Fun with numbers
The shell game goes on and on and on …
NATIONAL administrations may come, national administrations may go, but self-interested bureaucrats we will always have with us. This time an outfit based—where else?—in the nation’s capital of waste, fraud and taxpayer abuse says the Republicans’ proposed replacement for Obamacare will mean the end of the world as we know it. Or at least an end to doctor visits. But the more we look at the so-called Graham-Cassidy plan, the more it looks as though the thing could pass, and the sky would stay right where it’s located.
As is probably obvious by now, Obamacare was just one step—a large step—toward national health insurance, Medicaid for all. For proof, see all the Democrats getting on board Bernie Sanders’ call for a single-payer system. By 2020, it’s said, any Democrat not promoting a European-type health care program need not apply in the presidential primaries. If there is going to be any stall in the works, any obstacle at all, it might be found in the Graham-Cassidy bill. It’s promoted as a major reversal in the government takeover of health care.
Graham-Cassidy would repeal the individual and employer mandates of Obamacare, and turn the federal funding for Medicaid expansion (and those subsidies) into a block grant program to the several states. And according to that font of right-wing, conservative talking points—that is, CNN—the bill “outsources many of the toughest decisions about health care—what to prioritize, how to regulate the marketplace and cover health care for the poor—to the states.”
Why, sure. That should have been the case all along. Arkansas doesn’t have the same issues with health care that Maine might have. Why not allow these 50 laboratories of democracy to do their thing?
Speaking of state authorities, the Hon. and honorable Asa Hutchinson, this state’s chief executive and budgetcutter, isn’t buying the prediction that Arkansas would be in critical condition without Obamacare. He continues to support the proposed Graham-Cassidy health-care reform that would cut handouts to 34 states, including Arkansas plus the federal District of Columbia, by some $294 billion over the next decade. Which would amount to a big gain for the American taxpayer. And also for the principle of letting states discover for themselves which reforms work and which don’t. Why not use the various states as test cases instead of relying just on theory?
The usual cadre of campaigners for providers of health care in this state argue that more Arkansans will lose the health-care insurance that these very groups sell the state. There oughta be a law against this kind of misleading merchandising and there probably is.
On Friday, the governor’s office put out a statement that, as is habit with this governor’s office, made a lot of sense. It answered many questions.
For example: Will the block grants from Graham-Cassidy expire after 2026?
Maybe. But that doesn’t mean Congress can’t reauthorize funding, which it does all the time when these deadlines approach: “There is no reason to believe future Congresses and Administrations will act any differently in their approach [for] this new block grant program… .”
Will those with pre-existing conditions still be protected? According to the governor’s office: “Absolutely.”
The bill allows states to waive “certain provisions” in Obamacare, but “the statute clearly states that a Governor seeking such a waiver would have to show an alternative plan to provide” for those with pre-existing conditions.
Will Arkansas lose federal money with Graham-Cassidy?
This is stickier. The answer is yes, but.
Yes, but the American taxpayer—that is, all of us—will save money as spendthrift states like California and New York are put on a budget. Yes, but this bill doesn’t require a state match for Medicaid expansion, not 5 percent, not 10 percent, so this would save Arkansas up to a billion dollars in a five-year period. Yes, but Arkansas’ leaders will have the flexibility to find savings where they can, and set their own spending priorities.
Instead of commiserating with the supposed losers in this great healthcare lottery, maybe it’s the winners—the American taxpayers—who should be congratulated on the emerging shape of things to come in federal and state policy. Just maybe Washington can yet change its wasteful ways—or be obliged to do so by the American taxpayer and voter. Those states that chose not to expand Medicaid during the coming decade (2020 through 2026) like Texas, Georgia, and Mississippi might be the big winners. Honesty, it seems, might indeed prove the best policy.
POOR FOLKS who are also old and disabled, as if they didn’t have enough troubles, would also catch a break under the GOP’s reforms.
Meanwhile, if things stay the same, four states—California, New York, Massachusetts and Maryland—will continue to receive 37 percent of Obamacare funding. With about 22 percent of the nation’s population.
Altogether the Graham-Cassidy bill sounds like a win-win approach to a problem that’s been over-hyped by those who stand to profit by it, and who don’t mind American taxpayers sending money to blue states.
In the end, let’s reform where reform is needed. And when it comes to Obamacare, it’s most definitely needed. All need to resist panic and just keep rowing toward the finish line. Here’s wishing all smooth sailing in these troubled seas called repeal and replace.