Every serious study so far says Arkansas can provide expanded medical coverage to 250,000 more citizens at no increased cost in state general revenue dollars by joining expansion of Medicaid coverage provided by President Obama’s health legislation. Benefits of implementation of the Affordable Care Act also include broader insurance coverage for privately insured people, better drug coverage for seniors and access to private insurance for people who can’t now afford it. It will also be a boon to hospitals struggling with the burden of uncompensated care.

Heckuva deal, right?


Not to Arkansas Republicans. They want to cut the federal budget so they can cut taxes for millionaires.

This creates a bit of a messaging dilemma for Republicans facing election contests in Arkansas this fall. They can’t say what they mean:


“Just say NO to Medicaid expansion. We can’t afford to provide better health care for Arkansas citizens without jeopardizing tax cuts for the rich.”

No, that won’t do. So, their new gimmick:


Delay, delay, delay. The hope is that Republican majorities at the state and federal level can eventually sweep away any hope of providing a better life for all American people in favor of comforting the comfortable with more tax cuts.

Roby Brock reports on implementation of the Republican covering strategy today. As he reports, it takes the form of a letter to state officials begging a delay in implementation of the Affordable Care Act.

Here’s the letter from Republican leaders. It claims Medicaid growth is unsustainable, though the state’s own figures show that the expansion is sustainable by an increase in federal contributions. Gov. Mike Beebe has said he wants assurances, however, that the state can bail out if federal money falls short.

The Republicans haul out the usual bloody shirts to wave around:


* DRUG TESTING: They demand drug testing for recipients of medical coverage. I’ll agree to that the minute anyone turning in an expense reimbursement check at the legislature is required to submit to mandatory drug testing. Florida has already proved this is a waste of time and money, the latter of which Republicans claim to be so worried about.

* STICK THE POOR: Co-pays. Make the desperately poor pay some money for their benefits so they’ll appreciate our largesse more. We have a co-pay system for ARKids already, though I suspect what Republicans think is an acceptable co-pay and what I think could be quite different. I also wonder whether the existing co-pay program covers the cost of administering it.

* FRAUD: Stiffer penalties must be instituted for fraud and extraordinary measures must be taken to prevent it, Republicans say. The biggest expense in medical fraud is not on the recipient end, but on the provider end. I don’t really think Republicans are talking about going after doctors and insurance companies, however. They’re convinced it’s the dirt poor Arkansan, desperate for medicine, who’s costing them the big money. It’s an article of faith — rich people are holy, poor and low-income working people are cheaters and deadbeats, just looking for a way to cadge a dime from a job creator.

* WAIVERS: You gotta love the Republicans’ call for a Medicaid waiver that will “put more of Arkansas’s health care decisions in the hands of Arkansans.” This is the same #@%$@ group that dug in heels to prevent Arkansas-crafted health insurance exchanges, preferring to let the feds do it. That was then. Now is now. The law is the law, by concurrence of the U.S. Supreme Court. New reasons must be developed to stop Arkansans from getting better health coverage. Because: The rich must be served.