they would put it, welfare for able-bodied adults. Hendren, Meeks, and co. — the sort of folks that will be the key votes for a new policy — appear to be comfortable with the idea of universal coverage, but say they don't like the the private option. There's no doubt that the private option will have a new name and some new policy parameters, but there's really no evidence that the legislature is prepping a compete elimination of coverage, as Copeland's letter will misleadingly suggest. 

So not only is Copeland's letter incomplete, it's likely completely wrong. Its only purpose will be to gratuitously confuse and scare beneficiaries. It's worth noting that it doesn't even serve the ostensible goals of Copeland, a diehard private option opponent. His bill makes it no more or less likely that the Task Force will end the coverage expansion. It does no damage to the prospects of coverage going forward. It is not legally or morally meaningful in terms of what actions the legislature takes next. It does not help beneficiaries cope with the possibility that the legislature will snatch their insurance away. It will not make beneficiaries any less furious and heartbroken if the legislature snatches their insurance away. It will provide no cover for lawmakers should the legislature decide to do so.  It will tug at the heartstrings of exactly no one for lawmakers to whine, "we sent them a letter, they should have known." It does nothing but stroke the ego of lawmakers wanting to erroneously brag that they killed the private option. 

It does nothing, that is, except create a small burden — an alarming letter out of the blue — on the people in this state with the least political clout. It's the sort of misguided policy that a smug, out-of-touch politician like Copeland comes up with that has small repercussions he'll probably never realize — perhaps a family confused by the letter fearing that their coverage is gone now and not going to get the care they need. In the grand policy scheme of things, the very meaninglessness of Copeland's bill renders it harmful in only a relatively minor way. It's small. But it is precisely in the bill's smallness — in its petty void — that we see the smallness of our elected officials. 

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