This is compassion?

"We're a compassionate state," Gov. Asa Hutchinson said Sunday, perhaps forgetting where he was.

What happened last week suggested a decided lack of compassion in Arkansas, led by the governor himself.

The federal Health and Human Services Department told the Hutchinson administration to stop throwing poor people off Medicaid on uncertain income eligibility findings with only a 10-day period to object, and to grant 30 days instead.

Hutchinson responded with a tersely unpleasant statement about how he hoped this episode would represent the last "change in guidance" from the feds.

His administration responded formally by saying it could not apply the new federal edict retroactively to the 55,000 thrown off dubiously already. The state Human Services Department said its computers weren't smart enough to do that.

So maybe our kind hearts are being held hostage by this insurance-eating monster computer.

Or maybe we could figure out how to start over for those 55,000 if we really wanted to do it. Maybe a computer that can identify people one day can identify those people the next. And maybe the federal government should have ordered us to start over.

Well, there's no maybe about that. The federal government is as complicit as Arkansas on that point.

Apparently the feds were trying to keep Asa as happy as possible so he'll not be deterred in trying to save Medicaid expansion. And apparently the feds thought Asa's happiness would be disturbed if those 55,000 poor people got fair play extended to them over the objections of the burdensome right-wing base that Asa constantly seeks to assuage or finesse.

And maybe the federal government will yet order retroactivity, despite Asa's being on record as having endured just about enough of this dadgummed federal guidance.

If all of this is confusing to you, let me try to simplify: It's a clear-cut case of irresponsible meanness.

Arkansas got in a mad rush to throw people off Medicaid. The Hutchinson administration wanted to placate the right wing in hopes of getting the vital private-option form of Medicaid expansion renewed. Make it lean and mean and maybe the right wing will go along--that was the idea.

The state sent a first batch of 60,000 letters to people based on a difference exceeding 10 percent in their income as listed in Human Services records and Workforce Education records. Then it kicked most of those people off--based on that difference in agency records, not a credible or valid determination of income--if they didn't object in 10 days.

The process was so draconian that two big insurance carriers said they'd cover drug charges anyway for 30 days.

So on Thursday the Centers for Medicare and Medicaid Services sent the state a letter saying essentially as follows: Yes, it's true, we permit a minimum 10-day response period under federal regulations, but that's for individual income verification outside the usual renewal process. But what the state was doing in this case amounted to a mass renewal process, and, on those, recipients must get 30 days under different federal regulations.

So now the Hutchinson administration is planning to give the 30 days only prospectively. It's not proposing to do anything about those 55,000 who got purged under a system that the federal government has now determined to have been in violation of federal regulation.

So you have one set of 55,000 people who have lost health insurance based on unclear government records of their income and their failure to respond with clarifying data within a time frame the federal government declares is too short under the relevant regulation.

You have a different set of tens of thousands who haven't yet received their notices and will now get 30 days.

Is there a lawyer in the house?

Couldn't someone work up a lawsuit here in behalf of the first 55,000? Couldn't it argue that they were treated unequally under the law or without due process of law? Couldn't a lawyer handling such a suit call as his first witness the federal government?

The Hutchinson administration stresses that any of those 55,000 may still object up to 90 days under a federal rule allowing after-the-fact appeals.

That's true. It's also true that a lot of poor people--a lot of people generally--aren't well-equipped by time or expertise to fight proverbial city hall.

Meantime, the Hutchinson administration fears that the federal government's action of last week could make it harder to persuade conservative legislators to go along with the governor's scheme to continue the private option.

Hutchinson proposes keeping the private option into 2017 only with new conservatizing "flexibility" granted by a waiver from the same federal government acting in this case without flexibility.

But at some point you need to turn from politics to policy. Sometimes you must take the pacifier out of the right wing's mouth and simply do the right thing in the matter before you.

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John Brummett's column appears regularly in the Arkansas Democrat-Gazette. Email him at jbrummett@arkansasonline.com. Read his blog at brummett.arkansasonline.com, or his @johnbrummett Twitter feed.

Editorial on 09/01/2015

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