There is something you need to know about your little state of Arkansas. It’s that we have emerged as quite the national laboratory on health insurance.
We are pioneers. People are watching to see how we make out in the wild frontier.
They are impressed with our political innovation and bipartisanship. They are amazed by our extraordinary constitutional requirement for the number of votes to pass an appropriation.
And they stand bemused by a legislative culture where a bill can get voted on day after day, and where a legislator tries to save a program by saying he hates it and will kill it next year when the time is better.
So Gov. Mike Beebe was in demand over the weekend as he attended the National Governors Association meeting in Washington.
President Barack Obama, in his traditional speech to governors, made a favorable reference to Arkansas and Beebe, who can survive it only because he is not running.
The Kaiser Family Foundation, a major health-care policy organization, invited Beebe to come by and meet with 40 reporters before C-SPAN’s cameras on the goings-on back home.
Our governor was asked: If Arkansas were to repeal after one year the private-option form of Medicaid expansion that put it in the national health-care policy vanguard, should other states that have been looking at the program assume the program’s failure?
Oh, no, replied Beebe.
This is a isolated fight in Arkansas requiring a nearly prohibitive legislative majority. It’s between pragmatists and ideologues, he said. The outcome of that battle won’t change the fact, he said, that the private option is working—that it is, in fact, a demonstrable success.
It is creating savings in the state budget. It is shoring up hospitals. It is putting younger and able-bodied people into the health-care exchanges and luring more carriers into our market.
It promises, if continued, to hold health-insurance premiums for everyone lower than they would be otherwise.
Why would Arkansas point the way, then abandon the journey itself? It might be only because Arkansas has a history of eccentricity and of not acting in its own better interests.
Also on Monday, a blogger for The Atlantic provided a takeout on the Arkansas private option with this theme: Arkansas appeared last year to be showing the nation’s other conservative states, about half of the 50, how to Republicanize the Medicaid element of Obamacare. But now, the blog said, Arkansas threatens to show the nation this year that even a credible bipartisan innovation cannot be allowed to work in this polarized environment, at least on the epic health-care issue.
The Atlantic blog item took a serious look at Rep. Nate Bell’s seeming contradiction.
Bell wants to save the private option now—because it would be immoral to end it abruptly for a hundred thousand people just signed up—but restrict solicitation of new enrollment. That is so that the number of people losing insurance when he and others kill the program next year won’t be significantly larger.
Apparently the immorality is the abruptness, not the jerking of health insurance.
It’s an Arkansas thing, one supposes.
Finally, Beebe told the Kaiser-assembled reporters that Arkansas has a federal waiver to pursue an eventually bigger idea than the private option. He referred to his payment-reform initiative that begins to move Medicaid payments to providers from a fee-for-service model to a basic cost for treatment of a condition and rewards good outcomes achieved within that cost.
In the end, Beebe said, his state’s taking the lead in changing the very way we pay medical bills will affect more people than our already famous private option.
So if your ears were burning Monday, there’s no need to go to the doctor and squander health-care dollars. It just means you were being talked about.
Meantime back at the Capitol in Little Rock: The furor over continuing the four-person staff for the lieutenant governor in the absence of a lieutenant governor has been settled satisfactorily.
After considerable discussions with Senate President Pro Tem Michael Lamoureux, the employees have agreed to resign effective at the end of the fiscal year June 30.
Lamoureux told me the four employees had been “classy” through the debate and that all in the world he’d been doing all along—while I and others assailed him—was trying to buy time to arrive at this very resolution.
I see no need to fuss with him further.
I hope that all four employees find compelling new work and achieve great happiness while reaping untold wealth.
John Brummett’s column appears regularly in the Arkansas Democrat-Gazette. Email him at email@example.com. Read his blog at brummett.arkansasonline.com, or his @johnbrummett Twitter feed.