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Thursday, September 29, 2016


DB_medicaid_map

Knowing that Republicans would not have much interest in covering the estimated 15 percent of Americans who lack health insurance, the creators of the Affordable Care Act put both a “carrot” and a “stick” in the law to compel red states to offer more of their residents Medicaid.

The “carrot” was the federal government agreeing to pay 100 percent of the cost of expanding Medicaid to 133 percent of the poverty level at first and bring that percentage down to 90 percent by 2020. Currently the government pays on average 57 percent of the cost of Medicaid. So states could cover hundreds of thousands more residents, driving down the costs of those who rely on emergency rooms, while paying just a bit more than they currently contribute.

The “stick” was that the federal government could withdraw all Medicaid funding if a state rejected expansion. As the Supreme Court ruled that Obamacare’s individual mandate was Constitutional, it also decided that the “stick” was unconstitutional.

All the federal government had was the “carrot” to get Republicans to cover the 17 million uninsured the law was designed to help. And that mostly hasn’t been good enough. Wisconsin’s Scott Walker is even using the law as a chance to kick more than 80,000 Wisconsinites off the state’s Medicaid plan. As a result of this Republican recalcitrance, the Rand Corporation estimates that 19,000 Americans could die unnecessarily every year.

But a few “pro-life” Republican governors have actually recognized that the “carrot” is a great deal that their state will be paying for, even if they don’t accept it. Here are five Republican governors who have fought for Obamacare’s Medicaid expansion in their states. (See if you can guess what they all — except one — have in common.)

  • RobertCHastings

    It’s almost enough to turn SANE people off of ACA. These Republican governors, in spite of their histories of stupidity, have all actually acted in the best interests of their citizens. By opting in to the “marketplace”, and expanding Medicaid coverage,thier actions may NOT get them re-elected, but then, they just might find some unlikely supporters in their states’ Democrats.

    • John Pigg

      Yeah, I’m conservative, and also against the ACA. But why if I was a Republican governor should I deny the denizens of my state a free medicaid expansion. Why should our tax dollars go to only liberal states.

      It makes absolutely no sense not to go along on this issue. I think there would be more support for these governors if they are able to sell it using this reasoning.

      • RobertCHastings

        I wish you would write a letter of support to the Republican governors who have shown the courage to buck their party, and another letter to those Republican governors who REFUSE to do so, harming the poor in their state, and essentially putting an undue burden on the hospitals in their states that are bound by law to treat the indigent.

        • John Pigg

          Not bad advice, I think in my state they have already opted on a 3rd way policy.

  • howa4x

    Governors have to manage a state government and see the balance sheets. The uninsured costs the state more in the end because hospitals are allowed to bill their cost directly to the state, so it makes good economic sense to accept the expansion. The elected legislatures come from small districts and can’t see the big picture. I’m surprised the tea party didn’t back this plan since it saves state funds. But then we are not dealing with the brightest lights are we?

  • Allan Richardson

    One thing the Tea Party activists hate about expanding access to medical care, ESPECIALLY MENTAL health care, is they would lose voters when disturbed people get help seeing things rationally. For the same reason, they want to keep education down to just enough to work at fast food joints … and vote for Tea Party candidates.

    • RobertCHastings

      My brother-in-law works as a volunteer at our local YMCA, conducting water-robics classes for folks with arthritis. One of the people in his class is over400 pounds(as is his wife) and is on Disability and Medicaid, and STILL despises such government programs, even though without them he would, in all likelihood, be dead. Explain that one.