Medicaid Expansion For Me, Not For Thee

I’ve been reasonably outspoken over the two-years-and-change since the Supreme Court made the Medicaid expansion feature of the Affordable Care Act optional that acceptance of the provision by individual Republican governors and state legislative leaders would not be inevitable. And more recently, I’ve argued that even individual state GOP leaders who accepted the expansion on prudential grounds as a matter of taking free money from the feds wouldn’t necessarily support or (or indicate the inevitability of) a national policy of accepting the expansion.

If you want a good example of this second dynamic, check out the position of the Libertarian candidate for governor of Georgia, Andrew Hunt, as explained by the Atlanta Journal-Constitution‘s Greg Bluestein:

The national Libertarian party has put its opposition to the Affordable Care Act at the center of its platform for more limited government. Andrew Hunt, the party’s local candidate for governor, takes a different tack.

Hunt has raised eyebrows by joining Democrat Jason Carter in advocating for Medicaid expansion, a position that strikes a contrast with the national party’s platform.
That support has become a point of contention between Hunt and Gov. Nathan Deal, who questions how he can reconcile his stance with the party’s views. On Tuesday, Hunt explained his stance on Medicaid expansion to AJC colleague Nicholas Fouriezos.

“Georgia is a net negative on receiving money back from what it pays into the federal government,” Hunt said. “That hurts our economy. Until we can end Obamacare – because we shouldn’t have such federal programs – we need to get our money back.”

Hunt goes on to suggest that if he were governor of Georgia, he’d try to get him one of those nice waivers that have allowed GOP governors to mess with the basic Medicaid program in a conservative direction in exchange for allowing an expansion. And so he articulates both of the arguments that have been made it possible for hardline opponents of godless socialistic health care to expand Medicaid in their own states–but not as a matter of general principle applicable elsewhere.

If a Libertarian can pull of this position, Lord knows any Republican can. But as with Libertarians, the ideological pressure to swear off any complicity with the evil of Obamacare is a greater inhibition than logic or consistency.

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.