A sign at an Affordable Care Act outreach event in Los Angeles, California, September 28, 2013.
Jonathan Alcorn/Reuters

Republican failure in DC changes the game on Medicaid expansion

Once Louisiana Gov. John Bel Edwards (D) took office last year, one of the very first things he did was embrace Medicaid expansion through the Affordable Care Act. It’s worked out beautifully for the state and its residents.

In the national picture, Louisiana became the 31st to implement the Medicaid expansion policy, and it seemed for a while that the remaining holdouts would succumb to arithmetic and do the same. Then Donald Trump won the 2016 presidential election – and everything changed, at least initially.

South Dakota Gov. Dennis Daugaard (R), for example, was moving forward with plans to bring Medicaid expansion to his own state, but Mike Pence reached out to the Republican governor personally, and persuaded him to abandon the idea, since GOP officials were gearing up to destroy “Obamacare.”

Now that the Republican plan has itself been derailed, interest in the Medicaid policy is suddenly on the rise once more. The Kansas City Star reported overnight:
Kansas lawmakers ignored Gov. Sam Brownback’s wishes Monday and gave initial approval to a bill that would expand Medicaid to thousands in the state.

The Kansas Senate voted 25 to 13 to expand KanCare, the state’s privatized Medicaid program, after a lengthy debate Monday afternoon.
A final vote in the state Senate is expected today, where it will pass with bipartisan support, thanks to cooperation between Democrats and more moderate Kansas Republicans.

The news coincided with news out of Georgia, where Gov. Nathan Deal (R) is suddenly showing an interest in the ACA’s Medicaid expansion policy, and in Virginia, where Gov. Terry McAuliffe (D) is renewing his push for the same idea. In Georgia, the change would bring coverage to roughly 300,000 low-income people, and in Virginia, the number is closer to 400,000.

Yes, as a matter of fact it is rather ironic that the failure of “Trumpcare” may actually lead to hundreds of thousands of families gaining health security.

To be sure, none of this is a done deal. In Kansas, Gov. Sam Brownback (R), who may not be in the job much longer, continues to oppose the idea for reasons he’s struggled to explain; Georgia’s efforts are still in their infancy; and Republicans in Virginia’s legislature may not budge.

The broader point, however, is that GOP opponents of Medicaid expansion have now run out of excuses. For years, Republicans said, “We can’t adopt the policy because we hate Barack Obama.” More recently, these same GOP officials said, “We can’t adopt the policy because Congress is going to roll back the clock.”

Now, however, Obama’s out of office and “Trumpcare” is dead. Even the most stubborn Republicans no longer have a reason to do the wrong thing.

Postscript: If red states start adopting Medicaid expansion, bring health coverage to millions, and Donald Trump takes credit for helping so many people, it would be truly amazing.