Last August, 53% of voters in Missouri voted to amend the state’s constitution to expand Medicaid in the state. They joined voters in other red-leaning states: Maine, Oklahoma, Idaho, and Utah. The U.S. Supreme Court in National Federation of Independent Business v. Sebelius in 2012 upheld the individual mandate in the Affordable Care Act, but allowed that states could choose for themselves whether to expand Medicaid. Many Republican-controlled states refused. Voters had to push their lawmakers.
Republicans in Missouri’s state senate voted “20 to 14 against funding the winning measure, effectively punting the issue to the courts to determine whether a cut-and-dry referendum ought to be acknowledged,” Natalie Shure writes at The New Republic. “You’d be hard-pressed to find a purer distillation of the Republican Party’s nihilistic political project anywhere in the country.”
You’d be hard-pressed to find a purer distillation of the Republican Party’s nihilistic political project anywhere in the country.
Unless you visited Florida.
Nearly two-thirds of Florida voters in November 2018 approved a state constitutional amendment restoring voting rights to felons who had completed their sentences, parole, and probation. The next spring, the Republican-controlled legislature passed (and Gov. Ron DeSantis signed) a law requiring former felons to pay all outstanding fines and “user fees” from their sentencing before their rights are restored. A federal appeals court upheld the law in September 2020, despite the “administrative nightmare” it created. With no central database tracking such fees, neither felons nor county clerks could easily determine what was owed by whom.
The two thirds of voters that explicitly chose to restore voting rights to over a million fellow Floridians with a constitutional amendment could take a flying leap at the moon as far as Republican legislators were concerned.
Missourians only passed a referendum. Shure lays out the costs for the state:
The federal government currently covers 90 percent of Medicaid expansion costs, which leaves Missouri on the hook for only $130 million per year, a number quite a bit lower than its $1 billion budget surplus. And that’s before you consider added incentives in the American Rescue Plan Act, which would make expansion an even more plum deal for the state—and which Republicans in other states have likewise signaled will not thwart their opposition to Medicaid. In short, adding a few hundred thousand people to Missouri’s Medicaid rolls is startlingly cheap for the state itself, and could be accomplished using money already left over in the state’s coffers. Even the federal portion of the expansion would run less than $2 billion annually—a crumb of the overall federal spending pie.
If Republicans’ objections to Medicaid are clearly not fiscal, they are ruthlessly ideological: If expanding Medicaid wouldn’t bankrupt Missouri, it does further entrench a critical public welfare benefit for residents who fall well beyond those the right-wing would define as the most pathetic and deserving, thereby broadening the constituency for the sort of robust public programming it vehemently opposes. This has a significant political impact: Poor and disabled Medicaid recipients eligible before the ACA—those earning less than 21 percent of the federal poverty line in Missouri—were among the least likely to vote at all, much less vote for Republicans.
The expansion of the overall population of Medicaid beneficiaries has lent the means-tested insurance program wider and deeper support than it’s enjoyed in the past, more akin to the affection showered on Medicare. This helps explain why protests born out of a fierce loyalty to Medicaid in particular played a major role in saving the ACA from near ruin in 2017. Nevertheless, the idea of whetting appetites for an expanded welfare state is anathema to Republican goals, which boil down to enriching their plutocratic donors as much as possible and maintaining a haggard surplus workforce who are desperate enough to work for scraps—designs that are undermined by collective security that expanded health care benefits bestow. As state senator Andrew Koenig put his objection to funding the measure, “I’m sorry, if you are a healthy adult, you need to get a job.”
There are a lot of jobs out there for those willing to work. I know people who have two or three. And still they are haggard.
Serving the interests of the ultrarich is inherently undemocratic—but when Republicans aren’t obfuscating their disdain for democracy with disingenuous bloviation about nonexistent voter fraud, they make their position gobsmackingly plain: “If voters had all the information we do, I think they would have made a different decision,” Missouri Republican Senator Dan Hegeman asserted as he voted against funding the winning ballot measure. Representative Justin Hill took an even more paternalistic approach: “Even though my constituents voted for this lie, I am going to protect them from this lie.” Direct ballot measures are far from problem-free, but for all their faults, no form of electoral decision-making isolates voters’ desires quite as vividly. Beyond that, “having information” is hardly a prerequisite for voting, even if you presume the voters aren’t as savvy as the lawmakers who govern their lives.
After last August’s vote, Republican lawmakers in Missouri moved to make it harder to amend the state’s constitution.
Even clutching their pocket constitutions, wrapped in the flag, and misty-eyed at singing Lee Greenwood’s anthem, democracy — popular sovereignty — is really not Republicans’ thing. They don’t want to govern. They want to rule.