Taking the long view of an issue is often a difficult task for politicians. Pandering to a culture of immediacy, the habit of bowing to political expediency is easily acquired and painfully shed. We see a prime example of this going on at the state capitol as Medicaid Director Andy Allison, Surgeon General Joe Thompson and Insurance Commissioner Jay Bradford testified Wednesday morning before the Hospital and Medicaid Study Subcommittee of the Legislative Council. As reported by Arkansasnews.com, the officials were attempting to cajole lawmakers into supporting an expansion of the state’s Medicaid rolls under the federal health care act.
The proponents of expansion said the state would greatly benefit by expanding Medicaid to include people earning up to 138 percent of the federal poverty level, as the federal Affordable Health Care Act proposes. They stated that between 200,000 and 250,000 more people would be covered by the federal-state health care program for the poor, the elderly and the disabled under the expansion.
Thompson told the committee that Arkansas is one of the poorest states in the nation, with has one of the highest uninsured rates, which means it is one of the states with the most to gain from the expansion.
“The Affordable Care Act does a fundamental redistribution of federal dollars from states that have a low uninsured rate, like Massachusetts at 7 percent, to states that have a high uninsured rate, like Arkansas at 25 percent,” he said.
Bradford based his argument in part on the fact that current provisions permit coverage only for persons who earn up to 17 percent of the poverty level. This means that people between 17 and 100 percent of the poverty level would not have health insurance coverage. Under the proposed rules, individuals who make up to 400 percent would be provided insurance subsidies.
Independent reporting for Pine Bluff & Jefferson County since 1879.
While this line of reasoning garnered predictable opposition form the state’s Republican lawmakers, it is important to consider the proposal in the aforementioned longer view.
Testimony from Dan Rahn, chancellor of the University of Arkansas for Medical Sciences, and Bo Ryall, president and CEO of the Arkansas Hospital Association, demonstrates the long-range utility of the changes. Rahn testified that expanding Medicaid would greatly reduce uncompensated care at hospitals. In 2010, uncompensated care costs to Arkansas hospitals were estimated at $338 million.
Similarly, Ryall said health care costs should go down if patients receive routine care rather than seeking care only in emergencies.
“They will be receiving care along the way, which would be cheaper, rather than waiting till they are at their sickest point and then showing up at the emergency room,” he said.
This change in the paradigm of health care access and delivery has collateral benefits that opponents fail to recognize. Apart from the immediate benefits of having lower aggregate medical costs for the state, over time we will have a healthier population. Healthier populations in turn tend to have more stable work and financial habits. Moreover, as previously discussed in this forum, healthier families tend to have better educational outcomes, lower likelihoods of involvement with crime and greater residential stability. All of these work together to strengthen the economy and communities.
Will it cost more on the front end? Possibly. That short-term focus really misses the point. Government when run at its best does not merely provide for present needs, but anticipates future scenarios and plans for their resolution. While this may not benefit political posturing of the moment, it is in the best interests of our collective futures.