Jay Bradford’s Selling Hard on Health Insurance Exchanges. Are Lawmakers Buying?

Jay Bradford on Arkansas health insurance exchange
Arkansas Insurance Commissioner Jay Bradford

All right, show of hands: You’ve all heard of the old sales tactic called  the “foot in the door” technique, right? Where a crafty salesman gets a customer to agree to a small request, in order to soften up said customer up for larger requests to come? Why, it’s a timeworn classic (and well-supported by numerous egghead studies)!

If you’d like to get a great example of the “foot in the door” technique in action, drop in on a legislative hearing sometime when Arkansas Insurance Commissioner Jay Bradford is pitching lawmakers on setting up a health insurance exchange. The man’s a master.

At a hearing Monday, Bradford asked legislators to signal their approval for his department to move forward with an application for a $3.8 million federal grant to continue developing the Arkansas health insurance exchange. Recognizing that many lawmakers are wary of the exchanges, Bradford offered a warm bath of smooth reassurance if they’d just let him move forward: “That’s all we’re asking to do, is keep it alive,” he said. (No down payment! No commitment! Sign here!)

Bradford’s “foot in the door” is to emphasize that this is just a lil’ ole tiny grant, a few million free dollars from the federal government, that will allow Arkansas to keep setting up a state health insurance exchange, to keep those nasty feds from setting one up for us.

A consummate salesman, this Bradford: Keep lawmakers comfortable with this modest grant request, and hit ’em again down the road for a bigger commitment. That’s the ticket. And if the courts rule against Obamacare or a new president or Congress should scrap the law, why, by golly, the exchange can just “go away,” says Bradford, and we’ll be none the worse off.

Of course, that’s not likely to happen. Because once they secure the grant, move further the planning process forward and get the exchange ready to go, the rationale will change. It will morph into, “Gosh, we’ve gone this far and we’ve invested so much time and energy and money. If we pull the plug on this now, all that money will have been for nothing. We can’t let that happen.” Bureaucratic initiatives of this scope rarely just “go away,” as Bradford soothingly suggested to lawmakers on Monday.

Highly skeptical questioning from GOP House Minority Leader John Burris emphasized that, if Bradford and Gov. Mike Beebe want to move forward with the grant application, they don’t really need the legislature’s OK. (Blogger Jason Tolbert helpfully notes that it remains unclear exactly what would be the mechanism for the legislature to “show support” for the effort.)

The deadline for the application is September 30 (Friday). Will Gov. Beebe stake a portion of his storied political capital on making sure that the health insurance exchange stays alive in Arkansas, if lawmakers balk? Right now, it looks doubtful. But Bradford will keep his foot in the door for as long as it takes.

Background: The Arkansas Project’s Dan Greenberg, a former state lawmaker who knows more about health insurance exchanges than you do, offered up a fine briefing paper today on why legislators should be wary of plans to move forward with the exchange in Arkansas. Go, read!

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