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In fight over Medicaid expansion, AFP can't win them all

Americans for Prosperity thought they were positioned to win a red-state fight over Medicaid expansion. They thought wrong.
A sign at an Affordable Care Act outreach event in Los Angeles, California, September 28, 2013.
A sign at an Affordable Care Act outreach event in Los Angeles, California, September 28, 2013.
The Montana affiliate of the Kochs' Americans for Prosperity thought it was in a strong position to derail Medicaid expansion in the state, just as AFP activists did in Tennessee in February.
As it turns out, in Big Sky Country, the opposite happened.

The state Legislature has passed a bill expanding Medicaid eligibility to about 70,000 low-income Montana residents. The bill approved Saturday heads to Gov. Steve Bullock, who is expected to sign it into law.

Bullock is likely to approve the policy -- as the AP report added, the governor "issued a statement applauding passage of the measure, saying he's glad politics could be put aside on behalf of the health of state residents and the economies of rural towns." The legislature, however, has not yet formally transmitted the bill to the governor's office.
Remember, as we talked about last week, at this point a year ago, Medicaid expansion in Montana looked like a lost cause, but in early May 2014, Bullock started arranging some "non-publicized" meetings on the issue. The governor saw a possible opportunity to advance the policy, so he started quiet negotiations with state Republicans and private-sector stakeholders.
It worked. Assuming the Obama administration signs off on the package, which is likely, Montana will expand health security to tens of thousands of low-income residents, while improving state finances and bolstering state hospitals.
Montana's AFP actually became something of a punchline during the debate, at one point arguing that expanded coverage would defy "the voices of millions of Montanans who have made it clear that they do not want more Obamacare." Montana's population is roughly a million people. There's no such thing as "millions of Montanans" -- a detail health care supporters were eager to point out.
As for how health care proponents managed to prevail, Eric Stern had a good piece on this in Salon yesterday, noting, "Montana is the only state where the Kochs got beaten down like this."

For the Medicaid battle the Kochs tried a new strategy, one that never works in the West. They flew in a bunch of high-priced young politicos from Washington to get the job done. These held "town meetings" in rural communities at which they showed up in slim-fit suits and pointy shoes, looking like they were heading to a nightclub, lecturing farmers and ranchers on politics and the dangers of "more Obamacare" and publicly threatening moderate Republicans. It didn't take long for them to get booed off the stage by their own partisans.

Update: Gov. Bullock was in Boston over the weekend to run the marathon, but this is unrelated to the fact that the Medicaid bill has not yet been signed into law. (He finished with a time of 3:40.44, if you were curious).