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Archive for the ‘Arkansas Government’ Category

Slow down, feds tell the mad Medicaid purgers

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The federal Centers for Medicare and Medicaid Services told the state last Friday – a week ago today — that it had to stop terminating Medicaid recipients after giving them only 10 days’ notice to object to the state’s admittedly malfunctioning income verification system.

The Hutchinson administration, always keenly interested in the political appearance, insisted on formal written notification – something it could show right-wing legislators to demonstrate that the big bad Obama government was making the state extend this heinous due process to poor people.

Wheels moved slowly, as federal bureaucratic wheels are wont.

CMS apparently wanted to frame a nice-sounding rather than scolding letter because it appreciates that Gov. Asa Hutchinson, rare among Republican governors, intends to try to salvage the private option form of Medicaid expansion.

The final email notification came at the end of the week, and the Hutchinson administration put out a news release this morning saying that, golly, gee whiz, the state has decided to start giving 30 days after new “guidance” from the feds.

That’s euphemistic political speech for: The federal government has told Arkansas to stop being in such an all-fired hurry to achieve its apparent adrenaline rush from taking health insurance from poor people.

There are four persisting issues:

One – The feds apparently are not going to enforce this 30-day policy retroactively and the state has no intention on its own to do that. So the 58,000 or so already thrown off, many no doubt incorrectly, are still out of luck.

Two – Lawsuits are being prepared arguing that the income verification process was unfair and that the notice system was unfair. One will seek class-action status. An argument that due process of law was not followed would seem by my unlicensed legal eye to be made stronger by the disparate treatment given the first batch of notices as compared to the second batch after the federal government said essentially that the first batch was done improperly.

Three – None of this will matter much in the end, some administration officials think, because – 10 days or 30 – a ton of these people are over the income level and will be struck. If so, so be it.

Four – The potential political complication is that Hutchinson is now on record wanting to save the private option but only with  “flexibility” for the state granted by a federal waiver, and now CMS has given the state a little dose of inflexibility.

But it’s two different things – an arbitrary state initiative that is a catastrophe and gets called out by the feds, and a waiver, meaning a written contract, by which the federal government would formally agree in advance to conservatizing principles the state would apply to its private option.

You know, at some point you have to quit coddling the extreme right. You have to take the pacifiers out of the mouths of the troglodytes. You have to take your chances with the smart and correct policy.

Note: I’ll flesh this out and perhaps get really worked for a column Tuesday. Sunday’s is on the right wing’s obsession with Hillary Clinton.

 

 

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Written by jbrummett

August 28th, 2015 at 12:52 pm

An official Medicaid mess conversation

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The Medicaid madness, the mess, continues to leave me nearly flabbergasted.

I would be fully flabbergasted except that I get, to an extent, the pandering right-wing politics that the Hutchinson administration deems necessary.

I’ve had conversations lately with official defenders of this mass purge that is jerking health insurance from 50,000 people.

Let me relate how these conversations typically go:

Them: It is so unfair of me to make an issue of the shortness of a 10-day response period on income verifications before losing health insurance. That’s always been the policy, through numerous Democratic gubernatorial administrations. And it’s the same period used for ending food stamps.

Me: But this isn’t a standard annual income verification process, applied case by case as recipients’ annual dates occur. It is a first-time, one-time, statute-required mass inventory – a “redetermination” — of everybody. Ten days plus mass application of a flawed detection system – that is an entirely different and more irresponsible, and meaner, set of circumstances.

Me, continuing, fired up now: Anyway, the 10-day federal minimum is for Medicaid income verification. These people on the private option are losing private health insurance on the exchange. There are entirely different federal policies requiring longer than 10-day notification periods, but 30 days, for not renewing policies on the exchange.

Them: It’s 30 days. About. Almost. We give 10 days. Then we give five days for the mail. Then five days for us to process. And then they don’t really lost their insurance until the month ends, because they’re paid until then.

Me: Well, 10 plus five plus five is not 30. And they are purged at 20 days, effective at the end of the current month, when, some lawyer is going to argue, they should have been given another 30 days for private policies purchased from the exchange.

