Saturday, January 11, 2014

Will GOP Dominated States Rethink Rejecting Medicaid Expansion?

As Terry McAuliffe is sworn in as Governor of Virginia today the stage is being set for a battle with the GOP controlled House of Delegates to embrace Medicaid Expansion.  As noted before, this would bring health care to 400,000 Virginians, create an estimated 30,000 new jobs, and bring billions of dollars in federal money to Virginia.  Among rational, sentient people (which excludes most Republicans), expansion is a no brainer.  But among the Christofascist/Tea Party crowd, expansion is tantamount to heresy.  Why?  The real reason, in my view boils down to racism: the opponents of expansion think most beneficiaries will be poor minority group members.  You know, the folks these pious folks view as disposable garbage.  But despite this opposition from the GOP base, some states and governors may be reconsidering - perhaps because of the pressure brought by powerful hospital associations that would benefit from expansion.  Politico looks at the possible changing situation:
Republicans counting on a year of nonstop Obamacare-bashing may be in for an unwelcome surprise: more red-state governors ditching the political script to take a second look at the law’s huge expansion of Medicaid.

The party plans to make Obamacare and its early stumbles a central campaign issue in 2014; the House plans two anti-Obamacare votes Friday. But in the states, the Medicaid expansion — a giant, dangling carrot worth billions of federal dollars to states that sign up — has proved attractive to nearly a dozen GOP governors, and a handful more are on the fence.
Governors like Rick Perry of Texas and Bobby Jindal of Louisiana remain firmly in the “no way” camp. But Pennsylvania and Tennessee are actively working with the Obama administration to expand Medicaid, although their efforts to squeeze policy concessions on the GOP wish list — like requiring enrollees to pay more — could be a dead end.

Indiana and Oklahoma are eyeing alternative versions of expansion and were granted a one-year reprieve by the Obama administration to extend existing state health care programs while they think about it.
Governors in small, Republican-dominated states like Wyoming, Kansas and Utah say they’re keeping an open mind in 2014, despite their hatred for the overall health law. And in every undecided state, an unusual alliance of powerful hospital, business and religious interests has been leaning on Republican leaders to reverse course.

In short, the 26 states that have already approved Medicaid expansion are likely to be joined by at least a few more in 2014 — and the “hell no” states could find themselves an increasingly isolated bunch, concentrated in the South.
Already, seven states have approved expansion with the blessing of Republican governors — including Arizona’s Jan Brewer, Ohio’s John Kasich and New Jersey’s Chris Christie. Medicaid is growing quickly under Obamacare, with an estimated 3.9 million people determined eligible for the program in the first three months. Supporters say that if all 50 states expanded Medicaid, another 5 million people would become eligible.

In general, Republican-dominated states outside of the South aren’t taking as hard a line against expansion as conservatives would prefer.
Kansas’s top hospital trade group signaled that it’s readying a new Medicaid offensive in the coming legislative session. Just before the holidays, the Kansas Hospital Association hired former HHS Secretary Mike Leavitt, who’s advising GOP states on Obamacare implementation, to craft a Medicaid expansion plan that its members could pitch to reluctant state lawmakers.

Hopefully, common sense and decency - rare traits in today's GOP - will prevail.

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