Gov. Asa Hutchinson had me out to the Governor’s Mansion at noon today for a knuckle sandwich.
I mean a BLT from Community Bakery.
The purpose was for him to lecture me on my recent column assertions that he can’t claim on the one hand to abhor and want to repeal Obamacare while relying desperately on it on the other hand in order to make his state budget work.
“What’s amazing to me is that you’ve aligned yourself with Conduit for Commerce (an extreme right-wing anti-government group pushing Republican primary opponents for private option supporters),” he began, after the small talk.
“They are going around saying you can’t support ‘Arkansas Works’ (his proposed new name for a conservatized private option form of Medicaid expansion) without embracing Obamacare, and now you’re making their case for them by saying the same thing every day,” he said.
Actually, not exactly. That right-wing outfit is saying you can’t support Medicaid expansion without embracing Obamacare and that Obamacare is awful. I’m saying you can’t support Medicaid expansion without embracing Obamacare and that Obamacare is great. Well, starting to work, and in line to work better as we go along.
And what was that business about my hammering him “every day?” That was hyperbole, I countered.
So he picked up a thick stack of papers that he said represented my recent writings beating him up.
I bet they were triple-spaced to make a bigger pile.
So here is the governor’s position, which I summarized back to him after he’d presented it to make sure I had it. And I had it.
He inherited the “private option.” He did not start it. He was immediately faced with a budget based on its federal money and the prospect of pulling the rug from 200,000 people recently favored with new health insurance.
So he accepted it, provided we would end it in its current form and seek federal approval to do it differently after 2017 with work incentives, personal responsibility for parts of premiums and permission to require recipients working for companies providing employee coverage to use those employer-based plans instead.
So — I interjected — would he have gone along with starting the private option in the first place had he been governor when Mike Beebe was getting it done with Republican legislative moderates?
Asa grinned and said that was a speculative question he didn’t have to answer.
He said he might have said at some point that he wouldn’t have done it, though he couldn’t be certain, but that he wasn’t saying one way or another right now. And he kept grinning.
(He would have started it. That’s how I took that. But he didn’t say that. Which means he can add a printout of this blog post to his thick pile of bad Brummett stuff.)
He said it is “logical and rational” for him to make the best decision for Arkansas in the context of the landscape confronting him, while at the same time opposing the individual mandate and employer mandate of Obamacare – as affronts to “freedom,” he said – and supporting the prevailing position of Republican presidential candidates to repeal and replace Obamcare.
But … he is favorably inclined to the notion to replace the Medicaid expansion element of Obamacare with some kind of block grant to states that gives states enough money and full flexibility to insure people now insured – meaning the 200,000 on Medicaid expansion in Arkansas.
So – I interjected – he was saying he didn’t want Obamacare but did want all of Obamacare’s money without any strings attached.
He said no, sir, he wasn’t locking himself into that amount of money, or any definitive sum. He said states ought to be able to do more with less, given that full state flexibility he seems to see as a panacea.
Anyway, he said, it was impossible to make definitive statements on that now with the presidential race and the membership of the next Senate in such extraordinary flux.
Indeed, Trump or Cruz might be elected, in which case we’d all need to flee to Canada or New Zealand.
I said that. He didn’t.
I have an idea whom he favors among his party’s presidential candidates, but I dare not say. His life is one big political constraint, one extended exercise in duress and finesse.
Legislators whose votes he desperately needs for the three-fourths appropriation to continue Obamacare – uh, I mean private option . . . uh, I mean Arkansas Works — they are heavily divided among Cruz and Rubio supporters He needn’t offend one group or the other, or both, if he favors someone else.
The bottom line is that Asa’s positon is that he doesn’t want Obamacare but he does want enough federal money to let Arkansas do Medicaid, or its successor, as it chooses, and that he would opt – in that event – to find some way, or some mixture of nobly conservative ways, to keep offering health insurance to the current expansion population.
And there’s another bottom line, which amounts to the governor’s case for re-upping the private option in the looming fiscal session: With the prospect existing that the Republicans can undo Obamacare next year and do Medicaid their way at the state level, let’s dare not retreat right now on the private option and lose any leverage we have next year for doing it in a more conservative and demonstrably efficient way.
Hutchinson intends to say an increment of that Wednesday when he speaks to his health care task force. He also hopes at that time to have a letter in hand from federal Health and Human Services Secretary Sylvia Burwell expressing support in principle, subject to particulars, for the permissions he seeks in an eventual waiver – to refer private option recipients to work training, to steer relevant recipients to their employer plans and to require some personal contribution from the population between 100 and 138 percent of poverty.
I got the idea the governor has received some verbal communication of federal receptiveness.
And that reminded Asa: He objects to my calling these requested changes “cosmetic.” He asked: If they were purely cosmetic, why would he be required to apply for a formal waiver?
They could be sufficiently cosmetic that the waiver will be easily won.
But that’s just me.
Finally, on the way out, the governor made the point that his position was not that much different from that of Mike Beebe, who always said he was not crazy about Obamacare altogether but was sure-enough crazy about getting heaps of federal money to expand Medicaid.
There’s a little light between saying you’re not crazy about Obamacare and wanting to repeal it. But I concede Hutchinson a near-point.
I told the governor I was sick and tired of being sick and tired – well, of Obama getting trashed unfairly and Obamacare demonized when it fact it’s a good-faith effort to address a powerful problem and is beginning to show signs that it can work just when people who live off it are trashing it.
He said, well, thanks for coming out.