The Affordable Care Act is proving to be quite important nationwide, but it's been especially significant in Arkansas, where Medicaid expansion has brought coverage to more than 100,000 low-income Arkansans. Republicans in the state nearly blocked the policy, but there a compromise was reached: under the "private option," beneficiaries buying private coverage with Medicaid funds.
Because it's making such a difference in the lives of so many, the policy has left Arkansas Republicans in an awkward position: to oppose the private option and Medicaid expansion is to endorse taking coverage away from more than 100,000 Arkansans who need it. Or more to the point, to repeal "Obamacare" is to cut these struggling families off at the knees.
With this in mind, the Arkansas Times' David Ramsey asked U.S. Rep. Tom Cotton (R), currently a competitive U.S. Senate candidate, about his intention to destroy the Affordable Care Act in its entirety.
"We would repeal Obamacare and replace it entirely with many reforms for our health care program," Cotton said. I asked whether he had a specific replacement plan which would cover all the folks who would lose their coverage if Cotton succeeded in repealing the law. He trotted out some tried-and-true Republican talking points which would do no such thing, such as allowing insurance to be sold across state lines. "We want every Arkansan, we want every American, to have quality, affordable access to health care," Cotton said.
Really? Because if so, that's an interesting position for a Republican to lock himself into. In fact, GOP candidates and policymakers have generally avoided endorsing such a progressive goal because they realize guaranteeing affordable access to health care for "every American" is difficult -- and Republican proposals, when they exist, invariably fall short.
So, if Cotton supports giving everyone in the country access to medical care they can afford, why doesn't he support his own state's Medicaid expansion policy?
"The private option is a state-based issue," he said.
That's a nice try, I suppose, but it's not much of an answer. Cotton represents Arkansas constituents; he's running for statewide office in Arkansas, and he's being asked about whether Arkansas should accept federal resources for health care. Taking a pass on the question shouldn't be one of his choices.
But there's a lot of this going around.
Greg Sargent had a helpful round-up, noting that Senate hopeful Terri Lynn Land (R) doesn't want to give her position on Medicaid expansion in Michigan; Senate hopeful Thom Tillis (R) doesn't want to say what he thinks about Medicaid expansion in North Carolina; and former Sen. Scott Brown (R-Mass.) refuses to talk about Medicaid expansion in his new home state of New Hampshire.
In theory, isn't this supposed to be easy? Republicans have said for months that Americans hate the Affordable Care Act, so all GOP candidates have to do is oppose the law and wait for voters to rally behind them.
And yet, when pressed on Medicaid expansion, it seems quite a few Republicans don't want to talk about it.
It's as if the politics surrounding health care are a little more nuanced than some on the right would have us believe.