Love That Medicare, Hate That Medicaid

At the Prospect, Paul Waldman makes an excellent point about the rather strange rhetoric Republicans engaged in when they agree to expand Medicaid, playing off some comments by TPM’s Dylan Scott on Mike Pence’s framing of his own Medicaid expansion:

Pence doesn’t want anybody to get the idea that he doesn’t hate Medicaid. As Dylan Scott explains, Republican governors always seem to find different names to call their Medicaid programs when they accept the Affordable Care Act’s expansion, and they never utter the vile word “Obamacare,” even though that’s the source of the money they’re taking:

“Pence might have been the boldest yet. His office effectively portrayed his state’s plan as a blow to Medicaid and government-funded health care.”

This is actually the inverse of the way Republicans talk and act when it comes to Medicare. These Republican governors want to expand Medicaid for very practical reasons: having huge numbers of uninsured poor citizens creates a less healthy workforce, imposes costs on the state through uncompenstated care, and is generally an economic drag…. But in public, ideology demands that they claim that Medicaid is awful and they want nothing to do with it; in the extreme case, you get someone like Pence trying to convince people that he’s striking a blow against the program by expanding it.

When it comes to Medicare, however, it’s exactly the opposite. Republicans actually dislike it, precisely because it’s a huge government program that works. But because it’s so popular, they have to pretend in public that they’re its greatest defenders….

You’ll notice that every attempt by Republicans to privatize or other undermine Medicare is presented as a plan to “strengthen” it, the mirror image of how GOP governors now say they’re weakening Medicaid by expanding it. Maybe someone should propose moving poor people into Medicare, which Republicans say they love so much. Then they’d have no idea what to say.

Nah, they’d say Medicare is a retirement benefit you earn with hard work and payroll contributions, and thus isn’t for those people. Besides, you can’t “strengthen” Medicare by cutting it if you’re at the same time weakening it by expanding it. Or something.

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.