Our history affords few better examples of low politics subverting the public interest than the successful Republican drive to force 200,000 Arkansans to buy their health insurance through a federally regulated market rather than one set up for them in Arkansas.
It will require people almost certainly to buy more expensive insurance than they could get from an Arkansas exchange and make protection from unscrupulous insurance agents and companies harder to find and correct.
But those little inconveniences were secondary to making President Obama look bad, which was the game. Anything that could be viewed as stymieing a part of the new national health-insurance law was good, no matter what the actual consequences on people might be.
The Patient Protection and Affordable Care Act, which Republicans like to call “Obamacare,” requires individuals and employers with more than 50 full-time workers to acquire insurance starting in January 2014 or pay a small tax. Their medical bills now are typically passed on to everyone else who is insured through higher premiums and, of course, to the government. A national insurance exchange will be set up where people and employers can shop for a private insurance plan that is affordable and suits their needs.
But the law allows states if they wish to create their own insurance markets. It makes perfect sense for Arkansas to do so because insurance companies should offer less expensive plans for Arkansans since medical costs are lower than in most of the nation and they can make a profit even while collecting lower premiums. The government will subsidize the premiums for families with low to middle incomes.
Since the state Insurance Department rather than the U.S. Department of Health and Human Services would regulate the plans sold through the state exchanges, consumers would have a place to go to get speedier relief.
But the Republican contingent in the House of Representatives stood shoulder to shoulder to prevent the state from setting up the exchange. The state Constitution requires three-fourths of each house to vote for most appropriations—no other state in the country gives a small minority control over taxing and spending—and the Republicans united to keep the appropriation for the Insurance Department from passing. If the legislature failed to pass an appropriation for the agency, it would go out of existence on July 1 and insurance companies could no longer do business in Arkansas. That would be a major catastrophe, and even the Republicans knew it.
The Republicans threatened to do just that unless the rest of the legislature killed Gov. Beebe’s bill to authorize the Insurance Department to start setting up the Arkansas exchanges. When the sponsor of the bill finally pulled it down Thursday, the Republicans juvilantly went along and passed the appropriation.
They claimed a great victory. They said they had delayed implementation of “Obamacare,” their name for the law written by Democrats in the Senate and House of Representatives.
But they delayed nothing. It merely means that there will not be an Arkansas exchange and that people in this state who are uninsured will buy plans from Blue Cross, Aetna or another company that are designed for a national market, including high-cost centers like New York and Boston, rather plans formulated for the Arkansas medical market.
A setback for President Obama? Hardly. No one knows but he probably is happy for Arkansans to patronize the federal exchange.
Gov. Beebe was mystified that Republicans would celebrate strengthening the federal government’s hand in health care in Arkansas. It may be a political victory for the Republicans, if they are correct in believing that people are too busy or dense to understand what was done to them.
For Arkansas people who need medical insurance, it is a decisive defeat.
