OANH 8-5-26

The U.S. soccer podcast. I'm your host, Megan Klingeberg. And after interviewing so many dudes during this men's world cup, I'm so happy to be back with my U.S. women's national team players. I know the U.S. men's national team has changed how I think about myself, how I think about being an American, how I think about being on a team. It's one year out from that World Cup, and we're going to talk about the brightest prospects in U.S. soccer. You ready? I'm ready. Let's do it. The U.S. soccer podcast. Presented by Henko. Follow and listen on your favorite. platform. It's time to talk about the important issues for the natural state, and there's only one place to turn for that. Opportunity Arkansas's Nick Horton. You can find Nick's work at Opportunityarkansas.organsaw.org. And good Wednesday morning to you. Welcome back to first news. It is 20 minutes in front of 8 o'clock. And now returning to the show is the founder and CEO of Opportunity Arkansas, which you can find at Opportunity Arkansas.orgatso.org.org. When you go online as Nick Horton returns to the show. Nick, good morning to you. And we let you have a little small summer break for the last few weeks. So how have you been? Let's go. Hey, the big comeback. I'm so excited to be back with you guys. I'm doing great. I'm energized. And, you know, you make it a little bit of the unfiltered version this morning, Toby. I'm just really excited. Okay. I'm going on and feeling really recharged after a long summer. Great family time. We took the kids to D.C. for the fourth to celebrate the 250th and Branson and the lake, we've kind of done it all. So it's been a great summer. How about you? Much of the same. So, in fact, in fact, I was out of town last week. I was at the beach last week doing some summer activities as well. And of course, Nick, while I'm out of town, a bunch of things happened. And so a bunch of things that I want to talk to you about and get some explanations on. Top of the list for me was that Arkansas's request to extend the Medicaid expansion program was rejected by the federal government. And so can you explain in layman's terms what this means for our state? Yeah, this is a big one. And I'll take you way back in the files here, Toby, before, I guess before you were in Arkansas, but back before, a lot of people, you know, it was a long time ago. I'll just say that. I was very young. I had a lot more hair and a lot more personality back then. In 2013, in 2013, we had the first Republican legislature in state history. But we had a Democrat governor, and Democrats that still controlled much of state government. And the Supreme Court, Obamacare had passed in 2009, but the Supreme Court had just recently ruled that Medicaid expansion, the biggest part, the biggest pillar of Obamacare, was optional for the states. So the states did not have to opt in. And up to that point, Republicans had been pretty locked step. This was not something we were going to do. We were not going to add...

250,000 to 300,000 able-bodied working-age adults to our Medicaid program. That's not who Medicaid was intended to serve. Governor Beebe at the time, Democrat, partnered with the Obama administration. They came up with a, quote, conservative way to expand welfare to able-bodied adults. Turns out there's not actually a way to do that because this is not a population that should be served by this program. And then, yes, what happened late last week is that the Trump administration is finally getting this right. They're finally writing this wrong, and they're saying, you know what? This conservative quote unquote, I'm doing air quotes, but you can't see me. This conservative way that we expanded Medicaid, where instead of putting people into regular Medicaid coverage and these able-bodied adults, we gave them these premium, I call them Cadillac insurance plans through the Obamacare Exchange. That was twice as expensive, twice as expensive by the state's own estimates to do it that way. Wow. And we, Opportunity Arkansas and... myself and my personal capacity throughout my career when I was working at the national level on Medicaid reform, have told states and told Arkansas officials specifically, even when they submitted this most recent waiver request, specifically and directly, that at some point... The gig was going to be up. At some point, when we had a conservative presidential administration that actually got CMS and the federal government in line, that this sweetheart deal was going to go away, that they were not going to continue to be able to spend twice as much and drain twice as much from federal taxpayers and from state taxpayers as what otherwise would have happened. These Medicaid waivers, they're supposed to be cost neutral. They're supposed to be budget neutral. some experimentation and innovation and whatever in your Medicaid program, but it can't cost more money than it otherwise would have. And Arkansas's private insurance model has done exactly that for 12 and a half years. So the Trump administration is now saying you can't do that anymore. The media has gotten this wrong pretty much everywhere. Pretty much every media story I've read has suggested that the entire Medicaid expansion program is going away, or even that the entire Medicaid program is going away. Neither of those things are true. CMS and the Trump administration, thankfully, are saying, we're not going to let you continue a model that cost twice as much as it should. Yeah, which makes a whole lot of sense. Now, I think one of the questions that comes from this is what happens to the people that were using this expansion program, this current model from Obamacare? What happens to them to get health care? Are they responsible to go get their own health care coverage? You'll get jobs with companies that have health care. What happens with the people to get displaced on this?