Me, getting more worked up: Anyway, regardless of the length of notice, why in the name of the sweet Lord would you jerk health insurance from people with zero income – as your director admits is happening because your software detection thingamajig is, like, screwy?

Them: We have admitted mistakes have been made. I wish you could talk to some of these people who are working to put people back on their insurance because of mistakes like that. Then you wouldn’t be writing the most unfair thing you’ve ever written, which is that we set out to kick ineligible people off health insurance.

Me: But you did. And those people who are working so hard to restore health insurance to persons purged scandalously – good for them. But they are only having to do it because y’all messed up bigtime.

Them: Don’t we deserve credit for putting out the fire we started?

Me: No.

 

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Written by jbrummett

August 14th, 2015 at 8:44 am

The purge, as I am told and understand

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Here is what I get this morning on the horrid private option purge, checking in with Human Services in light of reporting by David Ramsey of the Arkansas Times that you can get purged for having your income move 10 percent either way, even down, assuming you don’t meet the 10-day response deadline to object formally and argue differently:

The best way they tell it to me, and the best way I understand and can relate it, is with a made-up example.

If DHS has your income at, say, 100 percent of the federal poverty level, and you’re on the private option that extends to 138 percent of the poverty level, and then if a computerized crosscheck with data at Workforce Services has you at 140 percent of the poverty level, thus ineligible for the private option, then what we have there is a more than 10 percent difference that overlaps the threshold, making you eligible by one piece of data and ineligible by another, and so you get a letter.

If you don’t respond to argue that the 140 percent assertion is wrong, or give notice that you intend to so argue, then, after TWENTY days, meaning the basic 10 plus five allowed for mail delivery both ways and five allowed for the processing cluster at DHS, then, yes, by the end of the month, you’re off.

You could still appeal after that and, under federal law, get 90 days. I think.

Now, the governor’s office and DHS argue that this is nothing new — that annual income verification is required by federal law, that a new state law insisted upon by private-option favoring Republicans required the current “redetermination,” and that 10 days is the longstanding state standard.

True.

What’s new is this mass one-time legislatively required redetermination. It’s one thing to do a deliberate and credible check each year when renewal time arrives for recipients. It’s another to send out tens of thousands of letters at once and purge 35,000 because you didn’t hear back.

I’m all for income verification. I don’t mind one-time “redetermination” if it’s done in an orderly way.

I do mind a hard deadline and jerking of health insurance because two state agencies have different sets of data and a guy didn’t respond because he didn’t get the letter or didn’t understand. Poor people move around. Poor people — like other people — are not universally fluent in bureaucratese.

All other factors aside, we are enduring this mean madness to try to accommodate the right-wing that just doesn’t like poor people or helping them.

Everyone has as much right as anyone else to get elected to the Legislature and get really good and cheap health insurance that way.

UPDATE: Oh, and about getting a verification letter if your income differential is more than 10 percent downward: Human Services spokesman Amy Webb says the computer software will indeed cause a “ping” for any 10 percent difference, even downward, but that you only get a letter if one of your reported incomes exceeds 138 percent of poverty. And if Human Services had someone at 140 percent of poverty, they would have been ineligible already. She says Human Services has not explained that well.

UPDATE TWO: David Ramsey, who knows this better than I and gets into the weeds more thoroughly, responds/amplifies on Twitter. I’ll just refer you to his Twitter feed. https://twitter.com/ArkDavey

 

 

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Written by jbrummett

August 10th, 2015 at 11:29 am

Too scared to rule, state Supreme Court rules — CORRECTED

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The Arkansas Supreme Court announced Thursday a little something I wish to paraphrase generously, indeed embellish, but only for worthy purposes of candor and clarity.

The court is dealing in chaff and somebody needs to get in there and pick out the wheat.

So here goes:

The court said that it did not want to rule on the same-sex marriage appeal properly before it, and would not, most likely.

The court said we couldn’t make it rule even if we tried.

It said its judgeship positons are matters of popular election and that the people of Arkansas don’t much like same-sex marriage, which the judges might be forced by, you know, justice and stuff, to permit.

