New Orleans Arkansas is a poor state. This is not shocking news to anyone who has ever been there. It should not come as a surprise either that a quarter of the people in the state outside of the range of federal health supports for children and elderly (between ages 14-64) have nada for health care coverage. Arkansas is not Louisiana or Texas where there is a charity support system on the state or county level which can provide some minimal coverage for the lower income workers. A huge number of Arkansas workers, like those in some many other states, are also employed by small businesses, who argue, perhaps gratuitously but still with some factual basis, that they are have been priced out of the market for comprehensive health care insurance.
This week Governor Huckabee, a Republican in the Wonder State, announced a that the feds were going to give the state a waiver to try to put in a bare bones plan that might end up covering as many as 80,000 uninsured workers in the state. If this is a safety net, it’s woven with some pretty big gaps in between the ropes. A worker would get 6 doctor visits and 6 days in a hospital per year. The worker would have to pay $15 per month and up to $1000 in co-pays for utilization of the maximum “benefit.” The employer — and this is a good thing — has to insure everyone or no one and has to pay around $100 per month to do so. Furthermore this is for workers making less than $35,000, that’s a lot of Arkansas workers! Another plus of the plan is that it bars low-riders — companies (does Wal-Mart come to mind?) that might be tempted to downgrade a policy to bottom fish with this plan.
It is amazing to think that this is where public policy around health care has now come — to the bottom of the barrel. It’s a bare bones plan that pretty much let’s you know that you better not break any of those bones! This is neither comprehensive care, nor is it catastrophic care. The poor, sorry Arkansas worker that has to fight cancer or a bad ticker or something like that is still — for the most part — out of luck, but so are a whole lot of workers in other states in the same predicament.
This is a plan that is advertised as “better than nothing.” I’m going to reserve judgment and hope that it works to tell the truth. I’m actually worried that a lot fewer than 80,000 workers will end up being covered by even this fig leaf around their health. For all of the whining about small business people, never discount the fact that some of them are just plain cheap, too.
We need to see what we can do to make sure that people really get enrolled. We need to push all of these small businesses into the plan. Then we need to see if it works. Give the devil, its due. And, if we can get there, let’s then see what we can do to improve it from this starting place.
We have to start somewhere. Why not Arkansas?
March 9, 2006