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Monday, December 5, 2016

This week Governor Jan Brewer (R-AZ) shocked many Americans by doing something that made sense. Brewer accepted the federal funds for Medicaid expansion in Obamacare, something she has spent the last few years raving against.

When the Supreme Court decided that states could turn down the expansion of Medicaid, most would have assumed that Brewer — given her contentious relationship with the president — would be the first to reject funds that would require the state to offer health insurance to any citizen earning up to 133 percent of the poverty rate.

But as she accepted it, Brewer made the central argument for the president’s signature reform. “With this move, we will secure a federal revenue stream to cover the costs of the uninsured who already show up in our doctor’s offices and emergency rooms,” she said.

The governor still needs to win over her Republican legislature but she — like fellow Republican governors Susana Martinez of New Mexico and Brian Sandoval of Nevada — has taken the crucial first step that more than a dozen Republican governors are likely to reject.

Though they haven’t said “no,” Republican governors in blue states like Michigan, Wisconsin and Pennsylvania haven’t said “yes” and are threatening to turn down the billions in funding that will cover the uninsured, prevent rate hikes causes by free riders and improve the economy creating good new jobs.

The argument that the states cannot afford the expansion is so fallacious that the Republican governor of Florida Rick Scott had to lie to do it.

The federal government covers 100 percent of Medicaid expansion until 2016 then 95 percent in 2017, 94 percent in 2018, and 93 percent in 2019. After 2020 the state will have to cover 10 percent of the costs. But as Brewer points out, covering the uninsured both lowers the cost of private insurance and state costs.

“An Urban Institute study estimates that under the ACA, states would see a decrease of between $26 billion and $52 billion in uncompensated care costs over the 2014-2019 period,” according to January Angeles at the Center on Budget and Policy Priorities.

The Congressional Budget Office estimates that states that do accept Medicaid expansion will pay only 2.8 percent more than they would be paying with current Medicaid. Some studies estimate that the states that accept the expansion will end up with nearly no increase in what they pay now while covering hundreds of thousands of the poorest Americans who earn too much to be currently covered by Medicaid.

Of course, the states who have already rejected Medicaid expansion are the ones that needed it the most — like Texas, Mississippi and Arkansas.

Republicans are unilaterally turning down Medicaid expansion for some of their poorest citizens, which will drive up the costs of private insurance and cost their states good jobs. So where is the outrage we saw when the public option was dropped from the Affordable Care Act?

Real people are being denied real health insurance and there’s still time to do something about it.

Photo by Gage Skidmore via Flickr.com

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