Not a single Republican governor has pledged to accept the new Medicaid funds and three Democrats are also considering turning down the money. In total, these states would give up $291.4 billion in federal funds and leave 10,297,221 Americans uninsured.
Keep in mind that the federal government is picking up the entire tab in the beginning and will only require states to pick up a nominal amount after that. And since the whole point is to “bend the cost curve”, states will end up paying less than they are today. And since I don’t believe these people are completely ignorant of that, the only explanation is ideology. They do not want to implement a new “entitlement” for the working poor — people they believe are undeserving. And we know who they think those people are.
The GOP frame for the Medicaid argument will not focus at all on insuring the uninsured. It will not breathe a word of how insured people subsidize uninsured people who use emergency rooms for care. Rather, it will extend and enlarge on this argument about a black President giving free stuff to black people (or Latinos in states like Texas). And I believe that will remain true even if Obama loses in November.
How could radical Republican governors not love engaging in that fight? It’s a damn good way to keep working class whites in the GOP party. It’s a damn good way to keep the base enthused. It’s a damn good way to distract from larger economic failures. It’s the same logic, of course, that has already led some of these firebreathers to embrace “Papers Please” laws that lose their states a lot of money.
Moreover, these same governors are already hard at work shrinking the number of people of color who will be able to cast their legal votes. Thus, the idea that these governors will have to respond non-Republican votes is weak, given that this fight will be accompanied by an effort to limit the number of non-Republican voters who can vote at all.
Finally, while I don’t think the TeaParty arose primarily out of racist resentment, I do think it has fed on it in the last three years. Given that fact, the likelihood its fight against Medicaid would get racist and ugly quickly is quite high.
Of course it will. That’s the underlying reason for many Americans’ obsessive hatred for the welfare state.
I really hope that the Democrats wake up to the fact that real human beings are going to suffer because of this and launch a counter-attack instead of smugly assuming that the states will come around in the long run so no need to do anything. In the long run a bunch of people will be dead who didn’t have to be.
I realize that the shiny exchanges are the technocratic centerpiece of the bill and the only thing that many wonks care about, but the Medicaid expansion is the liberal heart of this thing. So it’s a little bit hard to understand why all these Democrats are acting as if it’s a given that these governors will (eventually) sign on and in the meantime: shut up and clap louder. (Oh hell, I guess I just answered my own question, didn’t I?)
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