Here I go, seeing the future again. I regret that this takes all the fun out of the process.
What’s going to happen is that, eventually, the Beebe administration and the Republican leadership of the Legisalture will agree on the following on Medicaid expansion:
–To extend new Medicaid coverage to adults within 100 percent of poverty, not 138 percent, on income level. This is about 161,000. The other 90,000 or so in play, making between 100 and 138 of poverty, can go into exchanges and get health insurance for, oh, i don’t know, $30 a month maybe. A lot of those working poor between 100 and 138 of poverty won’t buy insurance, but, if they go to an emergency room, the hospitals will have a system by which they will be automatically applied for it.
–We will put in the law a “circuit breaker” so that, if the promised federal match is reduced, the state will automatically reduce proportionately the participation by sliding eligibility levels.
–We’ll institute co-pays for patients going to the emergency room when they could have gone to a doctor.
–We’ll add drug-testing, but, to be constitutional and affordable, it merely will be random and those showing positive merely will be advised as to treatment opportunities.
–Republicans will get more oversight, auditing and supposed business-like principles added to the Medicaid process. I can’t be more specific than that. But the Republicans will hold out for something to stop all those supposed cheaters out there and to take back to the Tea Party rally.
–Beebe will seek a federal waiver on all this hair-splitting, and get it pretty routinely.