Tuesday, September 2, 2014

Economic advantage to expanding Medicaid is sinking in . . . except in the South

Two articles by David Kurtz on TPM Editor's Blog hail the good news that some Republican led states are coming around to seeing the economic advantages to expanding Medicaid in their states, despite opposition to anything connected with President Obama.

Wyoming, where anti-Obama feelings are intense, is coming around because of the financial advantages to the state.  Kurtz writes:
That makes this an almost unthinkable reversal -- but one that typifies the shifting sands of Obamacare and Medicaid expansion specifically. Pennsylvania Gov. Tom Corbett, a Republican powered to office in 2010 by the tea party wave, struck a deal with HHS last week to expand Medicaid. Indiana, led by Republican 2016 dark horse Gov. Mike Pence, is already negotiating with the administration on its own plan. Tennessee, a state like Wyoming where there's no real Democratic threat to Republican dominance that would drive expansion talk, plans to submit a proposal for Medicaid expansion to HHS this fall.

Wyoming is perhaps the prototype for how Medicaid expansion might happen . . .   It is a combination of selling conservative lawmakers on the financial benefits of expansion and crafting an alternative plan that is more palatable to conservative ideals in the 23 remaining states that have not yet accepted the expansion.
But Kurtz also writes about the fact that the hold-out states are all in the South where poor African-Americans would be the ones to benefit most.
. . . .  A map of Medicaid expansion leaves out the five states that. . . . comprise the Deep South. You can tack on two huge adjoining states -- Florida and Texas. . . .  Arkansas and Kentucky are the most Southern states so far to expand, and both are led by Democrats. . . . 

In a June op-ed for Reuters, [Nelson] Lichtenstein [wrote]  . . .  'A ruling white caste (is) now putting in place policies likely to create a vast economic and social gap between most Southern states and those in the North, upper Midwest and Pacific region. . . .  Of course, such regressive social policies... are supported by a fierce white partisanship.'
And, of course, we should not be surprised by this.  Remember Romney's 47% comment, when he thought only his rich, white donors were listening?   It may appeal to them in states where they are in the majority -- "small government" gets trumped by money every time.   But in states where it's going to benefit those 47 percent-ers, no way.

There's your campaign issue, folks.   Listen up, Michelle Nunn and Jason Carter.

Ralph

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