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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