“The Party of Me, Me, Me”: The Republican Push To Defund Obamacare Is Just Selfish And Vindictive
Recently, Republicans have shown that their disdain for Obamacare is stronger than their level of caring about the American people, as evidenced by their wanting to shut down the government if there is not a one-year delay in implementating this legislation.
Seriously, tenacity is one thing, but acting like a bunch of spoiled brats at the taxpayer’s expense is not what Americans sent those politicians to Washington to do. Despite 40 votes to repeal, defund, etc., the GOP shows once again that it’s the main attraction at the circus, for they must know this is all for show. The Democratic ruled Senate is not going to vote in favor of such a proposal and, clearly, the president would not sign the law if it made it to his desk.
And are we forgetting the majority of Americans who voted for the president both in his first and second runs for the White House? Doesn’t the population who wants, and for many needs, the Affordable Care Act count? I guess not.
Whether it’s egos, their careers or the inability to stand apart from their terribly fragmented party, Republicans still shows they are the party of no, the party of the rich and the party of the inability to play nice with Democrats to do what is in the best interest of all Americans.
Having said that, we here on the left have been asking: if you want to repeal and replace this piece of legislation, what are you replacing it with? Well today, that has been answered.
A group of House Republicans is going to unveil legislation providing an expanded tax break for consumers who purchase their own health coverage and increasing the government funding for high-risk pools. What the GOP has clearly forgotten is one of the reasons the Affordable Care Act was passed, was because it’s, well, …. affordable!
Has the GOP seen the rates being put forth by the big insurance companies? My husband, my two children and I pay nearly $2,000 a month for our PPO plan; and we are all healthy, thankfully.
The proposal, which was endorsed by the Republican Study Committee, provides a tax credit to people who buy coverage that is approved for sale in their state. The GOP says the American people could claim a deduction of $7,500 against both their income and payroll taxes, regardless of the cost of insurance.
But there are several big problems here. 1) Who decides what is “approved” for sale and based on what criteria? 2) You are giving the states the power of dispensing insurance, but the states can’t afford to. 3) What happens to federal programs such as Medicare, Medicaid and the numerous states that hold their hand out for their check from Uncle Sam, including some GOP-led states such as New Jersey and Florida? 4) Millions of Americans who should pay their taxes do not. Now you want more people to pay less? And you constantly talk about our deficit and how our government can’t pay its bills? 5) This program is not fair. If one person has a very low-rate plan and is healthy, they can deduct as much as someone paying triple who might not be. And lastly, 6) If Obamacare is difficult to implement and there was much criticism on the delay of this plan, how would the complexity of this proposal be any less?
The RSC claims a membership of 175 members, about three-quarters of the House Republicans. I wonder, have all 175 Republicans read what’s in it?
Let’s face it. This party is angry. They’re angry a black guy won. They’re angry the black guy got his team to draft and pass health care reform, badly needed in this country. So they want their version, their turn to “win”; that is what this is about. This is not in the best interest of the health of America’s people, nor the health of our economy. If we turn the tables on the GOP, will their plan be a “job destroyer,” as they have suggested Obamacare will be? What’s the start date of their plan? Will there be any glitches?
The bottom line is, Obamacare has been passed. To hold the country financially hostage and threaten to shut it down if the GOP doesn’t get its way and its version of a piece of legislation that is already law is not good leadership; it’s selfish. Is that what America needs in Washington today? I don’t think so.
By: Leslie Marshall, U. S. News and World Report, September 20, 2013
“The Obamacare Is Falling! The Obamacare Is Falling!”: Here Are The Reasons You Shouldn’t Believe Any Of It
As we approach the full implementation of the Affordable Care Act at the end of the year, confusion still reigns. Most Americans don’t understand what the ACA does or how it works, which is perhaps understandable. It is, after all, an exceedingly complex law, and from even before it passed there was an aggressive and well-funded campaign of misinformation meant to confuse and deceive Americans about it, a campaign that continues to this day and shows no sign of abating. To undo uncertainty and banish befuddlement, we offer answers to a few questions you might have about Obamacare.
