Tuesday, March 04, 2014

EDITORIAL >> Only took five votes

Ordinarily, it would not be necessary to praise a huge majority of lawmakers, Republican and Democrat, who acted out of compassion for fellow humans or just practical wisdom. What else, after all, do you expect of your representatives?

But the House of Representatives’ approval yesterday of an appropriation to pay for medical services or long-term care for the poor, disabled and the elderly deserves just such a commendation because Arkansas’ crazy Constitution gives the advantage to a small minority who don’t follow such principles.

On its fifth vote—count ’em, five—the House approved the appropriation for the Department of Human Services, 76 to 24. The common interpretation of a confusing amendment adopted at the depth of the Great Depression is that the appropriation needed the votes of at least three-fourths of both houses—75 in the House—rather than a simple majority, which is all that is needed to pass laws that can take your life, freedom or property.

The House finally rose to the occasion, thanks to constant prodding by Speaker Davy Carter (R-Cabot). A small number of legislators tried to block the appropriation because it would spend federal money in Arkansas in a way that the widely hated (in Arkansas) President Obama wanted.

Yes, their argument also was that the spending might bankrupt the federal government and cause Arkansas to have to find lots of money in a few years to pay its small share of the cost of health insurance for upwards of 200,000 Arkansans whose income is so low that they cannot buy health insurance.

But the facts were not with them on either point. Obamacare, as the health-reform law is known, will reduce the deficit in the years ahead rather than enlarge it because of the savings in existing medical programs and the taxes on high incomes, pharmaceutical companies and medical-equipment makers. The government will no longer have to reimburse hospitals with high charitable expenses or pay the current huge subsidies to insurance companies that sell Medicare HMO plans.

By picking up some current Medicaid expenses, Obamacare gives Arkansas an extra $89 million starting this year as a leg up on the state’s share of Medicaid costs, which will be 5 percent in 2017 and 10 percent forever after 2020. When hundreds of millions of dollars are flushed into the Arkansas economy by Obamacare, it will generate millions in new revenues for the treasury. If the legislature doesn’t give all that money away in tax cuts or to other programs and pet projects, it will be there in 2017 and thereafter to meet Arkansas’ small share of caring for its people.

What drove most of the legislators, including many of its most rigid conservatives, to vote for the appropriation was the consequences of not doing it. The state would lose that $89 million a year in federal assistance, and it would have to make it up through higher taxes or drastic cuts in other services. The state’s community hospitals, including our own, would find themselves in dire straits on July 1, unable to bear the staggering cost of charitable care, which would be far greater than before the passage of the Affordable Care Act. The state medical center would be in grievous financial trouble.

It bears noting that the 24 representatives were not just voting against a piece of Obamacare but against appropriations for nursing homes and the lion’s share of revenue for the Arkansas Children’s Hospital. Unless an emergency remedy were found after the appropriation failed, they would have closed. Hospitals across the state were pleading for legislators to support the bill. So were medical groups, chambers of commerce, advocacy groups for the elderly like the American Association for Retired Persons.

That does not consider the most important group of all, the 125,000 or so working men and women who will have enrolled in insurance plans by the end of this month and who would suddenly be without insurance again on July 1 if the 24 naysayers had prevailed and got another two to join them.

Rarely has the well-being of so many people been at the mercy of a handful of lawmakers on one bill. It must be remembered that the legislature voted overwhelmingly last year to offer health insurance to every citizen of Arkansas who needed it but couldn’t afford it on their own without some help. That is the law of the land. To have failed to release the money already available to meet that promise would have been to say, “Hey, we were just kidding. The joke is on you.”

It should not be necessary, but we are compelled to say to the big majority, thanks for being responsible.