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Medicaid matters

Red states blocking Medicaid expansion matters at least as much as disruption caused by the Affordable Care Act.
Activists Demonstrate In Support Of Medicaid Expansion And The Affordable Care Act in Miami, Florida, September 20, 2013.
Activists Demonstrate In Support Of Medicaid Expansion And The Affordable Care Act in Miami, Florida, September 20, 2013.
E.J. Dionne Jr. raises an argument in his column this morning that's been getting short shrift by too much of the political world lately: Medicaid expansion matters, and far too many state Republican policymakers are blocking it for no reason.
"President Obama apologized last week after all the criticisms of what's happening in the individual insurance market," Dionne explained. "But where is the outrage over governors and legislators flatly cutting off so many lower-income Americans from access to Medicaid? The Urban Institute estimates that 6 million to 7 million people will be deprived of coverage in states that are refusing to accept the expansion."
The recent disruption in the health care marketplace certainly matters, and the Obama administration has a lot of work to do to put things right. But if we're going to talk about policymakers who need to apologize and show some semblance of regret, can we at least start to have a conversation about those keeping millions of struggling Americans from having access to coverage, largely out of partisan spite?
Jonathan Cohn published a good piece on this earlier:

Today it's a few hundred thousand people. By next year, it will be at least a few million. Their health insurance status is changing dramatically: What they have in 2014 and beyond will look nothing like what they had in 2013 and before. For many of these people, the difference will be hundreds or even thousands of dollars a year. In a few cases, it may be the difference between life and death. You probably think I'm talking about the people getting cancellation notices about their private insurance policies. I'm not. I'm talking about the people getting Medicaid. Both stories are consequences of the Affordable Care Act. But one is getting way, way more attention than the other.

There's been an obvious preoccupation -- on Capitol Hill, with Beltway media, etc. -- with website dysfunction and cancelation notices, while Medicaid expansion, which arguably affects a larger group of people, has been routinely overlooked.
Maybe it's because Washington is "wired" for Republicans and it's the right's complaints that have been driving the recent conversation. Perhaps it's the result of Medicaid beneficiaries lacking the kind of political capital that keeps their plight on the political world's front-burner. Maybe it's a matter of timeliness, with implementation disruption seeming "new" in ways Medicaid is not. Perhaps it's a combination of things.
Regardless, by my standards, this is a genuine scandal. The administration's missteps are real, but they're not deliberate. "Red" states rejecting Medicaid expansion because of some misguided contempt for "Obamacare" are leaving struggling families behind on purpose. The callousness is outrageous.
Cohn concluded, ""Should the president have been more candid about the impact his plan would have on people buying their own coverage? Yes. Should we pay attention to those people, particularly when they must now pay more for equivalent coverage? Definitely. Should this put extra pressure on the administration and some states to fix their websites? You bet. But that's not the only Obamacare news right now. The law is making life better for a great many people -- and would help even more if only Republican lawmakers would relent."