By Nic Horton | The Arkansas Project

Nic Horton

LITTLE ROCK —  I attended a recent health-care town hall meeting that focused on Medicaid, doctor shortages and federalism in Conway. The discussion was hosted by state Rep. David Meeks, state Sen. Missy Irvin and state Sen. Jason Rapert and moderated by Advance Arkansas Institute President Dan Greenberg.

Greenberg opened the forum, which about 100 people attended, by saying that the panelists are “three of the most genuine, principled legislators I’ve had the pleasure of dealing with.” Meeks, a Republican who represents District 46, then began by reiterating that the problems with the state’s Medicaid program aren’t new.

“We’ve had these problems for a while. Over $800 million of Obama stimulus money was used to cover our Medicaid shortfalls,” Meeks said.

Meeks also said that if the states reject Medicaid expansion, it will save the federal government $1.9 trillion over the next 10 years.

Irvin, a Republican who serves District 10, then spoke about the shortage of physicians in Arkansas — a fact that has been highlighted by recent news reports. She also cited a recent report that said 83 percent of doctors nationwide have considered leaving medicine over the Patient Protection and Affordable Care Act regulations.

Irvin, whose husband is a doctor, also described the difficulty of recruiting quality physicians — or any physicians — to rural Arkansas where her husband practices. And because Medicaid does not cover all of the costs of treatment, doctors must see 40 Medicaid patients a day just to break even. Because of this, Irvin recommends that Arkansas institute copays for Medicaid care.

She also emphasized that expanding Medicaid under the federal health-care law, commonly referred to as Obamacare, will “water it down” and prevent those who really need quality care from receiving it.

Rapert, a Republican for District 18, focused on federalism and the lack of a balance of power in the state of Arkansas.

“Gov. (Mike) Beebe is just like (President Barack) Obama — just doing whatever he wants,” Rapert said.

All three legislators echoed these comments later on in the forum, mentioning how they have not been consulted on Medicaid expansion and other critical issues that deserve the Legislature’s consideration, not just the executive’s.

One particular example is the acceptance of federal funding for Obamacare. “The Legislature never authorized the implementation of the exchanges,” Rapert said.

And he’s right: Beebe bypassed the Legislature, because Rapert and others were working to block it, and passed the grant acceptance through the Arkansas Legislative Council. There now appears to be some question as to whether ALC is actually authorized to do this.

Rapert said America is having a “crisis of federalism,” a sentiment with which Richard Peltz-Steele would certainly agree. He also said Arkansas’ movement toward expanding Medicaid while many neighboring states are rejecting expansion will turn our state into a “candy land” of entitlements, drawing in patients from neighboring states. The fiscal results will be catastrophic. We cannot even afford the patients we currently have on the state dole.