For family advocates hoping to see Medicaid expansion reach more struggling Americans, the 2014 midterms were heartbreaking. In states like Maine, Georgia, Florida, Wisconsin, and Kansas, voters elected Republicans who will guarantee a longer Medicaid gap for at least another four years.
But against this discouraging backdrop, there are signs of gradual progress. In September, Pennsylvania became
the 27th state to accept Medicaid expansion through the Affordable Care Act, and as Reid Wilson reported
the other day, the list is still growing.
Wyoming Gov. Matt Mead (R) was once among the handful of state executives to sue the federal government over the Affordable Care Act. Now, he says he wants his state to expand Medicaid under the ACA to cover thousands of low-income residents. In a Monday press conference, Mead said he would press the state legislature to act on a Medicaid expansion plan put forward last week by the state Department of Health.
"I agree it is not a good piece of legislation, but, as I see where we are, I think we have to be realistic and say this is the current law of the land and we need to either go forward with this or if the legislature wants to come up with a different plan, I certainly would be open to that," Mead said
last week. "But I don't think we can say to those people in Wyoming who are working who cannot get insurance that we're not going to do anything."
Mead almost certainly didn't mean it as a sharp rebuke to those Republican governors who continue to support doing nothing, but the comments nevertheless make many of his far-right brethren look a little worse.
It's worth emphasizing that this is not a done deal in Wyoming. State officials have been negotiating with the Obama administration on the details of a Wyoming-specific alternative that Republicans can live with, and the GOP-dominated legislature may yet balk at the plan that would extend coverage to 17,600 low-income Wyoming residents, while boosting state finances and state hospitals.
But there's clearly movement in that direction -- and not just in Wyoming.
Pennsylvania was the 27th state to embrace Medicaid expansion, and Utah appears likely to become the 28th
[Republican Gov. Gary Herbert], who surrounded himself by a phalanx of medical, insurance, business, religious and charitable leaders at a news conference Thursday, said Utah should provide concrete help in the face of such discouragement. "These are our neighbors, our friends and our family members," said the governor. "Turning a blind eye and doing nothing is really not the Utah way."
Estimates vary, but the plan, if approved by the legislature, would bring coverage to tens of thousands of low-income Utahans.
And let's not forget Tennessee, where Gov. Bill Haslam (R) has also said
he expects to move forward with his own approach to Medicaid expansion in the near future.
As we talked
about a few months ago, I still suspect the pressure on the holdout states, mostly in the deep South and Plains states, which refuse to consider the ACA policy out of partisan spite, will be unsustainable. States can only hurt themselves on purpose for so long before madness ends.