JOHN BRUMMETT: Asa explains it all

Editor's note: This is a revised and updated version of an item first appearing Monday on the columnist's blog.

Gov. Asa Hutchinson had me out to the Governor's Mansion at noon Monday for a knuckle sandwich.

I mean a BLT from Community Bakery.

The purpose was for him to lecture me on my recent column assertions that he can't claim on the one hand to abhor and want to repeal Obamacare while relying desperately on it on the other hand to make his state budget work.


"What's amazing to me is that you've aligned yourself with Conduit for Commerce," he began.

Conduit for Commerce is an extreme right-wing anti-government group that is promoting Republican primary opponents for Republican legislative supporters of the private-option form of Medicaid expansion.

"They are going around saying you can't support 'Arkansas Works' [his proposed new name for a conservatized private-option form of Medicaid expansion] without embracing Obamacare, and now you're making their case for them by saying the same thing every day," he said.

Not exactly. That right-wing outfit is saying you can't support Medicaid expansion without embracing Obamacare, and that Obamacare is awful.

I'm saying you can't support Medicaid expansion without embracing Obamacare, and that Obamacare is great. Well, it's starting to work, and is set up to work better as we go along.

So here is the governor's position:

He inherited the "private option." He did not start it. He was immediately faced with a budget based on its federal money and the prospect of pulling the rug from 200,000 people newly favored with health insurance.

So he accepted it, provided we would end it in its current form and seek federal approval to do it differently after 2016.

Would he have gone along with starting the private option in the first place had he been governor when Mike Beebe was getting it done with Republican legislative moderates?

The governor grinned and said that was a speculative question he didn't have to answer.

He said it is entirely "logical and rational" for him to make the best decision for Arkansas in the context of the landscape confronting him. And he said it is entirely logical and rational for him to oppose the individual mandate and employer mandate of Obamacare--which amount, he said, to affronts to "freedom."

But ... he is favorably inclined to replacing the Medicaid-expansion element of Obamacare with some kind of block grant to states that gives states enough money and full flexibility to insure people now insured--meaning the 200,000 on Medicaid expansion in Arkansas.

Was he saying he didn't want Obamacare but did want all of Obamacare's money without any strings attached?

He said he wasn't locking himself into any definitive sum.

What it comes down to is that Asa's position is that he doesn't want Obamacare but he does want enough federal money to let Arkansas do something akin to Medicaid expansion as it chooses.

Hutchinson believes the state should refer Medicaid-expansion clients to job-training programs. He believes a recipient with an income between 100 percent and 138 percent of the federal poverty level ought to pay a part of his premium. And he thinks a Medicaid-expansion recipient working for a company offering a health-insurance plan ought to take that plan rather than go on the state Medicaid plan.

That reminded him: He objects to my calling these changes "cosmetic." He asked: If they were purely cosmetic, why would he be required to apply for a formal federal waiver to do them?

They could be sufficiently cosmetic that the waiver will be easily won.

Finally, the governor made the point that his position was not that much different from that of Beebe, who always said he was not crazy about Obamacare but was sure-enough crazy about getting heaps of federal money to expand Medicaid.

I will concede this much to the governor: It is not entirely contradictory to want to repeal Obamacare--mistake though that be--while wanting to keep the Medicaid-expansion money in a new form to spend in your own way, presumably to keep the Medicaid-expansion population covered.

It's trying to have things both ways--your political way, because the easiest currency in Arkansas politics is to assail President Barack Obama and the Affordable Care Act, and your financial way, because the easiest money for affording tax cuts and the diversion of general revenue to highways is to keep taking hundreds of millions for health insurance from the federal government.

At least we have a Kasich-like Republican governor whose exhausting finesses are intended to keep poor people insured and state government flush amid a toxic climate on the governor's own right flank.

The governor asked me to try not to be so cynical.

But I'm not cynical. I'm confident Obama is nobly trying to do the right thing on health care, if only the Republicans and the states will let him.

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John Brummett, whose column appears regularly in the Arkansas Democrat-Gazette, was inducted into the Arkansas Writers' Hall of Fame in 2014. Email him at jbrummett@arkansasonline.com. Read his @johnbrummett Twitter feed.

Editorial on 02/18/2016

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