Do not be confused. The expected Republican hubbub over yesterday's release of their specially requested and clandestinely influenced Medicaid auditwas pre-planned theater.
Republicans like Bruce Westerman and David Sanders— and most of the rest of the GOP caucus — oppose universal health coverage of the working poor in Arkansas and will use any tool to stop movement in that direction. Including an audit that turned up well, not a whole lot.
A multi-billion-dollar program serving 700,000 people through hundreds of provider agencies and thousands of employees was found to have a high payment error rate in a narrow slice of about 1,000 of those served — people in the category of dwindling resources where questions are sometimes hard to answer as to whether a person is truly impoverished enough to receive Medicaid benefits. It's important to be right, of course. If procedures can be improved there, improve them.
But this is no reason to fight covering more people through federal Medicaid expansion. Indeed, if this country had the universal health care that is considered a birthright in other developed nations, we wouldn't have a need for expensive audits and bickering over "spenddown accounts." American people would have the health care they need. Don't ever lose sight of the fact that, as a matter of principle, Republicans oppose this. That's an honest debate, but one the GOP is loathe to engage.
Then there's the finding that a doctor in Arkansas who sees Medicaid patients had a 2000 conviction for possession of pornographic material in his e-mail involving minors. He had not made formal annoncement of that fact to DHS, which didn't think it necessary because it was well aware of his record. This doctor made the lead of the Arkansas Democrat-Gazette recitation of the audit findings and was trumpeted yesterday by a paid Republican flack when the otherwise unspectacular audit findings were released. The concern trolls like David Sanders were out in full force harrumphing about it.
The physician, fully licensed in Arkansas, isLonnie Joseph Parker. His past was hardly a secret. Indeed, Mara Leveritt of the Arkansas Times wrote several articles about prosecutorial misconduct in the course of his tortured journey through the federal court system. They are archived at this website. DHS, aware of his background, saw no need to require a formality that would tell them what they already knew. Nothing untoward has been said about him since his relicensure by the Medical Board and return to practice. The record is the record. He stands convicted. But, like a lot of things, his case doesn't boil easily down to the GOP's implicit meme — DHS turned a blind eye to a pervert run amok with children in the state's care and the earth should stand still on improving medical services. He's popped up in the news periodically as his past his been an issue in seeking employment. If David Sanders thinks this a legitimate concern, he should talk to the Medical Board, which gave Parker full authority to practice. DHS says it shouldn't be in the business of substituting its judgment for the medical regulators.
Again: Republicans want to stop Medicaid expansion. They'll use any tool at their disposal, including the inevitable lapses in a giant program that serves the state's neediest people in often extremely difficult circumstances. Some document shortcomings are reason to upend broader medical coverage? Not to a rational person.
I can't help but compare the rush for Medicaid delay based on these findings to Republicans' rush to close the limited public records available on concealed carry permit holders.
You want mistakes? There's ample evidence in Arkansas and everywhere in the U.S. that the gun background check process fails at times. Criminals get permits. The only accountability is through availability of public records. The public also needs the ability to check on people who commit crimes or make bad judgments while holders of permits (the quick-drawing doctor who opened fire on a fleeing car in a Little Rock grocery store parking lot and plugged an innocent car), will become an official state secret with approval of Fireball Holland's legislation to make permit records secrets.
But guns are sacred now. Nothing must stand in the way of more guns in Republican Arkansas, no matter who has them. Medical care for children, the elderly and working poor? Can't rush into THAT.
Oh and speaking of background checks: You DO know two Republican thieves with criminal records qualified for the ballot in 2010. One was discovered only after he began serving in the legislature. Maybe we should stop paying all lawmakers until we figure out a way to avoid seating felonious legislators in the future.
PS —Roby Brock has done an excellent extended analysis of the audit at Talk Business.