So the eminent justices said they simply will concoct lame, indeed nonsensical, excuses not to opine on Circuit Judge Chris Piazza’s stayed ruling legalizing same-sex marriage. They said they will stall until the U.S. Supreme Court handles the issue perhaps by June and makes moot the state case and gives everybody in Arkansas someone to blame, probably Barack Obama, who has nothing whatsoever to do with the court case, but so what?

Justice Paul Danielson, the real jurist in the group, dissented. Presumably he favors going ahead and deciding a case that’s been fully argued and pending for months while the other judges have been hiding under their desks with their robes pulled up over their heads.

Justice Rhonda Wood, who is newly elected to the court and didn’t hear the case last year, announced separately that she couldn’t find any record of those proceedings anywhere, mainly because she hadn’t looked, and was not going to participate in the case at all, even in any comical stalling tactics such as these otherwise undertaken by her colleagues, because . . . well, she doesn’t want to. And we couldn’t make her if we tried.

To be clear: Wood is disqualifying herself not only from the original appeal that she didn’t hear, but from this new lame-brained notion to start a whole new case right now on her watch on the question whether to start over on that thing last year she didn’t hear.

You see.

You don’t see? All right, let me break it down further: She don’t want to.

CORRECTION: Turns out I didn’t see either, which would be funny if not about me. Judge Wood tweets to explain what her letter to Chief Justice Jim Hannah plainly says: She disqualified only from voting on whether to create this new case to invite arguments about whether to rehear the original case. That’s because it affected her. She is not disqualifying from the original case or any rehearing of it. She says she is ready to hear the case itself, if the opportunity arises. She says she would have dissented from this latest action to create a new case on the question of whether to rehear, except – again — she disqualified on that, because it was about her. Check Justice Wood’s twitter feed to see if that’s still wrong. If this is unclear, apportion blame among me for the description and the court for the silliness. )

Let’s run through this narrative: Piazza ruled nearly a year ago that same-sex marriage was to be permitted in Arkansas. After a few days of gay weddings, the ruling was stayed for appeal to the state Supreme Court.

Sen. Jason Rapert, as God’s own legislator, got the Legislative Council to adopt an unconstitutional resolution presuming to tell the court that the legislative branch would darned sure appreciate it if the judicial branch would overturn this abominable ruling by this judge whom Rapert calls “Pee-at-zah.”

The appeal was fully briefed and orally argued in early November, and the justices, by usual procedure, would have gone into conference and decided it and issued a ruling by the end of the term in December.

But they didn’t. So then two newly elected judges joined the court in January. So then the Attorney General Leslie Rutledge asked the court to consider the question of whether to start over and rehear the case with the newly constituted court.

So the court said that was a swell question, right up its alley, and asked for briefs, which have now been submitted.

What specifically happened Thursday was that the court said it was now opening a whole new case on this issue of whether to have new oral arguments on this matter, and that, since it was creating a whole new case, the parties would need to supply fresh briefs for that case on the now-recycled question of whether to conduct start-over oral arguments.

It is unclear whether lawyers will be allowed simply to photocopy their existing arguments on that question.

Most likely, the Supreme Court will open a third case on that question.

There may now be a fourth case on the matter of the columnist’s contempt of court.

I would remind you that former Attorney General Dustin McDaniel once said this court seems result-oriented, meaning as opposed to blind justice-oriented. And I would remind that retired Justice Don Corbin wrote a dissenting opinion in a case that offered as a little aside that McDaniel might be right.

 

 

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Written by jbrummett

April 3rd, 2015 at 7:55 am

On the religion-gay issue

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I just released my column for tomorrow on HB1228, the religious conscience bill that outrages the gay and lesbian movement, after inserting a few hedging phrases in concession to a bit of morning buzz.

I am told that Gov. Asa Hutchinson, who has committed to signing the bill, has this morning become interested in Indiana Gov. Mike Pence’s idea to “clarify” his state’s similar new law, presumably by another measure to assert that the new law does not conflict with anyone’s civil rights.

The talk this morning was whether to put such an amendment on the Arkansas bill, still awaiting a final concurring vote in the House of Representatives, and on whether it would make any difference — either politically or to protesting gays and lesbians or on substance.

