The Health of Arkansas

Yesterday, Arkansas Governor Asa Hutchinson beamed as he announced a drop in the number of state residents receiving health insurance through Medicaid.

Today there are fewer Arkansans on Medicaid than when I took office in January 2015, while our state’s population continues to increase. In the last year alone, the rolls have decreased by 117,000 (10%). Because of the reduction in Medicaid enrollment, DHS is now projecting that it will spend roughly half a billion dollars LESS (taxpayer money) on Medicaid in SFY’19 than anticipated in the biennial budget.

Perhaps to some, this is great news. We’re saving money! Woopee! All those freeloaders out there sucking on the government teat are now out in the cold where they belong.

But wait. We’re talking about medical care here, people who are sick or disabled or otherwise unable to obtain health care because they can’t afford to buy insurance. By his own numbers, our governor just celebrated the fact that 117,000 people of Arkansas are no longer able to obtain health care.

Now maybe that’s not exactly true. Maybe some of those folks got well from cancer or liver failure or whatever caused them to qualify for Medicaid. Maybe some of them got great jobs and have insurance now through their employers. Maybe some of them became the sudden beneficiary of their Aunt Tilley’s fabulous estate. Or won the lottery.

Or maybe not.

The reduction might have something to do with the federal government’s deep cut in advertising about how to sign up for health care. Or the federal government’s reduction in the sign-up time period. Or the state’s questionable method of deciding who to remove from the program—the electronic data system currently in use automatically deletes anyone who doesn’t respond to a request for income information. As in, one lost piece of mail. One overlooked letter amid a pile of unpaid bills. One person’s inability to comprehend what is being asked of him as he undergoes chemotherapy.

Last year, the governor looked for all the ways he could reduce the amount of money Arkansas pays for health coverage. As reported in the Arkansas Times in the May 2, 2017, edition, the governor’s goal was to lower the income limits.

As part of the Affordable Care Act, Arkansas expanded Medicaid via a unique policy known as the private option, which uses Medicaid funds to purchase private health insurance plans for low-income Arkansans. The concept was later re-branded as “Arkansas Works” by the governor. The expansion covers adults who make less than 138 percent of the federal poverty level — that’s $16,400 for an individual or $33,600 for a family of four.

The governor’s proposed changes to eligibility remove anyone who makes more than the federal poverty line (that’s $11,880 for an individual or $24,300 for a family of four) from the Arkansas Works program. Only people who make less than the poverty line would qualify going forward. That includes not just the beneficiaries who are covered by private option plans but also those who were deemed medically frail under Arkansas Works (the 10 percent of beneficiaries with the greatest medical needs, who are currently routed to the traditional Medicaid program rather than private option plans).[1]

So just to be clear, any single person earning more than $990 per month or head of household with spouse and two children earning more than $506 per person would no longer qualify for government assistance in gaining health insurance. This hasn’t yet been implemented because the federal government has not yet responded to Gov. Hutchinson’s request for the change. But really, governor?

Even the 138% of poverty level leaves lots of people without access to care. In 2013, 21% of Arkansas adults went without health care because of the cost. Do bragging rights automatically come to Gov. Hutchinson because that number dropped to 15% by 2016? What is 15% anyway, besides a seemingly small number?

The state’s estimated population is 3,004,279. Take away 23.6% of that for people below 18 years of age (non-adults). That leaves 2,295,270 adults. Fifteen percent of that equals 344,290 adults in this state without health care. That’s a lot of friends and neighbors.

In a November 2017 report, the Arkansas Times explained another proposed part of Hutchinson’s Medicaid ‘reform.’

Those between the ages of 18-49 would be required to work 80 hours per month; if they were not working, they would have to participate in job training programs or certain approved volunteer activities. Beneficiaries must be in compliance for nine months out of the year or they would be removed from the program for the duration of the year. Beneficiaries 50 or older would not be subject to the work requirement; exemptions would be available for others who met certain criteria, such as caring for dependent children.[2]

Studies have examined the realities of financial need in the United States and have come up with a set of numbers that reveal just exactly how morally bankrupt is the governor’s reasoning (along with the increasingly evident moral bankruptcy of the entire Republican party).