What’s Happening When?
The next important date is October 1, when open enrollment for insurance plans on the new exchanges begins. Those who sign up will begin their new insurance on January 1, when the rest of the high-profile components of the law take effect. The individual mandate, requiring everyone to carry insurance or pay a fine, takes effect, as does the rule forbidding insurance companies from denying anyone coverage (or charging them exorbitant premiums) because of pre-existing conditions. In fact, after January 1 the entire notion of the “pre-existing condition” will become nothing but a historical curiosity, a feature of the dark past we’ve moved beyond. Insurance companies will also be forbidden from imposing annual limits on what people are covered for (an accompanying ban on lifetime limits is already in effect). Tax credits for small businesses to offer their employees insurance will be expanded, and millions of low-income Americans will be eligible to be covered through Medicaid. While we talk about January 1, 2014 as the date of full implementation, dozens of provisions have already gone into effect, from free preventive care to expanded coverage for young adults to the closing of the Medicare prescription drug “donut hole” (you can read a comprehensive implementation timeline here if you’re so inclined).
How Many States Are Expanding Medicaid?
There is probably no provision of the ACA that will have a more immediate and profound impact on as many people’s lives as the expansion of Medicaid. In the current system, each state determines how poor you have to be to become eligible for the joint federal-state program, but under the ACA anyone with an income up to 133 percent of the federal poverty level would be eligible. Unfortunately, the Supreme Court declared that states could refuse to accept the expansion, and many states dominated by Republicans couldn’t wait to say “no” to Barack Obama and to their own poor citizens who desperately need insurance, even though the federal government will be picking up almost all of the tab.
The cruel irony is that many of the states refusing the expansion are those that have the largest proportion of poor people who could benefit, and are already the stingiest with Medicaid eligibility. For instance, in Texas, a working adult with children can’t be covered in Medicaid if her income exceeds 25 percent of the poverty level. So a single mother with three children who makes over $5,888 a year is considered too wealthy to get Medicaid. In Alabama it’s 23 percent; in Louisiana it’s 24 percent. These are all states with high rates of poverty, and states where the Republican governors and legislatures have refused to accept the money the federal government is offering to expand Medicaid. In these states, if you’re a middle-income person, you’ll be able to get government subsidies through the new health-care exchanges, but if you’re poor but not quite desperately poor enough to fall below the Scroogian eligibility limits, you’ll get no help at all. These states have essentially cut off their noses to spite Barack Obama’s face, giving up billions in federal money, a reduction in uncompensated care they end up paying for, and a healthier and more productive populace, all so they can give the finger to the President.
When you look at map of which states are accepting the Medicaid expansion, with just a few exceptions it looks a lot like an electoral college map, with Republican states saying no and Democratic states saying yes:
In just the last few weeks, Michigan has decided to accept the expansion, and Pennsylvania has proposed to take the federal money but use it to give low-income citizens private insurance (the Department of Health and Human Services has to approve such a plan). That will bring the total to 25 states plus the District of Columbia accepting the expansion, with another four (Indiana, Tennessee, Ohio, and New Hampshire) still debating the issue. After the Supreme Court’s decision, many predicted that even Republican-dominated states would find the money the government is offering too good to pass up. So far it hasn’t happened, meaning millions of poor Americans who live in Republican states are out of luck. And you’ll be shocked to learn that the poor in these states, mostly in the South, are disproportionately black.
What’s Up With The Exchanges?
Setting up a health-care exchange requires time, effort, and some minimal level of concern for seeing your citizens be able to take advantage of the ACA’s benefits. So it isn’t surprising that nearly all the Republican states that said no to the Medicaid expansion also didn’t choose to bother setting up their own exchange. In the end, 17 states (including D.C.) decided to do it themselves. Another nine are partnering with the federal government on an exchange, leaving 25 states that have left the process entirely to the federal government. This certainly makes HHS’s job harder, but no one yet knows how well those federally-run exchanges will work. All of those 25 have Republican governors, legislatures, or in most cases, both.