Arkansas has no civil rights protections for gays and lesbians and, in fact, just enacted a crazy and hateful law denying local governments the authority to enact any on their own.

My column in the morning will deal with timing, context and perspective and conclude that Arkansas is the worst in regard to timing, context and perspective.

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Written by jbrummett

March 30th, 2015 at 11:52 am

Being real poor ain’t all that fair either

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So poor beleaguered state Rep. Warwick Sabin of Little Rock got pounded down this morning on his bill to provide tax relief to the working poor in the wholly viable and bipartisan fashion of an earned income tax credit, embraced nationally by Presidents named Reagan and Clinton.

 

Sabin argued for the bill by saying this session would be judged on how it acted on his bill, which would define whether, all things considered, it was fair to everyone in its determination to reduce taxes.

 

The defeat of his bill in the House Revenue and Taxation Committee invites me to ponder thus the overall fairness.

 

1. Gov. Asa Hutchinson, admirably, I think, chose to grant tax relief first and only to the middle class, those making from $20,000 to $75,000. You have to hand it to any Republican who pushes through a tax cut that does not extend at all, much less inordinately, to the rich people.

 

2. In order to pay for his cut, Hutchinson first proposed reducing a capital gains cut passed two years ago. That was positively Obama-esque, and, naturally, it would not stand. The Legislature is now in the process of restoring the capital gains cut, meaning that the rich people realizing capital gains will be either held harmless or given a break, depending on how you choose to apply timing.

 

3. Poor folks get diddly now that Sabin’s bill to increase the tax credit they could qualify for by working went down to defeat.

 

Fair? It is if you think poor people are themselves to blame for being poor and are getting enough from us already and ought to stand alone in this state as persons worthy of no tax break from this legislative session.

 

If you have certain instincts for justice and humanity, then you know that what this session is doing, taken in full context, is of breathtaking proportion in unfairness.

 

An earned income tax credit is not a handout. It is a credit low-income people get toward their tax bill by venturing out to earn a meager paycheck with hard work.

 

A few Republicans on the committee objected to the fact that the earned income tax credit would be refundable. That means it can amount to cash if the earned credit exceeds the tax bill.

 

Getting more back from the rest of us than they even owe — what the hell is that?

 

It’s simple: These people are poor. If they work enough for a penance to get a credit exceeding their tax due, then they can use the overage for help with regressive taxes they pay just for the opportunity to get out and do hard work for pauper’s pay — the gasoline tax,  the sales tax, both most burdensome on the little people.

 

So a guy will get no tax on a capital gain exceeding $10 million, but these poor working folks can’t earn a meager refundable credit by paying regressive taxes to get to a job paying an unlivable wage.

 

If history doesn’t judge that harshly, then history lies.

 

 

 

 

 

 

 

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Written by jbrummett

March 24th, 2015 at 12:54 pm

On big legislative dinner — and a buried lead

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It’s time to reactivate this long-dormant blog.

A good return-to-action post would be about lobbyists helping to raise money for last night’s speaker’s ball and the president’pro tem’s ball, long social staples of the state legislative culture, and harmless feel-good affairs.

But — thanks to the obsessive blog work of Max Brantley at the Arkansas Times — they’re kind of wrapped up in this whole matter of the voters approving Issue 3 to ban lobbyists’ gifts to legislators and of lobbyists and legislators finding a way around it.

It used to be — before Issue 3, or Amendment 94 — that the state Chamber of Commerce would bank these formal dinners late in session, by which I mean collect the money from corporate and lobbying sources.

That was bad, and the leading ethical purist of the Legislature, former state Rep. Duncan Baird of Lowell, now budget director for Gov. Asa Hutchinson, always wrote a hundred-dollar check to cover his part.

Issue 3 rather clearly banned the chamber-coordinated process.

While it’s true that the big loophole otherwise availed by lobbyists and legislators is that lobbyists may fete legislators under Issue 3 if they invite entire committees or the entire General Assembly to a “planned event,” the speaker’s ball and the president pro tem’s ball were mainly for those two individuals. Or at least it could be argued.

