Forbes: AR’s Private Option Architect Hopes To Revive The State’s Failed Obamacare Medicaid Experiment

By Nic HortonJonathan Ingram and Josh Archambault.  Mr. Horton is a policy impact specialist, Mr. Ingram is research director, and Mr. Archambault a senior fellow at the Foundation for Government Accountability.

Earlier this session, Arkansas lawmakers took an important first step in rolling back its disastrous Obamacare expansion. The legislature passed Act 46, which requires the Arkansas Department of Human Services to eliminate the Obamacare expansion by December 31, 2016. But a new bill proposed by one of the chief legislative architects of the failed Private Option experiment would reverse that progress and cement Obamacare into state law forever.

Days until the Private option is scheduled to end.

New Plan Would Keep Obamacare Expansion Forever

State Senator David Sanders has a new plan to keep his failed Obamacare expansion in Arkansas forever. His plan, cosponsored by Senator Jason Rapert and Representative Charlie Collins, would give state bureaucrats blanket authority to apply for virtually any waivers or state plan amendments they wish.

The Arkansas Department of Human Services, the Insurance Commissioner, the Department of Finance and Administration, and the state’s Obamacare exchange board would be able to apply for any waivers under Section 1115 or Section 1915 of the Social Security Act, as well as under Section 1332 of the Patient Protection and Affordable Care Act, otherwise known as Obamacare.

These new powers could even supersede explicit instructions by the legislature that the Department of Human Services terminate the Obamacare expansion.

A legislative impact statement on the bill says its impact on taxpayers is “unknown.” Perhaps a more accurate description would have been “immeasurable.”

Another False Promise of Flexibility And Free Money

Obamacare advocates are pushing Sen. Sanders’ new plan on the same false promises of “flexibility” and “free money” that they used to lobby for the failed Obamacare Private Option. Supporters contend that Section 1332 waivers are an Obamacare cure-all, giving Arkansas unprecedented flexibility to implement “innovative,” state-led reforms.

But rather than serving as an escape hatch from Obamacare, Section 1332 waivers create a stranglehold on state-led reform initiatives. As usual, Washington bureaucrats hold all the cards and they’re interested in only one thing: protecting and expanding Obamacare.

States would be required to provide benefits at least as generous as Obamacare, cap cost sharing at least as low as Obamacare and cover at least as many people as Obamacare. Worse yet, experimenting with these waivers would put state taxpayers at risk for cost overruns for federal programs. In other words, states can receive waivers to make Obamacare worse, but never better.

No wonder the Obama administration has proclaimed that these waivers serve as a backdoor to implement welfare policies that are even more liberal. Maybe Sen. Sanders is hoping to hire Obamacare architect Jonathan Gruber to help design Arkansas’ Section 1332 waiver, just as Gruber helped design Vermont’s failed single-payer Section 1332 waiver.

Abdicating Legislative Responsibility

To be fair, it’s hard to call Sen. Sanders’ newest proposal a defined plan at all. Rather than provide specific details, Sanders’ plan abdicates legislative responsibility for policymaking. Instead, the plan would give a blank check to the same folks that came up with the failed Obamacare Private Option. These are the same bureaucrats that have traveled the country on taxpayer time to promote Obamacare.

The last time the state gave these bureaucrats unchecked authority to make policy, they came up with “Health Independence Accounts” that encouraged over-utilization and unnecessary care, increased costs, and fostered more government dependence. Earlier this spring, the legislature passed a new law that ended this failed policy before it even got off the ground for most enrollees.

Time To Unwind Obamacare, Not Cement It In State Law

Arkansas lawmakers took an important first step by repealing its Obamacare Medicaid expansion, effective December 2016. In order to ensure the state meets that deadline, they should be focused on ways to slow the program’s growth over the next two years.

Unfortunately, this new plan would reverse the progress Arkansas has made so far, violating the promises legislators made to their constituents. It would write state bureaucrats a blank check to potentially keep Obamacare expansion forever and, if that weren’t bad enough, make Obamacare even worse than it already is.

Some lawmakers may be content to double down on another failed Obamacare experiment. But those looking for an Obamacare escape hatch will have to look somewhere other than Section 1332.

This article originally appeared at Forbes, March 17, 2015.


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