Arkansans on the Hook if “Private Option” Costs Soar

by Mark Moore

The Arkansas Times committed a random act of journalism yesterday when they reported that the feds are putting Arkansas taxpayers on the hook if the per-patient costs of the so-called “Private Option” exceed their Medicaid guidelines.   The feds are paying for the costs of the expansion during the three year life of the waiver, but we will be expected to cough up the difference if there has been any cost over-runs during that time.

So how much wiggle room do we have?  You are going to love this one.  Less than five dollars a month per beneficiary.   So for example, DHS predicted the costs for a medium, or silver, plan would be $495.79 per participant and the feds have told them that any costs over $500.08 would be billed back to Arkansas at the end of the waiver.   What are the odds that a government healthcare program can be contained so that actual costs stay less than 1% greater than its projected costs over three years?  Those are the odds that we won’t be stuck with a bill at the end of that period.

Actually, there is a caveat to that which could keep us from having a big bill at the end of this thing (at which point the feds are going to yank the temporary waiver and leave us with exactly what they wanted us to do at the start).  The costs are being calculated on a per-person basis, not a total cost basis.  That is, they don’t care if the total bill is billions more than first projected, we only get punished if the per-person bill is $5 a month more than anticipated.

Why keep score in such an insane fashion?   Because the socialists want as many people as possible to be forced into the program.   They want to force healthy people into the program.   This will keep the “per-person” costs down, even though it will raise total costs and take away freedom.   Look for the state of Arkansas to really start trying to push healthy people into this program.   This way of measuring costs is designed to leverage state government to be used against its own citizens and badger them into an unpopular program even if they don’t feel that they need it.

The Republican legislators who dumped Beebe’s plan on us are spinning madly, but its just spin.   This is nothing but Obamacare in a hat and sun glasses.   The so-called “Private Option” is Medicaid expansion, they just run it a slightly different way than normal (but it is something that has been possible under Medicaid for a long time).    And even this amount of leeway is temporary.   The temporary Medicaid Waivers (again, it operates under Medicaid waivers because it is a Medicaid program, its an expansion of Medicaid) can be pulled in three years and we can be billed for any cost over-runs.