So to the rescue came the proud Arkansas Republican Party, which said it would raise the money to honor these two fine Republican legislative leaders  — Speaker Jeremy Gillam and President Pro Tem Jonathan Dismang.

And they are, by the way, in my opinion, fine Republican legislative leaders. We could do way worse.

So it turned out the Republican Party prevailed on two leading lobbyists, Ted and Julie Mullenix, to help, specifically to hit up other lobbyists to cover sponsorships for the dinners.

That outraged me, both on principle and as an affront to the voter dictates of Issue 3. So I went on Twitter to call the process a cesspool.

So then Gillam and Dismang wondered if I could come out to see them at 2 p.m.

I could. I did.

They said (1) this is the same process governors have always used to raise money for their inaugural balls and (2) they didn’t know about any outside services the Republican Party was using and (3) they were not beholden in any to the Mullenixes or any other lobbyists.

But they said that, yes, there might be a better way to do it in the future.

I’d have members ante up to a dinner fund, especially now that members are in line for significant pay increases.

But Gillam and Dismang might not be in positions of authority after this session.

In that regard, I can now relate that I’ve buried the lead.

Gillam told me he has pretty much decided to seek re-election as speaker.

(ADD: I’ve complicated Gillam’s life. I apologize. He thought he was telling me that little tidbit for a Tuesday column, which was true.  But I got the wild hair to blog it, and now some of his pals are displeased that he hadn’t told them of his plan. Put that on me.)

Dismang? He says no to re-election as president pro tem, although he knows of no percolating candidacies as yet to succeed him. Gillam wondered if Dismang might accept a draft. The two good ol’ boys from rural White County have a good working relationship ,and it has enhanced the orderliness of the session.

Oh, and one other thing: Some lobbying cabals have kept open certain rooms and facilities for entertaining legislators in cynical finesses of Issue 3 by inviting all legislators to these standing “planned events.” Gillam and Dismang said those have been so poorly attended that they can’t imagine they would be continued. We can hope.

 

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Written by jbrummett

March 20th, 2015 at 4:17 pm

High drama on private option? Line in sand by Democrats?

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With Sen. Missy Irvin of Mountain View continuing to say it’s not all up to her and that she is a “no” on re-upping the private option for which she fashioned an all-about-me dramatic “aye” vote late in the regular session — though it apparently is indeed all about her — I’ve had very recent discussions with insiders suggesting the prospect for high drama in the fiscal session beginning Feb. 11.

This is insiderly and procedural, but it raises the possibility of high-stakes brinksmanship, which sounds positively Washingtonian.

To begin: The Medicaid appropriation to be introduced in the fiscal session is a mere continuation of the existing Medicaid appropriation. This it contains the hundred-percent federal money for the expanded population under the private option.

Presumably, the Republican minority seeking to obstruct continued existence of the successful and popular program — nine or so voters in the Senate and 25 or so in the House — would need to excise the private option money from the appropriation, and then, by the requisite three-fourths vote, pass old Medicaid with the federal-state match for a tiny segment of the very poorest.

That would require amending the continuing-level appropriation with special language in the Special Language Subcommittee of the Joint Budget Committee. The special language would affirmatively excise the private option money.

Amending the measure that way would require only a majority vote, but I don’t readily see how a narrow extremist minority barely able to stop a three-fourths vote could be expected to get a simple majority vote to take out the program that nearly three-fourths of the Legislature favors.

By that scenario, the appropriation would proceed to the chamber floors in full private option form, starting in the Senate because the House went first last time and wants the Senate to go first this time. And Irvin votes no and we’re stuck.

Presumably, then, faced with that logjam, legislators would concede to the tragic reality of the know-nothing obstructionist minority and amend the measure to take out the private option money to get something passed and get on home.

But now get this: There are some infant discussions — just that, at this point — that the Democratic caucuses of the House and the Senate might declare preemptively that they will vote only for a Medicaid appropriation containing the private option.

That’s 48 votes in the House and 13 in the Senate and plenty to prevent a three-fourths majority.

High drama. Private option or no Medicaid at all. Private option or we go home without any appropriation at all for Medicaid.