For a family with two adults and two children, the average cost of living in the United States hovered around $65,000 per year in 2015. The figure excludes discretionary spending on nonessential goods and services, such as leisure, entertainment and luxury items.[3]

To be fair, another source gathering economic data specific to locations gives credit to a lower-than-average cost of living in Arkansas. For a family of four in Little Rock, the average monthly cost is $2876.46. For an individual not paying rent, the monthly cost is estimated at $819.24.[4] However, in the governor’s proposed lower income limit, in neither case is there any ‘leftover’ income adequate to buy health insurance. In case you didn’t notice, the estimated average cost of living for Little Rock is $400 MORE than the cutoff income level for those seeking Medicaid coverage under the governor’s preferred income guidelines.

It’s no secret that Arkansas is one of the unhealthiest states in the nation. We rank 48th. We have higher rates of diabetes, cardiovascular disease, cancer, and general poor health both physically and mentally. In particular, according to a January 1, 2018, report published in the Arkansas Democrat Gazette, from 2013 to 2016, “the percentage [of Arkansans] who reported that their mental health had not been good in 14 of the past 30 days rose from 14.7 to 16.4 [percent.]”

The report I’d like to hear from Gov. Hutchinson would show data about the number of marginally-employed people who have gained better-paying jobs. It would show how many of those suffering mental or physical illness have gained any improvement in their health. I’d like to hear that Arkansas is spending more, not less, on health care not only in direct services but in education—I’m talking about nutrition education, cooking lessons, and everything else humanly possible to teach people how to eat healthy—which, tragically, probably doesn’t include toaster pastries for breakfast.

I’d like to hear the governor talk about how vouchers and private schools won’t be allowed to siphon money away from public schools. I’d like to hear his analysis of how inadequate education leads to poor self-esteem and how a positive self-image is key to a person’s ability to pay attention to diet and exercise. I’d like to hear him talk about how a person who doesn’t feel good either mentally or physically is a prime candidate for substance abuse.

I’d like to hear the governor discuss the abysmal status of substance abuse treatment options in the state, a crushing health care issue that gets short shrift in public discussion. More on that in another blog.

The governor needs to say that fundamentals like good health and proper education make all the difference in how a person participates as a vital member of society or how he/she gains and maintains sufficient employment. He needs to say, again and again, that a person who is well, who has learned how to reason, and who recognizes the responsibility of self-care and citizenship is the kind of person we absolutely must gain a lot more of in this state.

At any cost.




[3] Cost of Living



The Devil Within

ID-100214173(1)In my last blog post, I wrote about Josh Duggar, Justin Harris, and Arkansas’ continuing stream of revealed perversion by rightwing religious and political leaders. I thought I said it all. I turned off the light and went to bed.

Then came responses in defense of Josh Duggar. Oh, he was a kid. It happened a long time ago. It wasn’t that big of a deal, and anyway he confessed and asked forgiveness. They prayed and he became closer to God.

So let me first address those points.

There is no evidence that Josh Duggar came forward as a penitent to admit his wrongdoing. The heavily redacted police report allows for multiple interpretations of who said what. “Someone” tearfully came to the Duggar parents, stating that “someone” had been sneaking into “their” bedroom at night and that it had happened “four or five times.”

Another objection to the public airing of the poor boy’s ‘minor offense’ is that he was only fourteen. Yes, when first reported in March 2002, Josh was fourteen. His parents considered ‘discipline’ a sufficient response. Four months later in July 2002, Josh was found to have resumed his incestuous behavior. He was again ‘disciplined.’

Because if it didn’t work the first time, it’s sure to work the second time.

This too failed to achieve the expected results. Once again apparently oblivious to potentially permanent psychological and emotional harm suffered by Josh’s prey, the parents continued life as usual. A full year after the first report, in March 2003, the now-fifteen year old Josh’s incestuous abuse again came to the parents’ attention.