Well, a lot of things there. Number one, nothing's going to happen between now and the end of the year. So this current waiver that the state is operating on is going to continue through the end of this year. And then we'll see. I mean, this is going to be a major topic in the legislative session. I'll tell you, Toby, I mean, our position on this has been really clear from the inception of Opportunity, Arkansas, and we'll continue to be really consistent on this, is that this is a program that, frankly, just shouldn't exist. And that may be hard for some people to hear. But when you're a working age, able-bodied adult that is 19 to 64 years old, you've got to go get a job. You've got to go find, you've got to go do something to get back on your feet. 90%, maybe higher than that now, but several years ago, all of the data was showing that over 90% of private employers, private jobs, provide health insurance. So it's not as if. there are no options and nowhere for these folks to go. Right. But this is a population that prior to that wrong decision in 2013 didn't qualify for Medicaid. This was not a thing. Medicaid was never intended to serve this population. I often say when I speak about this topic publicly, I shouldn't qualify for Medicaid. I shouldn't be able to go quit my job and walk into a DHS office and sign up for Medicaid and stay on it for the rest of my life. Right. That's the system that we have now. So there's work requirements coming, which is a great thing, and that's starting in the first of the year. So that's going to help a lot of people get back out of the program and back onto their feet. But look, the legislature, and again, we've been really clear, and it'll be really clear about this. This is a program that shouldn't exist. It's a dramatic drain on our state budget. It has not helped our hospitals. It has not improved health outcomes. every single promise that they've made for this program has proven to not come true, every single one. So we've got to start thinking differently about Medicaid, and we've got to start taking care of people that really need it, people in our nursing homes, people with severe disabilities, people on our Medicaid waiting list. Those are the folks that we should be thinking about and working to make sure that they're getting what they need, not trying to spread these resources out across. Almost a million people that are in our Medicaid program now. We should be focusing all of those resources and energy on people that really need it. Nick, is this unique to Arkansas? Are there other states that are in the same boat that are going to be getting rid of the expansion? You know, this model is unique to Arkansas. So we were the only, well, we were the first state that came up with this private insurance model. There were a couple other states that did it briefly for less than a year in New Hampshire and Iowa. No one stuck with it because they learned very quickly the lesson that, frankly, a lot of Arkansas policymakers were just too prideful to accept, which was that this was dramatically more expensive than we were ever told. And even in states that didn't use the private insurance model, the programs have been insanely over budget, increased government dependency, well beyond any of the, any and all of the projections in virtually every single state.

And so there's a lot of states that have been looking for waste of rain and cost, doing work requirements, maybe capping the enrollment, maybe creating a time limit like we have, by the way, in every other major welfare program. Medicaid is really unique because it was not intended to serve this population, Toby. It didn't have work requirements. It didn't have cost sharing. It didn't have time limits. Basic common sense features that make sure these programs don't become lifestyles and that they're just temporary and that they're off-ramps back into self-sufficiency haven't existed in Medicaid because it was never intended to serve. that population, it was intended to serve the truly needy. And so now when you've taken the entire program and you've flipped it inside out, now states have been scrambling to figure out, okay, well, how do we try to fix this? And it's a federal program that's tied up in all these federal rules and laws and regulations. And it's a, it's a big ball yarn. As far as we're talking with Nick Horton, the CEO of Opportunity, Arkansas. On the positive side of the, you know, things that could come out of this expansion going away that could be positive. Is it possible that with this going away could just regular, the regular public that's paying for their insurance premiums through work or if they're paying for it to, you know, out of their own pocket hour they're doing it. Is it possible that premiums could go down out of this? Absolutely possible. I think very likely that that happens. We've had data from the state for a while that's shown that because we took this population of able-bodied working-age adults, a lot of people think, well, they're healthy because they're not disabled and they're able-bodied. Well, it turns out when you give someone something for free, Toby, they sort of use it as an ATM card. Right. So we've seen a very high... utilization rate where this population is significantly more likely to go into the emergency room. And they're significantly more likely to just go run up big medical bills because what happens when it's not your money, right? It's a lot easier. Yeah. And so we have we have hard data from. The state, going back years, that shows by having this population in our insurance pool, that premiums have more than doubled. In fact, they've close to tripled now over the last 10 years. And so by getting that population out of our health care exchange, health insurance exchange, we could very realistically expect, and I think we will see. dramatic reductions in premium. It's so interesting, frustrating, frankly, because the big special interest, the big insurance companies, the hospitals, and everyone else have said the opposite for years. In fact, one of the original promises of this program is that it was going to keep premiums down. And Arkansas premiums have increased dramatically more than our neighboring states and states around us that didn't do this model. So that is a silver lining for sure. And there's a great, I mean, there's a serious silver lining here for taxpayers.

