HCR: Dumas Spells Out AR Benefits

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    A funny thing happened on the way to the ultimate destruction of Arkansas that Timmy! Griffin, et al., predicted from the health care reform bill: some people actually took the time to explore just how Arkansas will benefit.

    Maybe only because it has been six months since the last TV commercials and newspaper ads brandished Frank Luntz’s poll-tested slogan “government takeover of health care[,]” [but] national health insurance is enjoying a modest rebound.

    Even in Arkansas, where a massive ad blitz to influence Arkansas’s pivotal congressional delegation turned the popular idea of universal health insurance into an abomination, the Patient Protection and Affordable Care Act of 2010 is gaining acceptance, sometimes verging on enthusiasm.

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    The state government, which must administer big parts of the law, has plunged into the details since its enactment in March and found much that it welcomes, including a huge infusion of cash into the Arkansas economy and even some relief for the severely stressed state budget.

    Far from bankrupting the state when Medicaid is expanded to cover poor adults in 2014, as some state officials worried during the furious final deliberations over the bill in the late winter, the law should ease state budget problems until late in the decade, when the state will begin to kick in a small match for billions of dollars in federal assistance for medical treatment and hospital care for low-income adults. Meantime, under an unpublicized provision of the new law, the federal government will pick up nearly the full cost of the original ARKids First, the expanded government-insurance program for children that Gov. Mike Huckabee always proclaimed to be his proudest achievement.

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    A study of the Medicaid provisions last month concluded that more than $12 billion could be pumped into Arkansas’s health-care system in the six years after the law’s major provisions are implemented.

    If the Affordable Care Act succeeds in insuring nearly everyone — Arkansas is going to administer it better than Washington or anyone else in the country, Beebe promised — then it should reduce uncompensated care and the shifting of costs for indigent care to insured and paying customers and the taxpayers.

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    Seniors, who according to polls turned heavily against health reform last year owing to reports that they would lose Medicare coverage or see higher co-pays, have been discovering that it wasn’t true. The law expands rather than shrinks Medicare benefits. For instance, starting the first of the year[,] Medicare will waive the deductible and co-insurance charges for screenings and other preventive benefits[,] and all 506,000 Arkansas enrollees will be able to get a free annual wellness visit.

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    By fall, thousands of Arkansans will profit from other relatively minor reforms. Insurance companies must allow young people to stay on their parents’ policies until the age of 26. Arkansas insurers have agreed to start doing that immediately. For a Little Rock educator it came at exactly the right time. His son, who exhausted his COBRA eligibility and has a congenital illness that might prevent his getting private coverage, went back on his father’s employer policy in June.

    In September, insurance companies will no longer be able to cancel people’s policies when they get sick, deny coverage to children who have pre-existing conditions or impose lifetime caps on coverage, three of the most common complaints about health insurance.

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    The plunge in support for sweeping health-care reform in the spring and summer of 2009 was peculiarly ironic for Arkansas, which by almost any measurement enjoyed poorer health and lower access to health services than nearly every state and will get more relief from comprehensive reform.

    Dr. Joe Thompson, the Arkansas surgeon general and the chief health policy adviser first to Gov. Mike Huckabee and now Governor Beebe, said the Affordable Care Act, while it has failings, came out remarkably well, particularly for Arkansas, given the conditions under which Congress had to act.

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    “The act differentially advantages Arkansas more than most states because we have so many poor people and so many people — 500,000 and probably more — who are without health insurance.”

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    It should be an economic boon in one way, [Dr. Thompson] said. Hospital and medical bills are the No. 1 cause of bankruptcies. The massive amount of federal assistance and the insurance that will be available to nearly everyone will greatly relieve that problem late in the decade.

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    In April 2009, Dr. Frank Luntz, the Republican PR consultant, gave congressional Republicans and other opponents of a comprehensive health law their marching strategy. Luntz, author of the best-selling book, “Words That Work: It’s Not What You Say, It’s What People Hear,” had come up with the phrase “death tax” in 1993 to describe the 90-year-old tax on great inheritances, and those words dramatically changed public attitudes and enabled Republicans, with Democratic help, to phase out the estate tax in 2001. The estate tax went out of existence this year.

    Luntz advised Republicans that no matter what Congress produced they should describe the legislation as “government takeover of healthcare” or “Washington takeover of healthcare” and that they should constantly refer to Washington bureaucrats making decisions about the treatment that people could get. They should say that medical professionals and patients would no longer be in charge, that Washington would ration care and that there would be long delays in people getting the treatment they needed. Focus groups showed that those words alarmed people.

    The other poll-tested strategies were that health reform would add to the national deficits and that Medicare benefits would be lost.

    None of those things would describe the act that eventually passed — its central features were proposed by President Richard Nixon and the Republican congressional leadership in 1974 — but the phrases were shouted at town-hall meetings conducted by Arkansas congressmen and senators and they still appear regularly in letters that swarm the editorial pages of newspapers.

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    So, from 2013 through 2016, if the Kaiser Foundation’s projections are credible, the federal government will pump $6 billion into Arkansas for health-care services for the poor at no cost to the state budget. In addition to the improved well-being of an eighth of the population, that cash will be quite a stimulus for the state’s economy.

    No state will be helped more by the Medicaid expansion to cover low-income adults. Arkansas does better than many states insuring poor children through the ARKids First program, but all the other 49 states and the District of Columbia do more for poor adults.

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    Meantime, starting Oct. 15, 2015, the federal government will pick up almost the full cost of the “B” phase of the ARKids First program, which insures some 70,000 children with family incomes above the poverty line. That will relieve the state of appropriations of more than $16 million at 2008 levels and much more if the state expands the program as the legislature and Governor Beebe planned before the budget crisis intensified.

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    “We supported the Senate bill [the Affordable Care Act] for a lot of reasons,” said Phil Matthews, executive director of the Arkansas Hospital Association. “There were a lot of things, including coverage for people with pre-existing conditions, that seemed to be the right things to do. The number of people without coverage has been increasing at such a rate that hospitals cannot absorb the increasing losses from uncompensated care that the lack of insurance produces. As we go down the road now, hospitals should be better off.”

    Gene Gessow, the state Medicaid director, said the Affordable Care Act, especially its Medicaid provisions, would be good for Arkansas.

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    Emphases added.

    Those are but a few highlights from the article, and the whole piece is definitely worth a read. If you are the trouble-making type, it’s also worth passing along to your Republican friends.