Clearly Josh sought opportunities to ‘cop a feel.’ Just as clearly, his targets did not report every single incident at the time it happened. Josh knew how far he could go without triggering a complaint. This is not the behavior of a child, but rather a person capable of calculated predation.

It was only after this third complaint that Josh’s father Jim Bob Duggar consulted with church elders. That’s because everyone knows that in cases of sexual deviancy and incest, church elders are the experts. According to the police report, the initial consensus was that Josh should be placed in treatment. On second thought, Mr. Duggar voiced concern about the possible negative effects of exposure to other youth at the treatment facility. It was this threat of contamination by troubled non-Christian peers that drove the placement of Josh with a known Christian friend in Little Rock.

Apparently the overriding concern focused on Josh. Get him away from his tempting sisters. Place him with an understanding adult male where no such temptation existed. Put a hammer in his hands and set him to hard labor for a while.

Based on statements made to date, we assume the possibility of mental health care never came up. Evidently a treatment program was initially viewed as a punishment, not a means to access therapy that might have helped Josh understand why he felt such urges. Counseling for his victims also apparently never entered the discussion.

A different face of the same problem awaits appropriate closure in the failed adoption of three sisters by Rep. Justin Harris and his wife Marsha. Certain that God guided them to bring the girls into their home, the Harrises pushed through a private adoption against the advice of therapists and caseworkers for the Arkansas Department of Human Services, who warned that the girls had endured significant sexual abuse in the home. According to the foster parents who had kept the girls in their home for over a year, Harris used his position as a state legislator to pressure DHS to sign off on the adoption.

Almost immediately, the oldest of the three, age six, was sent away after the Harrises experienced the extent of her disturbed behavior first hand. For the next year, the two younger girls suffered through the twisted parenting of Justin and Marsha which included being locked in a room stripped of books, toys, and other diversions and allowed no contact with her sister. The girls were signed in as ‘present’ at the Harris preschool, ‘Growing God’s Kingdom,’ but often were not present. And despite denials by the Harris attorney, former and current school employees have described Marsha Harris’ practice of ‘praying out demons.’ [The Arkansas Times’ ongoing coverage of the Harris adoption/preschool story has included use of assigned names for the three girls. The youngest, age four at the time of the incident described below, has the name Annie.]

The former classroom aide recalled a specific incident in 2013 in which Marsha Harris voiced a conviction that her adopted girls’ behavior was fueled by demonic influences. “I remember [Annie] was in the classroom just crying and crying, and [the other teacher] couldn’t even talk to her. I sat on the floor and started saying, ‘I see a purple dinosaur,’ or whatever was around the room. She’d cry, and then stop and look, and cry again, and I kept talking and kind of brought her out of the little tizzy she was in.

“I finally asked her what’s wrong. She said she wet her pants, and I said, ‘That’s OK, we all have accidents,’ and I went out, took her wet ones off, and was getting some other ones. About that time, Marsha came storming in and said, ‘What’s going on in here?’ I said [Annie] had an accident, and she said, ‘That was no accident.’

“And that’s when she told me that it was one of her demons that was making her do that. Then that afternoon or maybe later, she told me that they’d already driven out nine demons, but [Annie] still has one that’s making her do those kind of things.”

It wasn’t long after, in late 2013, that the Harrises gave up entirely on the girls and shuffled them off to another family, Eric and Stacey Francis.

Evidently God had changed His mind.

Only a few months after that, the middle girl now age six was raped by her new ‘father.’ After that incident and several other revealed instances of sexual abuse by Mr. Francis, he was ultimately sentenced to forty years in prison.

Just as the Duggars kept Josh’s secret for twelve years, so did the Harrises fail to notify parents of their preschool flock that a former instructor, Eric Francis, had been convicted of child rape and molestation. Harris also failed to mention that his and Marsha’s adopted girls had been given to the Francis household. Undoubtedly they would have preferred their role in the whole sordid mess never see the light of day. Only the careful journalism of an Arkansas Times reporter uncovered the mess.

