Sadly, Conduit Right Again!

In an August 2015 article Brenda Vassaur Taylor warned readers – any benefits to the Arkansas taxpayer of Arkansas’ Obamacare Medicaid Expansion would soon be behind us. It was a warning of future costs to Arkansas taxpayers.

At that time the program was 100% federally funded, plus Arkansas was siphoning off part of the “free” federal money by charging an insurance premium tax on each person covered. Things have changed. Now Arkansas has to pay part of the costs and the amount siphoned off through the insurance premium tax is only a drop in the bucket.

How did the Obama administration talk Arkansas into paying for a program primarily for able bodied working age adults who do not work?  Answer: A free trial. All Arkansas had to do was sign up and the federal government would pay the entire cost for the program for the first few years.

A free sample or free trial is an established sales ploy to hook consumers who might otherwise say “No.”

To help sell the program, the Arkansas legislation included a provision that would automaticly end the program (before Arkansas would have to pay), unless the legislature passed new legislation to extend it.  But, Governor Asa Hutchinson was hooked on the big government program. In 2016 Governor Hutchinson pushed passage of legislation for an unlimited extension of the program, despite future costs. He changed the name of the program from “Private Option” to “Arkansas Works.”

Now Arkansas has to pay part of the cost. Arkansas’ share will go up in the future.

The free trial is behind us. You get to pay for Governor Hutchinson’s program which is designed primarily for able bodied working age adults who do not work.

In 2017, Representative Josh Miller’s bill to stop new enrollment in Arkansas Works passed the Arkansas House of Representative, but Governor Hutchinson was able to kill the bill in the Arkansas Senate where is nephew, Senator Jim Hendren, is the Senate majority leader.

What does your state Senator and state Representative think about this program? You might want to ask because the legislature is about to begin its 2018 Fiscal Session.


Brenda Vassaur Taylor’s August 2015 article is well worth reading and we have included it below:

Economic Freedom—When to say “enough”?

By: Brenda Vassaur Taylor – Conduit for Commerce

Posted on August 21, 2015
Updated 8/22/2015 @ 9:00 PM

Welfare StateThis week Governor Asa Hutchinson put forth his “Seven Elements[i] on why the Arkansas legislature should continue to expand Medicaid under his “newly” designed seven conservative tweaks.   But as a fiscal conservative, should we continue Medicaid expansion?   The answer is a resounding “No!”  We encourage our legislators to stop now.  Arkansas has had all the Obamacare Medicaid expansion free money it can afford?”  Make no mistake, this optional program that our Governor is promoting IS Obamacare for the state!

If you think we are just holding firm to a worn out position, let the Governor’s own numbers speak for us.

Three Points by the Numbers!

  • The benefits to Medicaid expansion in Arkansas are behind us.
  • HCIP endangers Medicaid for our most venerable and helpless while supporting others.
  • Continuing to expand Medicaid is clearly a policy which fails to pass our CFC Economic Freedom Filter test.

***

First:  The benefits to Medicaid expansion in Arkansas are behind us. 

The key to the Governor’s argument to support the continuation of Medicaid toone-third of the Arkansas population[ii] appears to be found in the last line of his chart used in his speech titled Impact of Arkansas Health Care Independence Program (HCIP) on State Spending. [iii]

According to the Governor’s own numbers, he projects a $911.5 million net overall benefit to the Arkansas economy over a period from 2014 through 2023. We note the following taken from his chart as the most compelling points in assessing his program:

During 2014-2016:

  • Arkansas receives 44% of the total 10 year benefits and pays 1% of the total 10 year costs while the Federal government pays $3.2 billion.

During 2017-2020:

  • Arkansas receives 47% of the total 10 year benefits and pays 39% of the total 10 year costs while the Federal government pays $6.96 billion.

During 2021-2023:

  • Arkansas receives 9% of the total 10 year benefits and pays 60% of the total 10 year costs while the Federal government pays $6.15 billion.