One potential pitfall is that in many of those Republican-run states, the state government is taking active steps to sabotage the exchanges, particularly by making the work of the “navigators” as difficult as possible. These are local groups, like universities, hospitals, churches, and the like, who have gotten federal grants and training to help people find their way through the process of getting insurance through the exchange. For example, Georgia is forcing navigators to get special state licenses (the Republican state insurance commissioner pledged to do “everything in our power to be an obstructionist”); Florida has banned them from the grounds of state health facilities. It remains to be seen just how much of an impact the sabotage efforts will have.
Are My Premiums Going To Go Up?
The answer to that question can be summed up as 1) It’s complicated, and 2) It depends. If like most people you get insurance through your employer (or your spouse’s), things probably won’t change for you. Your premiums have risen steadily in recent years, and in the short term, they’ll probably continue to rise. Nevertheless, recent data show a dramatic slowdown in the rate of increase. Last year, premiums rose by 4 percent, half of the 8 percent per year average of the last decade. That mirrors a slowdown in overall health spending. In other words, that curve the ACA was designed to bend is already bending.
If you’re now on the individual market (or uninsured) and you’ll be buying insurance on the exchanges, how much you pay will depend on how old you are, where you live, what your income is, and what plan you choose. If you make less than 400 percent of the poverty level you’ll get a subsidy so that your premium doesn’t rise above a certain percentage of your income; if you want to try to figure out now what it would be, you can read this report to get an idea of what you might pay. While we can’t make any sweeping statements that apply to everybody, there will certainly be a lot of people who find that insurance is more affordable than they thought. On Monday, the Department of Health and Human Services released a report showing that because of the subsidies, 6.4 million people would be able to buy insurance through the exchanges for less than $100 a month. As one Rand Corporation study concluded, “after accounting for tax credits, average out-of-pocket premium spending in the nongroup market is estimated to decline or remain unchanged.” While there are some people who could pay more than they do now—say, young people who make too much to qualify for subsidies, used to have bare-bones insurance, and are now getting one of the more comprehensive plans available through an exchange—overall it doesn’t appear that the threats of “rate shock” will be borne out.
How Many People Are Going To Get Insurance Who Didn’t Have It Before?
This is also a difficult question to answer precisely, because there are a few unknowns. First, over time more states could accept the Medicaid expansion, increasing the number of newly insured people. Second, the fines for those who choose not to carry insurance are quite small, so some people (particularly the young, who are immortal and never get sick) could decide that it’s better to pay a fine that costs less than insurance does, but nobody knows how many of them will. Third, each state will be doing its own outreach to sign people up for the exchanges and for Medicaid; some will inevitably do a better job than others.
All of those variables make precise estimates difficult. One National Bureau of Economic Research experiment to see how uninsured people respond to the cost of getting covered concluded that “75 percent of the uninsured are projected to enroll, implying that 39 million individuals would gain coverage as a result of the law.” The Congressional Budget Office, on the other hand, projects that the ACA will reduce the ranks of the uninsured by 25 million. One thing we can say is that though tens of millions will probably become newly insured, there will still be millions of uninsured people in America. One of the main tasks in coming years will be getting that number as close to zero as we can.
Are There Going To Be Terrible Effects On The Economy?
If you’ve been paying attention to health-care news, you’ve probably seen stories featuring an employer who has 49 employees and says he’d love to hire more people, but since Obamacare’s employer mandate kicks in at 50 employees and he’d have to offer health coverage if he hired anybody else, he won’t do it. It’s quite remarkable how reporters always seem to find that business with just under 50 employees (my suspicion is that the National Federation of Independent Business, a conservative small-business group, finds them, recruits them, and passes them along to journalists). But the truth is that they’re extremely rare. According to the Kaiser Family Foundation, 93 percent of companies that size already offer health benefits, even before the law’s requirements kick in. And the administration has delayed the employer mandate by a year anyway.
