Governor Beebe and Davy Carter, the speaker of the Arkansas House of Representatives, rushed yesterday to get out statements claiming bragging rights for a bit of national good news for the state: Arkansas leads the nation in reducing the number of people who are not insured for sickness.
That is a significant development because for the length of its history Arkansas has trailed the rest of the nation on measures of health and health care.
The news is a survey by Gallup, the national polling firm, that showed Arkansas in the past year had the sharpest percentage drop in the number of uninsured people, followed by Kentucky. A year ago in June, 22.5 percent of Arkansans had no insurance. This June it’s down to 12.4 percent. Arkansas had one of the highest rates of uninsured in the country, so it had further to go. Nevertheless, it’s dramatic and it’s something that the political leaders who had anything to do with it can be forgiven for bragging about.
But to complete the picture, we need to mention two other matters. (1) Beebe and Carter are leaders of the opposing parties, Democratic and Republican. (2) Neither of them uttered the word “Obamacare,” which is the reason for the dramatic improvement in health coverage.
To ignore that little fact is a little deceptive and some would say hypocritical. But we are willing to give Beebe and Carter a pass. No politician in Arkansas—well, almost none—wants to say a kind word about Obamacare because, if he or she happens to be running for office, it may get him or her beaten. Ask Sen. Mark Pryor, who was unopposed six years ago with sky-high approval ratings and has done nothing different since then except to cast a vote for Obamacare.
Beebe’s statement did mention the official name of Obamacare: the Patient Protection and Affordable Care Act of 2010, but he mainly boasted about the “private option,” the name legislators and the governor applied to the state legislative act last year that implemented the biggest part of Obamacare: extending Medicaid to adults whose incomes are so low that they cannot afford any part of the premiums for private insurance. Carter boasted of the “private option.” He didn’t go as far as Beebe mention that it was a part of the Affordable Care Act, much less the hated “Obamacare.”
But that is what it is, and everyone should be honest about it. We predict that most everyone will after this November, when Republicans are counting on winning a lot of races by running against Obamacare and the president who said it was fine with him for people to call the act of Congress Obamacare.
Speaker Carter, who provided key leadership in getting an overwhelming majority of the legislature to embrace the central feature of Obamacare and call it something else, noted that 176,000 Arkansas adults who formerly were uninsured have enrolled in the Medicaid plan and another 8,000 who have applied but not yet approved will soon be added to the rolls. He might have added that 40,000 who earn too much to qualify for Medicaid had bought insurance in one of the Obamacare plans by April.
By next spring, some 250,000 or more Arkansans will have insurance through Obamacare and the percentage cited by Gallup, 10.4 per cent, will fall to 7 percent or less. That is in spite of the legislature’s enactment of a law in February that prevents the expenditure of even a dollar of federal money to help Arkansans enroll. Enrolling in insurance, as everyone in America knows, is extremely complicated because people have to choose among a variety of plans and also calculate the premiums they will have to pay after offsetting the tax credits that Obamacare makes most of them eligible for. But the legislators, or the minority of them who had the upper hand when the roll was called, wanted to make it as hard as possible for people to enroll so that Obamacare would not be seen as much of a success.
Now, a number of other states controlled by Republicans are looking at the Arkansas plan, which is to have people buy insurance, with federal dollars, in the private Obamacare market rather than simply enroll directly in the government program. Ultimately, Arkansas will have to pay a lot more for this kind of coverage because private insurers pay hospitals and doctors more than Medicaid and Medicare do and the insurance companies have to cover their overhead and make a profit. But the health-care providers and the patients, too, are happier with the more expensive private option. Not to mention the insurance companies. So, we think it is worth the extra cost.
Neither the governor nor the speaker mentioned the other developments on this front. Arkansans who already had health insurance shared in the $330 million sent to policyholders as rebates this spring because the insurance companies did not spend at least 85 percent of the premiums they received on health-care payments. Obamacare forced them to do that. Since Jan. 1 tens of thousands of Arkansans who were already insured have learned that their insurers can no longer halt coverage, briefly or forever, because the patients have reached the limits of their coverage, but most of them do not know that Obamacare is responsible.
Obamacare—at least its private marketplace—is a nightmare to administer, as everyone from the president down now knows and as lots of people predicted as long ago as the 1970s when it was the Republican plan for universal health insurance. It’s time to give this nightmare some grudging acknowledgment. It’s doing what it was supposed to do: get nearly every American covered, protect policyholders from the vicissitudes of commercial coverage, and halt the forever skyrocketing cost of medical care. You’ve noticed, no doubt, that medical inflation has almost flattened since 2010.
