For much of the year, policymakers were in a holding pattern when it came to the Affordable Care Act. The health care system continued to improve, and consumers continued to benefit, but officials were hesitant about adopting major changes, unsure what the Supreme Court might do to the law.
That period, of course, is now behind us. The court case is over; the system is intact; and "Obamacare" expansion is back on track. Take yesterday's developments in Alaska, for example. The NBC affiliate in Anchorage reported:
Gov. Bill Walker has announced unilateral plans to expand Medicaid in Alaska, after the state Legislature stymied his attempt to pass it during this year's regular session and a special session he subsequently called.
Ordinarily, when a state legislature balks at a legislative proposal, governors can't simply adopt a statewide policy unilaterally. But Alaska's Gov. Walker -- a former Republican who ran as an Independent with a Democratic running mate -- told reporters that state law empowers him to move forward with Medicaid expansion, with or without lawmakers' support.
"This is the final option for me -- I've tried everything else," the governor said He added, "Thousands of Alaskans and more than 150 organizations, including chambers of commerce, local hospitals, and local governments, have been waiting long enough for Medicaid expansion. It's time to expand Medicaid so thousands of our friends, coworkers, neighbors, and family members don't have to make the choice between health care or bankruptcy."
The Alaska Dispatch News added, "Walker's decision to expand Medicaid without legislative approval is not common but it's also not without precedent."
Barring a reversal in the courts, Alaska will be the 30th state to accept Medicaid expansion through the ACA, and while estimates vary on the number of beneficiaries, the move will reportedly expand health security to roughly 42,000 working-class Alaskans.
As for health care opponents, the KTUU report added, "Online opposition to Walker's announcement came quickly, in a harsh assessment from the Alaska branch of conservative organization Americans for Prosperity."
That's not surprising, though it's clear the Alaska governor was more concerned with state finances and health security than whether or not the Koch-backed group was pleased with his policy.
The same thing happened in Montana a few months ago -- AFP did everything it could to derail Medicaid expansion in Big Sky Country, but the policy prevailed anyway.
The right probably doesn't want to hear this, but conservatives should prepare for similar defeats soon. There will no doubt be some holdouts and dead-enders, but in time, the arithmetic and common sense in this debate are undeniable.
As we've discussed before, those who continue to argue that states should reject the policy out of partisan spite -- regardless of the benefits for families, regardless of the needs of state hospitals, regardless of the effects on state finances -- are facing headwinds that are only growing stronger.
States can only hurt themselves on purpose for so long before the madness ends.