Another charge is that employers everywhere are cutting employees’ hours below 30 per week, the level at which the mandate will eventually kick in, so they don’t qualify as full-time. While there are certainly employers who have done this, there’s little evidence it’s happening on a large scale. The number of workers just below that 30-hour cutoff is tiny to begin with and didn’t increase as the original date for the mandate approached. If employers were rushing to cut workers’ hours, those numbers would be large and growing; instead, the opposite is true.
You could condemn an employer who figures out a way to avoid giving her workers health benefits, even if not all of them are as repulsive as John Schnatter, the CEO of Papa John’s, who whined that if he had to give his employees health coverage it could raise the price of a pizza by as much as a shocking 14 cents. But one of the main things the ACA was meant to accomplish was to make those employer decisions less damaging to employees. “Job lock,” where you’re forced to keep a job you’d rather leave in order to hold on to your insurance, will be a thing of the past. And now that affordable insurance will be available to anyone regardless of whether they’ve been sick before, employers can decide to drop insurance without necessarily hurting their employees.
To see how, consider this story. Last week, Trader Joe’s announced that it would no longer be offering coverage for its employees who work less than 30 hours per week. Instead, it will give them $500 and send them to the exchanges. This seemed surprising, since Trader Joe’s is known for being an employee-friendly company. But as the company argues pretty persuasively, employees at that level are likely to get a better deal through an exchange than through their company policy when subsidies are factored in (and of course, the company will save money). We might see this pattern repeated with other employers. But would that be a bad thing? If an employee gets equivalent coverage for less money on an exchange, then they’ve effectively gotten a raise. Companies save money, which allows them to either raise salaries or hire more people. On the other hand, there is a cost to the federal budget of more people getting subsidies, but that may be a cost we’re willing to pay. It may be some time before we know how common an occurrence this is and what effect it’s having on the economy and the budget.
Is Obamacare Going To Make Doctors Quiz Me About Who I’m Sleeping With?
Here’s a good tip: if you read a story with a crazy new allegation about what the Affordable Care Act is going to do to you, there’s a good chance two things are true. First, it’s false. Second, Betsy McCaughey probably had something to do with it. She’s the woman who gave us “death panels,” and her latest bit of crazy is to try to convince you that because of Obamacare, doctors are suddenly being forced to ask you inappropriate questions about your sex life (this is a pattern you’ll become familiar with: she takes an ordinary feature of health care, like the fact that questions about sex are standard practice when taking a medical history, and makes it sound both sinister and a product of Obamacare). You can decide whether this kind of thing is just silly or pernicious and generally despicable (I lean toward the latter), but don’t be surprised if we see a whole round of new allegations like this one. Conservatives failed to stop the ACA from being passed into law, then failed to get it overturned in the Supreme Court, then failed to win the election that would have allowed them to repeal it. They will almost certainly get increasingly desperate after January 1st when the law is implemented and we don’t all suddenly find ourselves standing in breadlines wearing gray sackcloth, our spirits broken by the socialist hellhole into which we’ve descended. So who knows what they’ll come up with.
By: Paul Waldman, Contributing Editor, The American Prospect, September 20, 2013
“The Rejection Of Reality”: Conservative Claims About Low-Income Excess Are Just Wrong
Are people better off than they were before the recession? By most headline figures they’re not: Poverty and inequality have risen to record levels, median incomes declined. Unemployment has improved marginally, but 37 states have yet to regain their pre-recession job levels.