Harris has yet to apologize for his role in this little girl’s rape, for his utter and abject failure as an adoptive parent. Instead, his only response has been through an attorney and an occasional Biblical quote on social media such as: The wicked plots against the righteous and gnashes his teeth at him.

Oh poor Justin Harris!

Which brings up the bigger problem.

The crushing outcome of the Harris involvement in the lives of these already horrifically traumatized young girls didn’t earn Mr. Harris any censure or removal from office by his rightwing colleagues in the state legislature or a rebuke by the rightwing governor. Based on Mr. Harris’ most recent public appearances and remarks in social media, he continues to view himself as the victim. It surely has not occurred to him that he and his wife might benefit from mental health care in addressing Justin’s god complex and Marsha’s belief in demons.

Where is oversight—government or church—that could intervene? The Harrises are daily in charge of over one hundred vulnerable young minds in an operation funded by our tax dollars.

The failure of the Harrises, Duggars, church elders, and even a state police officer and elected officials to understand the need for mental health care for abuser and victims stems from the pervasive practice of willful ignorance among fundamental/evangelical extremists in general. They view mental health caregivers in the same ilk as witches and ‘godless pagans.’ There’s a belief that what a person ‘thinks’ is between him and God. Prayer is the cure for all ills.

For most extremists, practice of faith has moved a few steps away from refusing all medical care. But anyone can see a broken arm. No one can see the terror and confusion inside little girls who have lived with sexual abuse by meth addicts in their family home, then suffered moving through foster care to finally be adopted before learning—from their new parents—that they are demon possessed. No one can see emotional trauma that results from sexual molestation such as anxiety, fear, or post-traumatic stress disorder likely to surface years later in the Duggar abuse case. No one can see the obsession controlling the abuser’s acts, the neurochemical and dissociative high produced by intense sexual fantasy likely to surface at some point in Josh Duggar’s future.

This willful ignorance and inevitable negative results hold true not only in Christian fundamentalism-evangelism, but also in Amish communities and populations of orthodox Jews. One Israeli study confirmed that “…religious Jews who were in prison were more likely to be in for sex crimes.”[1] A study of freshmen at a southern university in the U.S. found that “…those who had been sexually abused by a relative were much more likely to be affiliated with fundamental Protestant religions.”[2] It probably goes without saying that Catholics have a sordid history along these lines. A study of religious affiliations among adult sexual offenders found that persons who maintained religious involvement from childhood to adulthood had more sexual offense convictions, more victims, and younger victims, than other groups including atheists.[3]

Studies in social dynamics have long shown that placing a person in absolute authority over others often leads to tyrannical behavior. The set-up for sexual abuse is inherent in patriarchal environments required by fundamentalist religion. The all-powerful male gains a sense of divine empowerment: “I can do anything. God is with me.” Abusers believe forgiveness through confession and prayer solves any problem. The abuser struggles with obsessive responses to sexual repression. The victims are within easy access, either siblings, children in a church group, or a church member seeking emotional support for some personal crisis. The victim trusts the abuser and accepts his authority. Fear and shame often prevent the victim from talking to anyone about the experience(s).[4]

In 2001, Dr. James Dobson’s evangelical radio show “Focus on the Family” hosted a discussion about a “crisis” among pastors of evangelical churches. A study had found that 21% of evangelical/protestant pastors had had inappropriate sexual contact with members of their congregations including children and youth. Sixty percent had a problem with pornography. Victims were pressured not to report the abuse—it would harm the church, harm the mission. God does not want you to tell, the Bible says to handle such offenses privately.

It’s almost as if sex offenders self-select for extremist religion because (a) they don’t understand their secret desires would be more appropriately addressed by mental health care, (b) God will cure/forgive them, and (c) they are more able to indulge their illness in an environment rich with molestation opportunities.

The rot goes all the way to the top.

