Far-Right GOP Senator from Red Southern State Defends Single Payer, Trashes Free Market

Tom Cotton at townhall: still supports repealing ACA but commits to protecting coverage for 300k Arkansans dependent on Medicaid expansion.

— David Ramsey (@ArkDavey) April 17, 2017

(says this is key reason he opposed AHCA, which would have eliminated the Medicaid expansion altogether)

— David Ramsey (@ArkDavey) April 17, 2017

Just so we're clear here:

1. Tom Cotton is a Republican U.S. Senator.
2. Tom Cotton is a Republican U.S. Senator from Arkansas, a red Southern state.
3. Tom Cotton is considered one of the more extremely right-wing Republicans.
4. Medicaid is a Single Payer, taxpayer funded healthcare program.
5. The ACA's Medicaid expansion provision is for poor & near-poor people. It is almost entirely paid for by taxes...mostly on the wealthy and on corporations.
6. Tom Cotton is defending this part of the ACA.
7. The ACA healthcare exchanges are for middle class people to buy insurance policies from private, mostly for-profit insurance carriers.
8. The ACA healthcare exchanges are based primarily on (regulated) free enterprise, with private companies competing for retail dollars.
9. Tom Cotton is trying to get rid of this part of the ACA.

We're living in strange times indeed.

That is all.

OK, there's one important caveat to keep in mind here: Unlike most Medicaid expansion states, Arkansas utilizes a special version called the "Private Medicaid Option", which simply means that instead of the expansion population actually enrolling in Medicaid itself, they're instead enrolled in the same commercial policies that other exchange enrollees sign up for...except that the money which normally would go to the Medicaid program is instead used to pay their premiums, deductibles and co-pays.

In other words, this amounts to signing up for a Platinum exchange policy with 99% of it paid for by APTC/CSR subsidies.

On the one hand, I suppose it could be argued that since the money is still going to private, profit-based corporations, this is still "supporting" the "free market". On the other hand, 77% of Medicaid itself is also "managed" by private insurance companies on behalf of the government anyway, so really...what exactly is the difference here? This strikes me as a hair-splitting distinction.