The above summary may be helpful.  But specific details from the Governor’s Chart are better understood when examining specific numbers as referenced below:

10 Years Total Benefits to AR               (Net Impact of AR HCIP) Total Direct Costs to AR     (State Required Match plus Admin Costs) Benefit to AR Exceeding Direct Costs Cost to Fed Govt  (Influx of Federal Funds)
Dollars Percent Dollars Percent Dollars Dollars
2014-2016 403 Million 44% –7 Million 1% 396 Million 3.2 Billion
2017-2020 429 Million 47% -452 Million 39%  -23 Million 6.96 Billion
2021-2023 79 Million 9% -692 Million 60% -613 Million 6.15 Billion
Totals 911 Million 100% -1.151 Billion 100% -240 Million 16.33 Billion

It is obvious from an examination of these numbers that benefits received during years 2014-2016 are irrelevant to the issues at hand.

The only relevant information when deciding whether to continue to expand Medicaid is—“What do the benefits and costs to Arkansas look like after 2016?”  During the last three years of those noted by our governor, these numbers show benefits after 2020 of $79 million to our state while costing us $692 million.

Others may want to argue that when considering the benefits, we must also include the savings gained to Arkansas by our reducing payments for the vulnerable and more-needy in our state under traditional Medicaid; the savings from uncompensated care; and the added tax revenue from the premium fees charged insurance companies (which are actually paid by the taxpayers as well since the non-profit insurance companies are guaranteed a 20% profit on the gross revenues).   But those claimed off-setting figures in no way mitigate the clear trend downward as we struggle to support one million people on the government life-boat.

From the Governor’s own numbers, years 2017 forward chart an undeniably dangerous fiscal future for Arkansas (as well as for our Federal government.)  Clearly the benefits to this program are behind us.

Second:  HCIP endangers Medicaid for our most vulnerable and helpless while supporting others.

From the column of totals from the Governor’s full chart referenced above, we observe the following:

  1. HCIP takes $666 million away from the historically vulnerable and needy under traditional Medicaid to pay $1.15 billion in state money for 250,000 able-bodied adults who work less than full-time and have no dependent children;
  2. It saves money given to hospitals for uncompensated care in the amount of $362 million (a system the Governor stated had been dismantled under HCIP);
  3. Collects $378 million in new taxes from insurance companies (being 2.5% of the total premiums paid to the insurance companies by the state) which means the state will have paid insurance companies $15.12 billion over that 10 year period);
  4. Cost the Federal Government $16.4 billion over the same 10 years to support this welfare expansion. (Note that 15.12 Billion of this goes to insurance companies.)

Third:  A policy which continue to expand Medicaid does not pass the CFC Economic Freedom Filter test.

Conduit for Commerce is not supportive of the Governor’s position to continue Medicaid expansion due to three simple facts regarding his proposal:

  • It grows state and federal government—which have already proven to be inefficient and ineffective when exercising control over our health care, a vital piece to our economic freedom (with examples too numerous to mention);
  • It adds to government dependency by adding/maintaining at least 250,000 able-bodied adults to the Medicaid welfare rolls, most of whom do not work full-time and are mostly without dependent children, while simultaneously taking away needed dollars from Arkansas’ needy and vulnerable (the poor, children 19 and under, disabled, and elderly—on our state’s traditional Medicaid);
  • It spends money we do not have—costs to our Federal government–$16.4 billion over 10 years. Currently the federal government is in excess of 18 trillion dollars in debt.  This money therefore will come either from additional taxes on all Federal taxpayers or will be borrowed from our potential enemies.

Conclusion:

PLATE - THREE -3Governor Hutchinson believes it is more beneficial to Arkansans over a ten year period to retain 220,000 to 250,000 able-bodied non-working Arkansans from ages 20 to 65 on welfare for each of those ten years.   We respectfully disagree.

Using Governor Hutchinson’s own numbers, Arkansas should not pursue the continuation of Medicaid expansion after 2016.  To do otherwise will solidly entrench at least 250,000 able-bodied Arkansans into a welfare system they will have every reason to expect must continue….no matter how unsustainable by the taxpayers of Arkansas.

It is our belief that this continued policy of Obamacare Medicaid expansion will permanently move us away from our hopes of returning to a Land of Opportunity and permanently crown us:  “Arkansas–the Welfare State.”

 

 


 

[i] See attachment –Governor Asa Hutchinson handouts to his speech August 19, 2015 regarding HCIP

[ii] Arkansas has a total population of 3 million people with one million now enrolled on Medicaid since the 2014 HCIP expansion according to numbers of enrollment reported by DHS.

[iii] See attachment -Governor Asa Hutchinson handouts to his speech August 19, 2015 — HCIP