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Sunday, July 15, 2018

My liberal sister, a hospital worker, staunchly supports Obamacare on moral grounds. Marsha believes that no American should go without needed medical attention for lack of money. But does the prospective repeal of the Affordable Care Act worry her personally? Not in the slightest.

That’s because Marsha lives in Massachusetts. “We’ll still have Romneycare,” she said.

Romneycare is the nickname for the statewide system of universal health coverage signed into law by a Republican governor, Mitt Romney, 10 years ago. Recall Romney’s response when Republican rivals in the 2012 presidential race hit him for creating the state-run health plan that became the model for Obamacare. Romney pointed out that it worked quite well in Massachusetts and said he’d leave it to other states — not the federal government — to create their own programs, if they wanted.

We are now entering 2017 with the Obamacare vision about to be killed or eviscerated nationally but, as we see, not necessarily locally. States with the will and the money can enjoy universal health coverage.

The underreported truth is that Obamacare transfers huge amounts of money from blue America to red America. Half of the nearly $33 billion in annual tax credits used to help people pay their health insurance premiums went to residents of just five states, according to the Kaiser Family Foundation. We note without further commentary that four of the five states — Florida, Texas, North Carolina and Georgia — voted for Donald Trump. The one that didn’t was California.

Current plans to cancel Obamacare would deliver a considerable tax cut to the coasts and other well-to-do parts of America. The Republican reconciliation bill now serving as the template for repeal would end the Medicare tax surcharge and a tax on investment income. Put them together and you have a tax cut totaling $346 billion over 10 years, according to the Congressional Budget Office. Every penny of those tax cuts would go to households making more than $200,000 a year.

Should Obamacare go down, states could replace it with a Romneycare-like plan or something more along the lines of single-payer. And the blue states would have more money to do that with because they wouldn’t be subsidizing others as before.

California, for one, could adopt its own individual mandates, says Nicholas Bagley, a health care expert at the University of Michigan Law School. The requirement that everyone buy coverage, much despised in most Republican circles, is what keeps the insurance pools stable. California’s exchange is robust, and with a mandate in place, insurers would find little reason to leave. That would not be the case in markets where the healthy could easily depart and leave insurers burdened with expensive sick patients.

Blue states like Connecticut, New York, Oregon and Washington would be likely candidates to try a similar strategy, according to Bagley.

But what about the struggling people of Appalachia, the South, the Rust Belt? They may have put Trump over the top, but they still greatly need the comprehensive health coverage that the new administration and Republican Congress seem determined to gut.

Liberals should resist their natural urge to jump up and solve everyone else’s problems. (I’m sitting on my sister as I write.) Red-state Americans suddenly finding themselves with little or no health coverage would have to fight for what was taken away from them. If they chose not to, that would be their right.

It’s possible that Republicans will come to their political senses and leave Obamacare basically in place with a few useful tweaks. But it’s not Democrats’ job to save them from folly. Blue-state politicians have local needs to attend to. Let them keep the money at home.

Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at fharrop@gmail.com.

IMAGE: Six-month-old Hazel Garcia chews a pamphlet at a health insurance enrollment event in Cudahy, California March 27, 2014. REUTERS/Lucy Nicholson 

23 Responses to How Blue State Americans Can Keep Their Health Coverage

  1. In a single payer system, would you have a border control problem? Persons coming in from the adjacent Red State to take advantage of Blue State single payer?

    I agree that the collapse of Obamacare will injure thousands if not millions. I equally agree that it entirely is up to the Republicans to replace it. They’ve been arguing for “repeal and replace” for years.

    • You’d have to prove that you are a resident of the blue state in order to take advantage of that state’s health care. If you’re a non-resident, you pay out of pocket or through your own insurer. For example, when Americans are in Canada and require health care, they either pay out of pocket or present their US insurance coverage. (Of course, Canadian health care is less expensive than comparable care in the US.)

        • Not in the republican world, first they have to crash and burn, and then they ask the democrats for help in getting them out of their mess. Happens every single time, and the clock starts Jan. 21.

    • Since day one they have been crying, look how much money Cruz spent on lawsuits, trying to repeal, and replace. Now we find out they want to replace with hot air.

