Theory vs. practice: scrapping ACA benefits isn’t easy

In theory, Republicans are desperate to destroy the Affordable Care Act and take insurance and related benefits from millions. GOP lawmakers in Congress have demonstrated their commitment to this goal with literally dozens of votes to repeal “Obamacare.”

 

But these efforts generally come with an important caveat: they’re hollow. Republicans know these efforts won’t become law, at least not anytime soon, so it’s all for show — GOP lawmakers are effectively pounding their chests in a display intended to make themselves feel better.

 

When the debate is less theoretical and more practical, Republican bravado isn’t quite so effortless. Take yesterday, for example, where Arkansas’ new GOP governor was weighing whether to kill the state’s Medicaid expansion policy.

This outcome was hardly assured. Hutchinson, a former congressman elected governor just a few months ago, would not take a position on Arkansas’ Medicaid-expansion policy during the campaign. Just 24 hours ago, it was not at all clear whether he intended to take coverage away from 200,000 low-income Arkansans.

 

But as it turns out, it was a step the Republican governor just wasn’t prepared to take. There’s a larger significance to this that extends past Arkansas.

 

Let’s make this plain: there’s a big difference between Republicans saying, “We hate the president, so your family will no longer have access to basic medical care,” and Republicans actually doing it. Plenty of GOP governors have blocked Medicaid expansion in their states in part because of this dynamic — once families have health care coverage, it becomes extremely difficult for Republican policymakers to announce they’ve decided to take those benefits away, leaving struggling Americans with practically nothing.

 

Getting Medicaid expansion approved in Arkansas wasn’t easy, but faced with the option of killing the policy, Hutchinson found it easier to keep it alive for a couple of years while he considers alternatives. His motivation seems pretty straightforward: after a month on the job, the governor didn’t want to be the guy to take health security from 200,000 of his own constituents.

 

Also keep in mind, as Greg Sargent noted yesterday, the policy is working: “Thanks in part to Arkansas’ Medicaid expansion — a.k.a. the Private Option — the state showed one of the steepest drops in the uninsured rate in the country.”

 

Hating “Obamacare” is one thing; confronting the reality of “Obamacare” succeeding is something else.

 

Of course, it’s important to emphasize that Hutchinson’s announcement yesterday was not the final word on the subject, and Arkansas’ Republican-led legislature will still have to approve the governor’s preferred approach. To put it mildly, that won’t be easy.

 

But for now, Hutchinson’s remarks yesterday were a reminder of the practical realities surrounding ACA politics that many of its opponents too often fail to appreciate.