I am dedicated to finding REAL answers to make medical care more affordable for working Arkansans. Obamacare is not the answer. Enrolling almost 40% of our population in an entitlement program is an irreversible decision that will lead to far reaching consequences we will never recover from.
The expansion of Medicaid is one of the biggest problems Arkansans face.
1. Do you oppose PPACA (Obamacare)?
Much of the opposition to the affordable care act was because of Medicaid expansion. States now have an opportunity to reject the Medicaid expansion provision of the affordable care act. Supporting Medicaid expansion is embracing the affordable care act.
2. From where is the money to expand Medicaid going to come?
Does the federal government have the over $1 billion per year that will be required to fund Medicaid expansion in Arkansas alone? Where will the $1 billion plus come from? The ultimate answer is increased taxes that will be required to pay off huge debts. Check your pay stub SSI, Medicare, and Federal Tax are real money that come from Arkansas taxpayers. There is no free money.
3. What is the future cost to Arkansas?
10% of $1 to $2 billion per year is a lot of money. Someday, Arkansas will have to deal with the future commitment if Medicaid is expanded today. Medicaid already has built-in unfunded liabilities because of the increasing cost of healthcare that is not addressed in baseline budgeting. Expanding Medicaid at this time with so called "free money" really will be kicking the can down the road, creating even more problems in the future not only for Arkansas but for the whole United States
4. How will we effectively spend an influx of $1 to $2 billion for health care?
If $1 to $2 billion of additional funds are put into the Arkansas health care system, who will provide the legitimate services to spend those funds? Are there enough health care providers and facilities to provide a 20% plus increase in Medicaid services? Will there be future funding requested to expand hospitals, clinics, etc. ?
5. Is expanding Medicaid philosophically the direction we want to go?
Is it philosophically in the best interest of Arkansas to increase dependence on government services and programs? Wouldn't a better approach to providing health care services be to unleash the Arkansas economy so working age adults could get good jobs and afford their own health care services while contributing to the tax system rather than taking from the system? Would this not allow better medical care for all involved, including the truly needy who rely on Medicaid?
6. Is Medicaid expansion the type of " economic development" we want for Arkansas?
DHS claims a $372 million benefit to Arkansas with Medicaid expansion. The logic behind this calculation is basically: Take $1.2 billion of federal tax money and spend it in Arkansas. The projected 4% state tax collections on the $1.2 billion federal tax dollars spent in Arkansas along with some projected savings in uncompensated care and transition populations less the projected administrative program costs to implement the expansion is equal to $372 million over 7-years. Is this the kind of economic development plan we want in Arkansas?
7. If a system is broken should we reform it or expand it?
Medicaid in Arkansas is a broken system that has been running deficits for several years now. These deficits, to the tune of over $1.0 billion ($200 million/year), have been covered up with one-time stimulus money and the Medicaid trust fund that is currently being depleted. The rate of burn through the Medicaid trust fund is currently at a level of approximately $300 million per year and this is after an increase in Medicaid's budget of $116 million in general revenues that are being matched with federal funds at a rate of 2.37 to 1. Do we want to expand a broken system? Arkansas Medicaid needs to be fixed, not expanded, so it can be sustainable in the future for those who are truly in need.
8. The governor has approval from HHS to "get out" of the expansion program if it doesn't work as intended. Do we believe that a government program would be expanded to include 250k additional folks and then scrapped? Show me an example where that has ever happened. Are there doubts about the success of the expansion if we need a back door for the program?
One of the most important things we must do is put Arkansans back to work in the private sector. This is where real wealth is produced. If instead we add huge costs and taxes for the service sector (medical care) the private sector (especially farming, mining, energy production and manufacturing) already in trouble will never have a chance. If we do not recover the private sector, we will be in a permanent recession economy that will continue to spiral downwards making universal health coverage more and more impossible.
In other words, the rest of the economy is built on our ability to feed ourselves and produce things. All real wealth comes from these areas. We must address them and what they need and what we need to put Arkansans back to work before we spend billions we don't have. This will only put us in a permanent deficit situation and eventually the medical system will bankrupt us all and permanently stunt the economy.
Do we want to expand Medicaid in Arkansas? Can we afford to expand Medicaid in Arkansas? Before Obamacare even kicks in we face a shortfall of $400 million dollars for Medicaid in the next legislative session. That money has got to come from new taxes or be taken from something in the budget like roads or education. The answers are not going to be easy.
Obamacare proposes to spend up to $2 billion more on Medicaid in Arkansas. With Arkansas's part only being 10% of that for the first 3 years, that is still up to another $200 million Arkansas taxpayers have to shoulder.