When I saw that the Arkansas House of Representatives voted yesterday, 76-24, to fund the Private Option for another fiscal year, I halfheartedly hoped that the extra “yes” vote might have been Rep. Josh Miller. After all, the filing period had ended, and Rep. Miller had neither a primary challenger nor a challenger in the general election. Maybe, I thought, a lack of fear of losing his seat meant that Rep. Miller had finally come to his senses and had seen the hypocrisy in his “Medicaid for me, not for thee (at least if thee is poor)” position.
Instead, Miller remained a “no” in the final tally.
Now, just for all of the reasons detailed here, at the Arkansas Blog, and on MSNBC (video), Rep. Miller’s position would be troubling enough on its face. But I could think of some things that would look even worse. Say, for example, using your position as a legislator to make blatantly self-serving changes to the Medicaid law so that it’s easier for you to get the same coverage that you would deny to others.
Rep. Miller was the primary sponsor on a whopping three bills in the 2013 Regular Session. One created a special Children’s Cancer Research license plate. That was the extent of his altruism in 2013.
The second bill required that any in-home caregiver who is paid with Medicaid funds must undergo drug testing and a criminal background check (and must pay for the criminal background check themselves). Because, hey . . . you certainly can’t have a pothead taking care of someone who got paralyzed by drinking and driving, right?
That bill, however, pales in comparison to Miller’s pièce maîtresse salaud, Act 1048.
Prior to Act 1048, Arkansas law defined an “eligible person” for purposes of receiving Medicaid as:
an individual who meets the disability assets and unearned income standards to receive supplemental security income, who would be considered to be receiving supplemental security income benefits but for his or her earned income, and whose net combined family income is less than two hundred fifty percent (250%) of the federal poverty guideline.
Miller’s bill, however, made the definition look like this:
an individual who meets the disability assets and unearned income standards to receive supplemental security income, who would be considered to be receiving supplemental security income benefits but for his or her earned income
, and whose net combined family income is less than two hundred fifty percent (250%) of the federal poverty guideline.
That’s right — while lawmakers and policy wonks were arguing over the propriety of expanding Medicaid in general to include non-disabled adults making up to 138% of the federal poverty line, Rep. Miller was working to ensure that, no matter how much money he might make, he could never lose his sweet, sweet government-funded insurance. (Before you ask, of course he did not make a similar change for children under Arkansas Code Annotated 20-77-1104(d)(4)(A).)
Then he took it a step further, moving straight from “selfish” to “whoa…seriously?” Act 1048 also changes Arkansas Code Annotated 20-77-1204 regarding the administration of Medicaid for “Low-Income Disabled Working Persons.” Specifically, Rep. Miller’s bill added 1204(c), which states:
A rule adopted under this section shall not include a test for income, assets, or resources.
Yup. Oh, sure, 1204(b)(2) explicitly requires DHS to adopt rules that establish “premium and cost-sharing charges on a sliding scale based on income” (emphasis added), but, thanks to Rep. Miller, DHS cannot actually include any kind of means testing in those rules. Because if Josh Miller or anyone else under the program wants to tell DHS that he or she makes a certain amount of money, who is DHS to verify that amount before cutting a check?
Then, to cap it all off, Rep. Miller’s bill made it clear that, if required, DHS needed to take active steps to protect Rep. Miller’s government-funded healthcare:
SECTION 3. DO NOT CODIFY. (a) The Department of Human Services shall adopt rules to implement this section.
(b) If necessary, the department shall apply for a waiver from the Centers for Medicare and Medicaid Services for approval of the rules adopted under this section.
“Do not codify,” huh? Yeah, I guess it might look bad if people realized that Rep. Miller was saying, by golly, if this plan to expand Rep. Miller’s federally funded health care does not fit with current Medicaid rules, DHS better get a waiver and make it happen!
The sad irony in all of this is that Josh Miller could have been the poster child for compassionate conservatism in the state. He could have been a voice of personal experience that, in theory, other Republicans would have had no choice but to listen to when it came to understanding that, sometimes, life deals a person a really terrible hand that Medicaid is uniquely positioned to help that person deal with. He could have sold the Private Option to Republicans around the state as a free-market answer to a Medicaid expansion that was in everyone’s best interest on a personal level. Hell, he could have quoted Matthew 25:40 and explained that Medicaid expansion for the working poor is so obviously Christian that we should not even be having this debate.
He could have done all that. Instead, he chose to do none of it, while simultaneously making it easier for him to keep his own Medicaid.
That’s more disgusting and shameful than just about anything any recent politician has done vis-a-vis the working poor.