Rejecting Medicaid Expansion: No Ground To Stand On

One of the more bizarre phenomena transpiring across the country–sort of a slow-motion riot–involves the efforts of (mostly Republican) governors and state legislators to deny their citizens the benefits of the Affordable Care Act’s Medicaid expansion, which would significantly expand access to health insurance at a relatively small cost to states (a cost which is offset partially or even entirely by the reduction of uncompensated care).

At this point the leadership of ten states, all with Republican governors, have rejected participation in the Medicaid expansion. Five more states–again, all with Republican governors–are said to be “leaning against” participation. And things are entirely up in the air in twelve other states, eleven of them with Republican governors.

I guess you can perceive the pattern here, and it’s not a coincidence.

So of the most outspoken opponents of the Medicaid expansion have posed as representatives of their people resisting interference in their affairs by a distant, alien, socialistic Federal Government. Rick Perry of Texas, for example, has denounced “both the expansion of Medicaid as provided in the Patient Protection and Affordable Care Act and the creation of a so-called ‘state’ insurance exchange, because both represent brazen intrusions into the sovereignty of our state.”

But even in Texas, a new survey sponsored by the American Cancer Society Action Network has found, there’s strong majority support for the Medicaid expansion.

The survey extended to seven states that have been mulling the subject (in one, New Mexico, Gov. Susan Martinez has very recently come out for accepting the Medicaid expansion, making her one of just two Republican governors to do so), and the results were not ambiguous: majorities support the expansion before and after hearing the standard arguments for both positions. The percentage supporting their states’ taking the federal money and implementing the expansion range from 70% in New Jersey to 65% in New Mexico, to 63% in Florida, Kentucky and Michigan, and then 58% in Texas and 57% in Iowa.

The percentage of self-identified Republicans supporting the Medicaid expansion ranges from 32% in Texas up to 45% in Kentucky.

If Democrats cannot find a way to make this a campaign issue in 2014 in states where Republican incumbents have fought or defeated the Medicaid expansion, they aren’t really trying. Some variation on the theme of “Stupid Or Mean? Mean or Stupid?” might not be a bad slogan for describing the efforts of GOP state officials to carry on the national GOP’s war against Obamacare at their own states’ expense.

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Ed Kilgore

Ed Kilgore, a Monthly contributing editor, is a columnist for the Daily Intelligencer, New York magazine’s politics blog, and the managing editor for the Democratic Strategist.