Blog Credo

The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.

H.L. Mencken

Wednesday, December 11, 2013

John Robert's Poison Pill

When the Supreme Court ruled the ACA constitutional, Roberts did strike down the required expansion of Medicaid at the state level.  It was widely seen as a curious decision, considering he left the rest of the bill intact.  The "controversial" individual mandate was ruled okey dokey but the expansion of Medicaid was not.

With the benefit of hindsight, it looks like Roberts allowed the law to pass, but also allowed GOP governors to really sabotage the law.  The lack of expansion of Medicaid is having a truly profound effect on the rollout of Obamacare.  The only bigger problem has been the lack of state exchanges.  In just about every state with their own exchanges and Medicaid expansion, the rollout has been pretty smooth.  Kentucky obviously stands out as an example of a "red" state with a Democratic governor who has made Obamacare work really well in the rollout phase.

Dylan Scott outlines the next states that might opt in to the Medicaid expansion.  The fact is that NOT enrolling in the Medicaid expansion is truly awful public policy at the state level.  It is a level of stupid that resides somewhere on the absolute scale of stupid between Louie Gohmert and sticking your tongue in an electrical socket to see what electricity tastes like.

To summarize: Florida would be a huge gain for ACA, but the House leader there is trying to demagogue his way to higher office and sees opposing ACA as a ticket out of Tallahassee (and who can blame him for wanting to leave?).

Virginia just elected Terry McAuliffe, who ran heavily on Medicaid expansion.  But the legislature is still controlled by the GOP.

New Hampshire has a GOP Senate holding back the expansion, but it could be close.  Of course, it's New Hampshire - a small New England state with a relatively small population that would benefit from the expansion.

North Carolina is having a numbers crunch that might force them to take up the expansion just to balance their books.

Maine has a governor so dumb and mean, he's considered a bio-hazard in most developed countries.  The legislature could override his veto.

Iowa just got approval from HHS to do a hybrid form of expansion, and it could be that other red states follow suit.

But not enough is being made about the fact that the GOP - as a national party - is actively denying health insurance to millions of America because they just don't like the idea of the government providing health insurance.  Not because of fiscal reasons, expansion is a great deal for the states.  Simply for ideological reasons.

That's twisted.

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