In that even if the expansion itself, and I'll just reiterate the nuance of this, we don't know that the expansion is going away, but we know that the insurance model is going away. And so even if we just go to a conventional Medicaid expansion. We can expect the cost to come down by at least half because this program cost twice as much as what regular Medicaid expansion would have cost taxpayers. So you're talking about $100 million in state savings. A tenth of the corporate income tax for reference is $50 million. So you're talking about potentially another two-tenths of revenue that can be used to put money back in families. pocketbooks, back in family budgets, so that they can afford to go buy groceries and pay their rent and pay for their own health insurance and other things. So there's a lot of, there's a lot of positivity about this. Of course, that's not how the media and other folks are going to cover it. But there's a lot of good news here for sure. Yeah. Look, this is a good corner for our state to go around. And so I'm glad that we're at least making headway at this point. Another item, Nick, that I saw last week was it the ballot measures amendment to rewrite our state constitution. They were counting signatures when I left town. And it appears that as I come back that they didn't turn in enough signatures. So is that the end of that amendment, at least for this voting cycle? Yeah, that's it. And I think we can expect, probably, I don't have any inside information on this, but just based on past history that there may be some litigation. Someone tried to say, well, you know, the Secretary of State's office was unfair, and they cut corners and whatever else. But I think it'd be hard to even find the most liberal judge in Arkansas to be able to say that this thing should go forward in advance on the ballot. It's disqualified in two different ways. And this, again, is another one of those things. Toby's just so frustrating because... The media gets it wrong. They don't appreciate the nuance, and the left's going crazy, obviously, to cry conspiracy, and, oh, there were technicalities, and this isn't fair. But two different ways that this was disqualified. Number one, they did not have enough valid signatures, and that is pretty clear. When you look at the amount of fraud, they had signature sheets that were notarized incorrectly. They had numerous duplicate signatures. Obviously, you can't sign the thing twice. You can't vote twice, so you can't sign the thing twice either. They had turned in, Toby, signatures for the wrong ballot amendment. So they had sheets of signatures that they turned in that were actually for the Education Rights Amendment that they turned in for this amendment instead.

And so by the time the Secretary of State's Office and shout out to them for all the great work that they did being really thorough with this process, by the time they counted through the 108,000, 105,000 signatures that were turned in, they didn't have enough valid signatures. And then it was also thrown out because it turns out, Toby, the petition language that they were asking our candidates to sign did not match the language that was approved for the ballot title. by the Attorney General's office. So they had two different versions of the language floating out there, and that is disqualifying on its face. And the whole thing has to be thrown out at that point. So they got this very wrong, sort of this, you know, this last-ditch effort with this million-dollar donation from the NEA. They got a lot of the details wrong, which is not surprising. We've seen this for years and years and years. Kudos to the Secretary of State's office for highlighting the fraud and the things that they got wrong. And they want to cry now and say, well, this is nitpicky and these are technicalities and the voice of the people was squelched. The people that want to now rewrite the rules through these massive changes to our state constitution. can't get the rules right they can't follow the rules it's not nitpicky to say that the piece of paper that you ask people to sign to put something on the ballot has to match what's actually going to be on the ballot? That's not nitpicky. That's like literally just basic rules and basic English. So it's done. It's over. They'll probably come back with it in two years. But it's over for now, and it's great news for the people of Arkansas and for our state constitution. Well, and Nick, kudos to you and opportunity, Arkansas for being the boys of reason on this situation and getting that out to the public. I think that helped a lot as well with fighting this thing off. But of course, yes, most definitely. definitely did. And so if you would like to read up on what Nick and I have been talking about this morning, you can go to OpportunityArcassau.org. Of course, you can find Opportunity, Arkansas on any of the social media outlets as well. They've got lots of coverage online that you could look at. And, of course, we'll post at newsradio 1029.com. Also, it'll go up at opportunity, arcasaw.org. The interview we've done this morning, so you can go download that if you miss parts of it. I can listen back to it as well. But Nick, great to have you back each week here on Wednesday. And, of course, so we'll talk again next week. But I appreciate you coming on the show. And a wealth of information, as always, man. I sure appreciate it. Well, lots of words at least. I appreciate y'all. Glad to be back. Mike Drop, hosted by former Navy SEAL Mike Ritalin. How would you characterize your prowess? I'd say my style is that I just kind of outwork everybody until I get there because I'm not a quitter. It's just you. It's yourself. Everything else is team-oriented. The motivation, it was a sort of anger at myself for being weak. That ends up being the driving factor. That anger, that pride, that ego, I think it's a muscle. It gets stronger. When you take that voice seriously, you start to change your life. Mike Drop, follow and listen on your favorite platform.