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Nic Horton

How AAI’s Town Halls Have Changed the Medicaid Debate

Updated: Apr 13

Ed Haislmaier of Heritage speaks to a packed house in Conway.


This week, while legislators were at the Capitol talking to each other, the Advance Arkansas Institute traveled around the state talking to the people of Arkansas about the perils of Medicaid expansion. The meetings featured two national health care policy experts: Christie Herrera of the Foundation for Government Accountability and Ed Haislmaier of the Heritage Foundation.

Meetings were held in North Little Rock, Conway, Hot Springs, Hot Springs Village, and Benton. I attended every one of them, plus a luncheon that was hosted for legislators. After speaking with hundreds of people from around the state, one thing is abundantly clear: the people of Arkansas do not want the legislature to rush the “private option” through. They said it at every event, in every way they could. They want more time to examine the details of the plan and to talk with their legislators. Perhaps if legislators took more time to discuss their plan with their constituents and were less worried about rounding up votes — or if they had attended our town hall meetings — they would be more in tune with what their constituents want.

Instead, legislators are on the defensive, starting Twitter wars against AAI: just this morning, the estimable Speaker of the House Davy Carter suggested that calling ourselves an organization was a “stretch” because we only have two employees. (We have five, but whatever.) Multiple legislators groundlessly charged that our experts hadn’t read the private option bill and legislators, eager to believe in their own rhetoric about the wonders of Medicaid expansion, have tirelessly generated and regenerated baseless rumors and attacks on our organization. If anything, I think this series of Twitter bombs demonstrates:

1. the effectiveness of AAI;

2. the fear amongst legislators that the wheels are falling off of their private option train;

3. the terrible future for Arkansas that awaits under the private option, assuming that the legislators who have demonstrated how careless they are about describing AAI’s conduct have been equally sloppy in attending to the details of the private option.

Yesterday, just minutes before we began the Hot Springs town hall event, Majority Leader Bruce Westerman dropped his support of the “private option,” removing his name as a cosponsor from the enabling legislation. (This news garnered a loud round of applause from our town hall attendees, many of whom were his constituents.) On Monday night, Senator Jason Rapert told the crowd in Conway that he would join Rep. Westerman’s calls for delaying a vote on the private option. Additionally, Rep. David Meeks said he would vote against the private option plan.

I think all of these developments demonstrate the impact that AAI and The Arkansas Project are having on the Medicaid debate. Perhaps they also explain the flurry of unflattering tweets and irrelevant criticisms from proponents of the “private option.” If only those legislators had paid similar attention to the substance of Medicaid reform when tweeting at us, perhaps we might have had a productive dialogue.

On Monday, news broke that Ohio is abandoning Medicaid expansion — they have a Republican governor who advocates for expansion, but their Republican legislature is saying no. Our neighbors in Missouri in the Republican-led Senate have told their Democrat governor “no go” on expansion as well. Senate President Tom Dempsey said he believes the federal government will have to revisit the Obamacare law as early as this year. Therefore, it seems prudent for his state to delay implementing the program. Finally, news broke late last night that Governor Bobby Jindal in Louisiana is opposing Medicaid expansion — specifically an expansion that adopts the “Arkansas model.”

Back in July, Senator Rapert told a town hall in Conway that if Arkansas expanded Medicaid while our neighboring states rejected it we would “turn Arkansas into a candy land of entitlements.” Presumably this was an undesirable policy outcome. Now, our neighbors in Louisiana, Texas, Oklahoma, and Missouri have said no. Mississippi — which has a Republican governor, house, and senate — is still debating but will likely say no. Will Arkansas, with the first Republican majorities since Reconstruction, become the only state in our region to expand? Will we become the land of entitlement junk food?

To see part of AAI’s North Little Rock town hall, see the video below:


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