GOP Govs and Medicaid Expansion: The Exception That Proves the Rule

At TNR today, Brian Beutler tells liberals (like me, I suppose) not to mock Ohio Gov. John Kasich for a self-contradictory attitude towards elements of the Affordable Care Act, because (a) his position would be good for people who otherwise will be denied health coverage, and (b) may represent a critical GOP constituency for preserving some or all of Obamacare in a party otherwise hellbent on total repeal.

Well, Brian’s obviously right on the first point, though I doubt very seriously Kasich chose to accept the vast fiscal subsidies associated with Medicaid expansion because he wanted liberal praise, which leads me to the second point: individual governors supporting the Medicaid expansion in their own states don’t necessarily add up to a national constituency for Medicaid expansion.

The reason an awful lot of pundits (though not me!) predicted all or nearly all Republican governors would go with the Medicaid expansion is that it’s kind of nuts not to thanks to the insanely generous match rate. It took some serious ideological derangement for so many of them to say “no,” particularly when it became evident the Obama administration would allow states to do all sorts of conservative “experimentation” with the entire Medicaid program if they’d only accept the expansion.

But the logic of an individual governor taking free money isn’t the same as the logic of a Republican politician supporting the Medicaid expansion as a national policy. And should Kasich actually run for president, I imagine he’ll find it easier to just shrug and cite the fiscal prudence involved in the deal instead of defending it on the merits.

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.