Tuesday, May 28, 2013

Republicans Refusing to Expand Medicaid Tighten Their Own Noose


Conservative rhetoric since Barack Obama was elected has been about how his administration has cauterized progress in the US. You’d think it would be hard to get around the fact that the US economy is doing a lot better than many other countries because Obama understood the fatal ramifications of austerity, and despite what he inherited. But rhetoric, like water, will flow seamlessly around obstacles no matter how rational and fact-based they are.

Republicans have opposed Obama on everything they could whenever they could. Yet, ironically, he provides a measure of cover for them. They want control of Congress and the White House, but if they succeed after the next elections – God help us all - they’ll have to take the rap for the ill effects that are bound to result from their conservative policies. Whether they’re conscious of that or not is hard to know. This is group of politicians notorious for their skill in slipping the noose around their own neck and tightening it.

The latest gimmick is for Republican states to resist expanding Medicaid. In 2010 Congressional Democrats approved the health care law as they intended to expand eligibility for Medicaid in each state. If that had happened, people too poor to afford medical insurance or medical attention would have received Medicaid. The Urban Institute has estimated that it’s about 5.7 million people.

Predictably, there was huge Republican resistance. Last year the Supreme Court ruled that states could decide for themselves. The New York Times states that 25 - mostly Republican - states decided against. So those 5.7 million people will lose out. Surely a victory for Republicans.

Meanwhile, Obama and his administration continue along the path of most resistance but also most effectiveness for the economy and the recovery of the middle class. Beginning next month the president and a team, including the secretary for health and human services Kathleen Sebelius, will fly around the country informing people about their options. They want to reach those who are eligible but don’t realize it or don’t know what they have to do to access it.

Unfortunately the team will also have to explain to those in states with no expanded eligibility that they’re too poor. That is going to be heartbreaking. It’s hard to know whether or not the blame will fall on Obama at first. But over time it’s going to be pretty clear who’s responsible. That noose is tightening. But the collateral damage is something awful.