Conservatives like to push back on claims of rising inequality or worsening poverty by pointing out that their measure of poverty or inequality insufficiently captures the increasing well-being of even the poor. They’re better off, they say, because low and middle-income Americans are living better than they did in the past. These arguments manifest themselves in concern over “Obamaphones” or access to liquor or drugs, and generally recommend policy solutions as odious as drug-testing as a prerequisite for welfare or stricter control over food stamps. As Matt Bruenig aptly pointed out on this blog, even taking these conservative policy solutions at their face value, fraud complaints are spurious. We want poor people to have more money. Programs like food stamps and Medicaid undoubtedly accomplish that.
But let’s dive deeper into whether families are better off. The Census Bureau periodically publishes assessments of well-being. Their most recent iteration, released yesterday, measures well-being comprehensively based on various conditions such as homeownership (or rentership) and housing condition, access to appliances and electronic goods, neighborhood conditions, meeting basic needs to avoid eviction and eat, and ability to get help from families or the community should they need it. Most of the trends in the results aren’t shocking, with extreme differences in situation based on age, sex and race.
Their headline results are sobering, however. How households fared from 2005 to 2011, according to the Census Bureau’s more comprehensive assessment:
Families are having an increasingly difficult time paying basic expenses. From 2005 to 2011, the number of Americans who couldn’t pay rent or afford food climbed from 16.4 to 16.9 million, a 16 percent increase.
Households with unmet essential expenses increased from 16.4 to 20 million. One in five households now experience difficulty meeting basic needs.
Those experiencing food shortages increased from 2.7 to 3.4 million.
A plurality of households lack access to basic appliances. 36 percent of households didn’t have either a washer, dryer, fridge, stove, dishwasher or phone.
There are strong racial correlations to decreased well-being. Only 44 percent of Hispanics reported access to all six basic appliances compared with 71 percent of white households.
So, even conceding that headline stats don’t tell the whole story, conservative arguments fail on their own merits. No, there isn’t an increasing access to basic appliances that would signal a middle-class lifestyle. No, low-income families aren’t better able to meet basic needs like paying rent or purchasing food. Families are worse off because they’re poorer. Making some goods (like phones) marginally less expensive in the face of collapsing incomes and household wealth hasn’t truly improved the plight of low-income workers. Trying to restrict or reduce proven government programs despite these conditions isn’t then a conservative acknowledgement of nuance, it’s the rejection of reality.
By: Joe Hines, The American Prospect, September 6, 2013
“Love For Labor Is Lost”: Politicians Today Can’t Even Bring Themselves To Fake Respect For Ordinary Workers
It wasn’t always about the hot dogs. Originally, believe it or not, Labor Day actually had something to do with showing respect for labor.
Here’s how it happened: In 1894 Pullman workers, facing wage cuts in the wake of a financial crisis, went on strike — and Grover Cleveland deployed 12,000 soldiers to break the union. He succeeded, but using armed force to protect the interests of property was so blatant that even the Gilded Age was shocked. So Congress, in a lame attempt at appeasement, unanimously passed legislation symbolically honoring the nation’s workers.
It’s all hard to imagine now. Not the bit about financial crisis and wage cuts — that’s going on all around us. Not the bit about the state serving the interests of the wealthy — look at who got bailed out, and who didn’t, after our latter-day version of the Panic of 1893. No, what’s unimaginable now is that Congress would unanimously offer even an empty gesture of support for workers’ dignity. For the fact is that many of today’s politicians can’t even bring themselves to fake respect for ordinary working Americans.
Consider, for example, how Eric Cantor, the House majority leader, marked Labor Day last year: with a Twitter post declaring “Today, we celebrate those who have taken a risk, worked hard, built a business and earned their own success.” Yep, he saw Labor Day as an occasion to honor business owners.
More broadly, consider the ever-widening definition of those whom conservatives consider parasites. Time was when their ire was directed at bums on welfare. But even at the program’s peak, the number of Americans on “welfare” — Aid to Families With Dependent Children — never exceeded about 5 percent of the population. And that program’s far less generous successor, Temporary Assistance for Needy Families, reaches less than 2 percent of Americans.
