Gov. Asa Hutchinson will entertain media questions at a 9:30 a.m. session today that is said to cover health care and highway funding.

A leading edge of the health care remarks likely came in a Democrat-Gazette article today in which Hutchinson’s spokesman, J.R. Davis, said Donald Trump’s decision to end federal subsidy payments for federal marketplace insurance coverage would have little impact on the “state’s cost” of its expanded Medicaid coverage.


The key in that statement is low impact on “state cost.” That is not the same thing as low impact on people who need health insurance. Here’s how the D-G described the impact of the loss of federal subsidies, which reduce the cost of deductibles and co-pays for lower-income people, and rate increases of up to 25 percent announced by insurance companies:

As a result of the increases, the state will pay higher premiums next year to provide coverage under Arkansas Works, as the expanded part of the state’s Medicaid program is known.

But, to offset that cost, the state will no longer provide insurers with its own version of the additional subsidies, known as cost-sharing reduction payments.

If your insurance premiums go up 25 percent and the state is no longer subsidizing premiums at the same level, the individual cost of coverage is going to go up, isn’t it? Won’t it drive some people out of insurance coverage? Particularly since the governor has already proposed to end coverage for 60,000 people by covering only those making 100 percent or less of the federal poverty level in income, rather than 138 percent.


The poorer you get, the harder it is to make payments. Combine that with higher premiums and reduced state help and it looks to me like the result will be many fewer people with health insurance. And when you start talking fewer people with insurance, you are also talking more unreimbursed care by hospitals and others. Very soon, we have the return of that old punishing spiral that has made Obamacare, for all its flaws, increasingly attractive in the country.

The New York Times illustrated before and after Obamacare through Republican Baxter County. They still love Trump and they still gripe about Obamacare but they are forced to admit that without it, the impact on the big regional hospital in Mountain Home will be damaging.  One in four jobs in Baxter County — 1,600 at Baxter Regional hospital — are tied to the health sector. That number is going to fall when the effect of cuts in Arkansas’s Medicaid expansion take effect.


The state can always hold itself harmless from federal budget cuts. Just stop participating in the Medicaid expansion. It’d be a little cold to 300,000 or so Arkansans, but we seem to be trending that direction in any case.

The inevitable reduction in health coverage for Arkansas people isn’t perhaps the best time to talk about raising taxes to pay for more highway construction. And tax increases are the only way for more construction, except robbing revenue from other government programs. Your pick: schools, prisons, higher education.