After a particularly threatening scandal came to light in a 2011 20/20 report, the nation’s flagship fundamentalist institution Bob Jones University commissioned an internal study by a group called Godly Response to Abuse in the Christian Environment (GRACE). GRACE was founded by Boz Tchividjian, a grandson of Billy Graham and a professor at Liberty University. In 2003, driven by his experiences as a sex crimes prosecutor, Tchividjian set up a team of investigators including lawyers, pastors, and therapists. He sums up his work over the intervening years by stating that evangelicals are worse than Catholics at covering up sexual abuse.

[An extensive article about the work of GRACE can be found here.]

GRACE spent over two years working on the Bob Jones University case. They found that men in top positions at the school, one of them charged with providing counseling to students, routinely engaged in victim blaming and shaming in order to suppress complaints. After BJU reviewed preliminary copies of the GRACE study, they attempted to cancel the study. That too became public and they re-engaged. Released in late 2014, the study revealed that Bob Jones III, chancellor and grandson of the founder, and Jim Berg, counselor and dean of students for thirty years, earned the harshest criticism. (Typical for such cases, Berg had zero professional training in counseling.)

GRACE found that students who reported abuse were blamed for bringing it on themselves and that proper authorities had not been notified. The organization said Jones, as the president from 1971 until 2005, and Berg, who stepped down as dean in 2010, were primarily responsible. The report recommended that Jones be disciplined and that Berg be banned from both counseling and teaching counseling and that the school no longer use or sell his books or DVDs.

To date, BJU has ignored these recommendations. Berg remains on staff. BJU ‘investigated’ and found that his teaching materials followed the Bible and there was no reason to discontinue them. The school evidenced no concern for the emotional or psychological health of the victims, not only students at BJU, but people everywhere who relied on Berg’s teaching materials for guidance on how to handle such problems.

What did GRACE find at BJU that caused them to recommend the dismissal of Berg? Here’s a small sample from the report:

[BJU student Cathy] Harris said she was counseled by Berg for six months in 1996 after she started to have flashbacks of childhood sexual abuse. She said she’d go to his office on the second floor of the Administration Building weekly and sit in a wing-back chair. He remained seated behind his desk.

She told him she wanted to go to the police, she said.

“He said the police wouldn’t believe me,” she said.

He told her a report would bring shame on the cause of Christ.

Berg also asked whether she felt any pleasure during any of the abuse and, if she did, she needed to repent, she said.

[See more here ]

Tchividjian says the goal of GRACE is to avoid a major scandal for Protestants similar to what happened over a period of years within the Catholic church. He wants churches to be more open, more responsive to the victims’ needs. Tchividjian worries that while a few larger institutions and even a few homeschooling systems have accessed GRACE and followed its recommendations, many who commission studies refuse to accept the final report. It’s a perfect storm of denial and the inability to comprehend the full extent of the problem.

Even worse, many churches and homeschooling networks in particular continue to operate with the traditional patriarchal framework that leads to such abuses in the first place: authority of males over females, an obsession with sexuality, tribalism, hostility to science and anything else modern, and an extremely literal interpretation of the Bible.[5] The persons in charge are those who have the most to lose. They won’t let go easily.

Coming Soon: The Threat of Willful Ignorance

Image courtesy of David Castillo Dominici at


[1] Ben-David S, & Weller L (1995). Religiosity,criminality and types of offences of Jewish male prisoners. Medicine and law, 14 (7-8), 509-19 PMID: 8667998

[2] Stout-Miller, R., Miller, L., & Langenbrunner, M. (1998). Religiosity and Child Sexual Abuse: A Risk Factor Assessment Journal of Child Sexual Abuse, 6 (4), 15-34 DOI: 10.1300/J070v06n04_02

[3] Eshuys, Donna and Stephen Smallbone, “Religious Affiliations Among Adult Sexual Offenders.” August 2006.


[5] “The Duggars: How Fundamentalism’s Teachings on Sexuality Create Predatory Behavior ,” Diary of an Autodidact. May 23, 2015.