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Health Care Exchanges: Wait, Exactly Who’s the Dope in Beebe’s Rope-A-Dope Strategy?

Mike Beebe and Obamacare: Flatlining in Arkansas?

Democratic blogger Michael Cook at the Look Who’s Cookin’ blog weighs in today on the disputed matter of the Arkansas health insurance exchange. Last week, Gov. Mike Beebe elected to forgo pursuing a $3.8 million grant for establishing the state level exchange after receiving pushback from a handful of Republican lawmakers.

(Pushback = a two-and-a-half-page letter signed by six legislators arguing that they don’t think it’s such a great idea. Man, these Republicans play hardball!)

Cook is, predictably, certain that this is yet another of Beebe’s tactical masterstrokes, but that’s mostly because Beebe is the master and Cook’s job is to stroke him. “It’s a rope-a-dope strategy, see! Why, yessir, ole Mikey’s got them no-account Republicans on the ropes now, boy howdy!”

Except probably not.

The argument that Beebe is advancing, with the help of his swooning handmaidens in the state media and at the Arkansas State Chamber of Commerce (which we’re required to pretend is an independent organization representing the business community, but which is in fact an unofficial arm of the Beebe administration), is this: Either Arkansas can set up a health insurance exchange, or the federal government will set it up and run it. Who would you rather have in charge? Huh? Who? Well?

It’s a nonsense argument. In fact, the much-vaunted “state control” of health insurance exchanges is likely an illusion, given the heavy hand of federal rules and regulations that Obamacare brings. That’s according to health care policy whiz Ed Haislmaier at the conservative Heritage Foundation:

The combined effect of these regulations and grant requirements are that a state would have to agree to surrender any last vestiges of meaningful control over how Obamacare is implemented. Thus, a state would now have no more real control over an exchange it set up than over one HHS established.

While just 24 months remain until exchanges must open for business, HHS has made little discernable progress toward creating federal fallback exchanges.

Consequently, at this point the best course of action for states is to neither apply for nor accept exchange establishment grant funding.

Moreover, there’s also the question of why, if the health insurance exchanges are such a winner, so many states are moving slowly to establish them. (According to the National Council of State Legislatures, 14 states have moved to establish exchanges in the 18 months since Obamacare was passed.)

Florida has opted out, turning away millions in federal grant money. Kansas and Oklahoma returned federal grants totaling $32 million and $55 million, respectively, rather than accept the chains that come with Obamacare. Even in deep blue New York, obstreperous Republicans in the state Senate blocked the state from pursuing federal money to set up the exchange—the same grant rejected by Arkansas Republicans, who, let’s not forget, do not control either arm of the legislature here.

And anyway, why all the posturing and maneuvering from Beebe? If he wants to continue pursuing federal money to set up the exchange, he has control of the executive branch and his party has control of the legislature. And we’ve already established that Beebe doesn’t need Republican lawmakers to give him the go-ahead. If moving forward with setting up the exchange is the right thing for Beebe to do, as Cook and others would have it…what’s stopping him?


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