Yet even as the number of Americans on what we used to consider welfare has declined, the number of citizens the right considers “takers” rather than “makers” — people of whom Mitt Romney complained, “I’ll never convince them they should take personal responsibility and care for their lives” — has exploded, to encompass almost half the population. And the great majority of this newly defined army of moochers consists of working families that don’t pay income taxes but do pay payroll taxes (most of the rest are elderly).
How can someone who works for a living be considered the moral equivalent of a bum on welfare? Well, part of the answer is that many people on the right engage in word games: they talk about how someone doesn’t pay income taxes, and hope that their listeners fail to notice the word “income” and forget about all the other taxes lower-income working Americans pay.
But it is also true that modern America, while it has pretty much eliminated traditional welfare, does have other programs designed to help the less well-off — notably the earned-income tax credit, food stamps and Medicaid. The majority of these programs’ beneficiaries are either children, the elderly or working adults — this is true by definition for the tax credit, which only supplements earned income, and turns out in practice to be true of the other programs. So if you consider someone who works hard trying to make ends meet, but also gets some help from the government, a “taker,” you’re going to have contempt for a very large number of American workers and their families.
Oh, and just wait until Obamacare kicks in, and millions more working Americans start receiving subsidies to help them purchase health insurance.
You might ask why we should provide any aid to working Americans — after all, they aren’t completely destitute. But the fact is that economic inequality has soared over the past few decades, and while a handful of people have stratospheric incomes, a far larger number of Americans find that no matter how hard they work, they can’t afford the basics of a middle-class existence — health insurance in particular, but even putting food on the table can be a problem. Saying that they can use some help shouldn’t make us think any less of them, and it certainly shouldn’t reduce the respect we grant to anyone who works hard and plays by the rules.
But obviously that’s not the way everyone sees it. In particular, there are evidently a lot of wealthy people in America who consider anyone who isn’t wealthy a loser — an attitude that has clearly gotten stronger as the gap between the 1 percent and everyone else has widened. And such people have a lot of friends in Washington.
So, this time around will we be hearing anything from Mr. Cantor and his colleagues suggesting that they actually do respect people who work for a living? Maybe. But the one thing we’ll know for sure is that they don’t mean it.
By: Paul Krugman, Op-Ed Columnist, The New York Times, September 1, 2013
“An Important Milestone”: In Michigan, A Defeat For The Tea Party And Victory For Common Sense
Obamacare took a big step forward on Tuesday night, when the Michigan Senate approved an expansion of the state’s Medicaid program. The state House is likely to back the same measure, as early as next week. And while the program requires a special federal waiver, the Obama Administration is likely to grant it. Assuming all of that happens, Michigan will become the twenty-fifth state to expand Medicaid as part of the Affordable Care Act. As a result, a few hundred thousand residents are likely to get insurance—and the state will get a much-appreciated infusion of federal funds, while putting up a much smaller share of state money.
For the advocates of making health insurance available to all Americans, it’s a huge victory. But the victory did not come easy—or without some last-minute drama.
Tuesday’s vote was the product of a long, sustained campaign by Democrats, moderate Republicans, progressive organizers and business leaders. For months, they have made the case for expansion—citing the likely financial and health benefits for Michigan’s uninsured citizens, and the expected boost to Michigan’s economy. The federal government is picking up most of the expansion’s costs, they have argued, and hospitals need the revenue to make up for money they lost on charity care and declining reimbursement from other sources.
Among those assessing the statistical impact were Marianne Udow-Phillips, director at the Center for Healthcare Research and Transformation and a lecturer at the University of Michigan School of Public Health. As she told me on Wednesday,
if you look at all the facts—the fact that the majority of physicians in the state are ready to serve this population; the positive impact on the state budget, on the state’s economy at large, on hospitals, on businesses, on all those who are currently insured (by reducing cost shifting) – not to mention the half a million people who will directly benefit by getting health insurance coverage in a program that has the highest satisfaction of any insurance coverage type in the state – you have to draw the conclusion that the Medicaid expansion is the right thing to do for the state.
