Sunday, June 25, 2017

Now Come the Tough Choices on Medicaid

Some of us warned about this day six years ago when the Republicans in this state signed us onto "The Private Option" with claims that it was "the furthest thing from Obamcare". Some of us knew at the time that was untrue, but it confused enough people long enough for them to get it going until they could change the name to "Arkansas Works" and reset the Confusion Clock.

Of course the few activists who were warning about this were dismissed as "unappeasables" who didn't know anything. I specifically said "the money to pay for these promises does not exist. It never existed." But hey, the national credit card was not maxed out just yet so party on dudes. What has the next generation ever done for us anyway? Let's stick 'em with the tab and congratulate ourselves for saying "yes" to more government spending on health care.

So now that the health care system and insurance plans in this state have been re-arranged to Obamacare, the money is running out and major changes have to be made. You may think that is a good idea, or you may think it is a terrible idea- but it doesn't matter because the money to do all this was never there. Governor Asa Hutchinson took the first step by moving able-bodied adults from 101% to 138% of the Federal Poverty Level off of Medicaid and onto the exchanges. They will still be somewhat subsidized on the exchanges but nothing like the sweet deal they got on Medicaid (sweet deal from them, terrible deal for tomorrow's children who will be stuck with the debt).

Before Obamacare we had Medicare for the elderly. It is not quite pure socialized medicine because people paid in all their working lives, but it was going broke even before George W. Bush did big pharma a huge solid and socialized prescription drug coverage for the elderly. We had Medicaid for Children, the disabled, and the very poorest of the poor. So those groups already had the government paying for their health care, and it was straining the safety net. What Obamacare did was add a lot more able-bodied adults into the safety net and it is giving way due to the strain.

Now it is time to figure out who to reduce benefits to. The Republican plan from Senator Tom Cotton et al looks like it is trying to keep FEDGOVS hand in the pie, but still give smaller pieces of pie to every group that got pie under Obamacare. What that means is the elderly, the disabled, and children will have to get smaller pieces of pie going forward. Why? So that the group that Obamacare added- able-bodied adults who are poor but not the poorest of the poor, can keep getting government pie. That allows the lefties at the ARKTIMES to deride the plan as "annals of mean" for "cutting" benefits to children.

Now that the Democrats (with Republican help) have extended the reach of the federal government into the healthcare of able-bodied adults the Republicans just can't seem to simply let go. They can't seem to get behind a plan which would simply take FEDGOV out of that new area of life that they invaded and took over- even if they don't know what they are doing and don't have the money to do it anyway. It is like they are control freaks who cant. let. go.

Yet the right thing to do is so simple. Simple but not easy. The able-bodied adults who have gotten a free ride at the expense of tomorrow's children have to get kicked off the bus. If it is a choice between whose benefits to cut, cut theirs before you cut benefits to children and the disabled. Just admit that you are having a devil of a time managing the vast federal programs that were on your plate before Obamacare and it was a mistake to add more to that load. But they can't seem to bear doing that, no matter how obvious it is they should. I sure hope they get over whatever psychological issues won't let them come to grips with the reality that they need to let go, and that they do it before the credit card is maxed out.


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