  2. I still have not heard any type of argument from the gop, as to WHY all of the Safety Nets have to go…I don’t understand the republican opposition to SSI, SSDI, Medicare and Medicade…? I have not heard any real arguments against them other than the mindless mantra of repeal replace…the gop has not explained clearly why they are so radical and willing to destroy peoples’ lives….they have not made the argument…all they want to do is Rule with an Iron Fist…and we little people should shut up and suffer in silence….Trump will never be a president…not in any sense of the title…Cruel and Unusual punishment for committing the crime of being poor…FUCK ALL REPUBLICANS, and MAY THEY HAVE A HORRIBLE FUCKING CHRISTMAS….

    • The safety nets have an 70-80% approval rating across all voters.
      I have no f**king idea what “Stupidest Smart Guy” Ryan and the other morons think is going to happen when they try to take them away…

      Maybe they’re planning to try to blame that on the minorities and Democrats too?

    • One of the many things about republicans that galls me is their insistence that they are good Christians at the same time that they want to take away the safety nets and “Let ’em die!” if the poor can’t pay for their own healthcare. Have they not read in the scriptures that “the poor will always be with you”? And are we not admonished to help and take care of them? Can they not see that holding one position negates the other?

  3. It boggles my mind that people in the red states (mine included) vote against their own best interests….in the interest of what? We are retired and seriously considering moving out of Ohio….just not sure where yet.

    • The safest bet is Massachusetts and its Romneycare, for retirees. Health care is a major concern in retirement, but beside that, the state is still run by Democrats. In addition, the state is far enough north not to be affected by increasingly hot temperatures due to climate change. It’s education system is superb as well.

        • Not sure about that. Sorry. There might be retiree communities designed to walk everywhere yet still in an urban setting, which offer a nice opportunity to take advantage of cultural amenities of city while living on human scale. Good luck!

      • I am completely serious! I live in northern Ohio so weather is not an issue. We are more or less “cold weather” people but moderate would be nice. We looked at Florida but not a place I would want to actually live in full time. What do you have in mind??

        • Was thinking about help finding a place, help lugging stuff.

          Mostly trying to find out what you’d like, where you’d like, what services or amenities, i.e. big city, small city, rural.

          • You are very kind. We are quiet mostly keep-to-ourselves people. We both like to volunteer and both take advantage of the amazing national park system at our back door here in Ohio. We don’t mind cold weather but not MN type cold. A blue state with reasonable cost of living would be great! Know of any?

          • Just trying to do my bit.

            Reasonable cost of living?: Aye, that’s the rub.

            The Mid-Atlantic States have any number of Civil War Battlefields. I’m not sure you’d call Pennsylvania or Virginia Blue States. MD & DE are Blue though. The expenses may be too much.

            The Four Corners area in the South West is beautiful, if you like stark desert. The living expenses are held down by the poverty of the various Reservations in the area. UT and AZ will never fit anyone’s idea of Blue though.

            Frankly, you’re caught. Areas of the most grinding poverty, where living costs are low, tend to be in States like MS, AL, TN, and LA. Redder than Moscow on May Day.

          • HAHAHA! love the redder than Mosco on a May Day. Thanks for your thoughtfulness. I suppose “reasonable cost of living” is a relative term. We are traveling to NM later this winter to browse around and check things out. We were in Florida last winter and while it may be a good place to spend the winter I would certainly not want to be there much longer than 3 months at a time. We have good friends in Portland who say it’s paradise so that could be a good possibility too. Are you in MA?

          • Check out Taos, NM is one of my favorite states. You might find a nice sleepy community there. We winter in Az but I would have preferred NM
            I am originally a Pennsylvanian (northwestern) but am fortunate to call Canada and it’s very adequate health system home.

          • thank you Karen! Erie PA by chance? You are so fortunate to be a Canadian citizen. And thank you so much for the idea of Taos, I will check it out. Many of my friends live or winter in AZ but it just has no appeal to me for a move.

          • I’ve been in Canada 13 years now but have not obtained citizenship
            We live close to the border so I can make frequent visits to Erie!

  4. All I can say is I’m ever so grateful I live in a solid blue state. I’m sorry for those foolish enough to vote Trump & thought he didn’t really mean it about taking away Obamacare. Oh he meant it 1 of the few truths from him you can count on

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