Yesterday afternoon, in an act of courage, Congressman Rick Crawford released a stellar press release condemning the “private option” or the “Arkansas Medicaid plan.” Crawford — who I have sometimes disagreed with in the past — could not be more right on this issue. In his release, he said:
In my view, the current un-winnable situation in which state legislators find themselves will become significantly worse if they set up a government-funded private insurance program and are forced to pull it back in a few years after the entire provider system has plugged into it. Perhaps a better approach would be to petition Congress to delay ObamaCare for two or three years and ask the hard question – isn’t it the height of recklessness to add $1.3 trillion in new entitlement spending in the middle of a debt crisis? I encourage all state legislators who are concerned about our nation’s debt crisis to set aside the Arkansas Plan and call on Congress to delay the multi-trillion-dollar ObamaCare entitlement program.
Delay Obamacare? Hmm…where have I heard that suggested before?
All kidding aside, Congressman Crawford is right: Obamacare, which is crumbling, should be rejected by the legislature, not embraced with open arms. And the legislature has the ability to do this. Despite what some lawmakers are saying, the decision of whether or not to expand Medicaid rests solely with them. The governor can talk all he wants but he cannot make this decision — they hold the purse strings and the power to block this massive expansion of government in Arkansas.
Crawford emphasized that the so-called “private option” can “only receive temporary approval at best.” This is a vital point: as I reported earlier this week, the Department of Health and Human Services has now said in an official memo that the waiver for the private option will expire in 2016 and “may or may not” continue from that point forward. At that point, Arkansas lawmakers will be forced to 1. End the program and kick hundreds of thousands of people off of the rolls or 2. Raise taxes to pay for the skyrocketing costs. It’s not hard to imagine what path they will choose.
SPEAKER CARTER’S REACTION
Notably, Arkansas House Speaker Davy Carter (and Senate President Michael Lamoureux) announced their endorsement of the “private option” yesterday. This is more than a little bizarre, because many of the details of the private option remain hidden, and the HHS memo pretty well demolished the notion that the plan is much different than regular Medicaid expansion. When the federal government admits something isn’t going to save us money, that’s a pretty damning verdict.
So when Congressman Crawford blasted the private option in his statement, perhaps Speaker Carter took some offense. After all, who could be against a glorious plan that will cost Arkansas only $2 billion over the next 10 years? He issued this statement to Talk Business in response to Crawford’s release:
The U.S. Congress gave us ObamaCare. The Arkansas legislature has led the fight against ObamaCare and turned a losing hand into a winning one. A vote for the private option in Arkansas is a vote against ObamaCare.
A vote for the private option in Arkansas is a vote against Obamacare? Did he really say that? Who is running the Speaker’s communications operations over there? How can the Speaker argue that a vote to (a) embrace a key component of Obamacare, (b) set up Obamacare exchanges through which federal funding will flow through, and (c) trigger Obamacare funding from the federal government is a vote against Obamacare?
HOW TO DO THINGS WITH WORDS
I think the Speaker’s comment illustrates a difficulty we have seen throughout this entire “private option” debate: its advocates have chosen to use everyday words in highly unconventional ways. For instance, Speaker Carter has said that the private option will “save Arkansas money!” Well sure. We can save $670 million (supposedly) if we spend $2 billion — which, by the way, still costs more than doing nothing. Speaker Carter has said this plan is a “free-market approach.” Well, yeah — in the same way that farm subsidies are a free-market approach to farming.
Among the many questions this kind of sloganeering raises is this one: If a vote for the private option is a vote against Obamacare, is a vote against the private option a vote for Obamacare? Regrettably, when politicians decide they are entitled to use private definitions of public words, they can say just about anything they want to. Speaker Carter’s comment isn’t analysis — it is just rhetoric that is dissociative and unsettling.
It is just a little too reminiscent of 1984’s Winston Smith — the protagonist of George Orwell’s dystopian fantasy — whose job it was to serve as an official historical revisionist. Smith was tasked to rewrite old newspaper articles so that they conformed to the current party line. The refrain that “we have always been at war with Eastasia” floats through Orwell’s novel like an off-key chorus:
Actually, as Winston well knew, it was only four years since Oceania had been at war with Eastasia and in alliance with Eurasia. But that was merely a piece of furtive knowledge, which he happened to possess because his memory was not satisfactorily under control. Officially, the change of partners had never happened. Oceania was at war with Eurasia: therefore Oceania had always been at war with Eurasia. The enemy of the moment always represented absolute evil, and it followed that any past or future agreement with him was impossible.
That of course is from the first part of the book when Smith’s country had always been at war with Eurasia. Later on, things changed and Smith was required to explain that his country had always been at war with Eastasia — this phenomenon is commonly referred to as “revisionist history.” I understand politics sometimes demands people say silly things. The conclusion is that sometimes politics asks too much.
THE BOTTOM LINE
The bottom line is that expanding Medicaid, whether it’s through the classic expansion model or whether it’s through the “private option,” is implementation of Obamacare. It’s as simple as this: if we didn’t have Obamacare, we wouldn’t even be having this debate. Expansion is a fundamental part of that law; if Arkansas lawmakers go along with it, they are embracing it, not rejecting it. This is a sad reality, and it’s a tough pill for some of us to swallow. After all, many Republican candidates campaigned on opposing the implementation of Obamacare in Arkansas. Now they’re embracing it. I don’t think saying “By the way — the election promises we made? In 2012? We were just kidding!” is going to fly.
In three years, when the Medicaid private option waiver vanishes and Arkansas is stuck trying to figure out how to grapple with hundreds of thousands of new enrollees hanging in the balance, many Arkansans may not remember Davy Carter — he will, perhaps, have vanished into the political sunset. But Arkansans will remember Obamacare: they will face it every day in the form of higher taxes, low-quality health care, and mountains of new bureaucratic regulations. How unfortunate, then, that short-time lawmakers want to throw Arkansans headlong into this monstrosity that will have repercussions for generations, long after they are safe from the political consequences.
If you’d like to learn more about the “private option,” please join us and the Advance Arkansas Institute for a series of town hall meetings next week. To find the town hall meeting closest to you, please visit AdvanceArkansas.org.
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