Governor Rick Snyder and the state Chamber of Commerce have been among the strongest proponents of expansion. The state’s health care industry, naturally, has lobbied furiously. But Tea Party Republicans and their allies have been dead set againt it, arguing that Medicaid is a wasteful, expensive program that subsidizes the indolent—and that the size of the federal subsidies masked the true impact on the state, which would actually be negative.
Writing this week in the Detroit Free Press, Joseph G. Lehman and Clifford W. Taylor from the Mackinac Center for Public Policy warned that
The state’s main incentive to expand Medicaid is a federal promise to transfer to Michigan $2 billion (increasing to $3 billion) annually for three years if we add 320,000 Michiganders earning up to 138 percent of the poverty level to Medicaid rolls.
After three years our federal subsidy would shrink by $300 million per year, meaning either Michigan taxes increase by that much or lawmakers kick 320,000 people off Medicaid, which seems unlikely.
Expansion supporters have responded that, even after the reduction, the federal government would still be picking up 90 percent of the new cost. They have also tried to accommodate concerns about Medicaid efficiency, by, among other things, proposing that some Medicaid recipients pay a portion of their own costs. The compromises changed a few votes, and in June the state House approved its version of the expansion. But the Senate in June surprised everybody, including the governor, by rejecting the measure. One likely reason: Tea Party groups, and their financial backers, were threatening to support primary challenges to Republicans who voted yes.
The expansion’s supporters spent the remainder of the summer making their case, rallying the public, and lobbying individual members. As of Tuesday morning, they were confident they had 19 senators willing to vote yes. That would produce a tie in the 38-member chamber, with the lieutenant governor prepared to vote yes and break the tie. But when the Senate first voted in early afternoon, only 18 said yes. The chamber quickly voted to reconsider and, after a feverish few hours of lobbying and meeting, tried one more time. This time, the bill passed 20 to 18.
Progressives aren’t thrilled about some of the compromises, particularly those asking Medicaid recipients to pay a larger share of their costs. (Sarah Kliff has more of the details if you want them.) And it’s not out of the question that the federal government will raise objections, because the federal Medicaid law limits the ability of states to change the program. But given political resistance to any expansion, supporters are mostly elated at Tuesday’s outcome. “It’s not perfect, but it’s going to help nearly half a million Michiganders,” Amy Lynn Smith wrote at Electablog, a progressive website based in Michigan.
Michigan’s decision is an important milestone in the effort to make Medicaid available to all low-income Americans—an endeavor that has proven far more difficult than most experts anticipated. Last summer, when the Supreme Court made it easier for states to reject Obamacare’s planned expansion of Medicaid, many of us assumed the vast majority of states would participate anyway. The need for coverage was too great, and the allure of federal money too tempting, for even most Republicans to reject. Quite obviously we were wrong. Conservatives serving either as governor or state legislators have successfully blocked expansion across a wide swath of the country, including the huge states of Florida and Texas, where a few million people would be eligible.
But the Medicaid expansion has gotten support from several other Republican governors, including Jan Brewer in Arizona (where the expansion is already going forward) as well as Rick Scott in Florida and John Kasich in Ohio. Florida looks hopeless, at least for the time being, given the grip extreme conservatives have over the legislature. Ohio is another story: The politics there look a lot like the politics in Michigan. The same goes for Pennsylvania, although that state’s Republican governor, Tom Corbett, doesn’t yet support expansion.
Obamacare’s Medicaid component, in other words, is moving ahead. But progress is taking place in fits and starts, with frequent setbacks, thanks mostly to political opposition that’s strongest in the most conservative parts of the country.
Yeah, you should get used to that pattern.
By: Jonathan Cohn, Sebior Editor, The New Republic,
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