Here’s the question:

Is that politically advantageous high ground for these Democrats, drawing a line in the sand for an innovative national program for the working poor and for hospitals and for the state budget’s money for prisons and higher education?  Didn’t that recent Talk Business-Hendrix College poll show a strong plurality of respondents favoring the continuation of the private option?

Or is it political quicksand for Democrats, introducing Washington-style apocalyptic politics like that? Would they get blamed for dysfunction rather than nobility?

That’s such a good question. I think I know the answer. But let’s let the idea percolate for a bit while we think on it a little longer.

 

 

 

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Written by jbrummett

January 31st, 2014 at 9:26 am

Private option looking great except politically

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There are developments regarding the state’s innovative Medicaid private option — developments beyond the potentially tragic political signals sent by the Jonesboro area in the special election Tuesday.

First: The state has compiled the demographics on the tens of thousands of persons below 138 percent of poverty who have been enrolled so far, and they show most of them are younger.

That is the full opposite of the state and nationwide experience in the non-Medicaid health care exchange — where few young people have enrolled so far, but plenty of folks my age have, leading to concerns about “adverse selection” and “death spirals” by which Obamacare rates might be expected to explode to unaffordable levels,  causing the entire reform to collapse under its own weight.

The remarkable thing in Arkansas, then, is that we are using our federal Medicaid expansion money to deliver poor folks to private insurance and produce a more actuarial credible risk pool for Blue Cross and Qual Choice. Our rates conceivably — conceivably — could remain at or near current levels in the second year if not beyond.

That is to say — just to put it in clear individual terms — that my own Obamacare options to be unveiled in October might remain relatively reasonable thanks totally to our state’s private option.

Furthermore, the preponderance of younger folks in this PO pool means they’ll pay relatively lower premiums — to the extent, it seems, that we are going to tap less federal money than previously estimated.

All of that is to say our private option is unfolding as a smashing success just in time for know-nothings to kill it in the budget session beginning Feb. 10.

Second: The Joint Public Health Committee will meet at 3 p.m. today to hear the state’s star consultant, former Utah Gov. Michael Leavitt, a Republican, testify about the personal health saving account component of the private option on which Sen. Missy Irvin of Mountain View insisted on the next-to-last day of the session before casting her vote.

I am advised to expect a bold proposal. It will require getting the federal government to approve an amendment to the waiver by which we’ve done the private option. It ought to be enough to hold Irvin’s vote.

Senate President Pro Tem Michael Lamoureux is quoted today as worrying about several more senators than Irvin.

One Republican legislator favoring the private option told me the only way it survives in February is if something really conservative is put into it.

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Written by jbrummett

January 16th, 2014 at 10:49 am

Darr’s two minds, and the one he’ll follow

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My best reading is that Mark Darr is currently of two minds and goes back and forth between these minds with great speed and dexterity and frustration.

One mind: Yes, I made errors and I was wrong. But, darnit, it’s not serious thievery and I could be given a hall pass to make amends except for this raw political partisanship that is at work against me. The best thing I can do is be strong and take a stand against this criminalization of politics. To resign would be to concede to that criminalization of politics, even encourage those in my party who tell me they resent what’s being done to me and will counterattack some Democrat for retribution.

The other mind: My resignation is the practical thing. It would save the state the nonsense of distracting impeachment. It would relieve those of my party of whatever burden my predicament places on them. What I should do is put my own interests aside and gracefully bow out. I should do so with a statement declaring my innocence of truly impeachable offense, but couching my action as a personal sacrifice for the sake of our state, and pleading with those of both sides to cease and desist this kind of politics of personal destruction.

I think he bounced from one mind to the other yesterday.

I believe he will bear the inconvenience of regretting following either mind, of taking either action, but will choose, at some point soon, to offer himself in sacrifice and resign while making that plea for a less toxic political climate.

It’s the better of bad options, and I think he knows that.

As soon as he takes it, he’s going to be mad at himself. But that’s the nature of his dilemma. A little time away with family might be good.

 

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Written by jbrummett

January 10th, 2014 at 10:56 am

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