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Wyoming latest to reject Medicaid expansion

If healthcare scandals are all the rage, Republican governors rejecting Medicaid expansion for no reason -- other than political spite -- deserve the spotlight
U.S. Governor of Wyoming Mead Matt speaks during a session of the 22nd World Energy Congress at Exco Hall in Daegu, South Korea, October 15, 2013.
U.S. Governor of Wyoming Mead Matt speaks during a session of the 22nd World Energy Congress at Exco Hall in Daegu, South Korea, October 15, 2013.
At this point, just about every state has weighed in on Medicaid expansion, and in the process, offered a straightforward test on whether Republican-led states prioritize arithmetic over partisanship.
It's a test Wyoming Gov. Matt Mead (R) appears to have failed (thanks to my colleague Tricia McKinney for the heads-up).

Mead, a longtime opponent of the law, said the federal health-care exchanges set up under the ACA have hurt more than they have helped, undercutting his confidence in the federal government's commitment to cover 90 percent of the costs of Medicaid expansion into the future. [...] Wyoming's Republican-dominated legislature last year voted against accepting federal funds to expand Medicaid. While some Republican governors have been able to expand the program by executive action, the Wyoming legislature's bill prohibits implementation without express legislative action, according to the Kaiser Family Foundation, which keeps tabs on state action on Medicaid expansion.

The consequences of the decision will leave 16,000 struggling adults in Wyoming behind, while undermining state finances and state hospitals for no particular reason.
What remains striking is the inability of these Republican governors to defend their own position. In this case, Wyoming's Mead told reporters, "[W]hen you see the exchange, in my view, doing more to kick people off of insurance instead of putting them on, sort of the whole notion, the whole pretext of how this is going to work is in doubt."
It's just not possible to take this position seriously. For one thing, exchange marketplaces aren't kicking anyone off their insurance -- some folks who've received cancelation notices go to the exchanges to get new coverage, not the other way around.
For another, whether one approves or disapproves of marketplaces where private insurers compete for consumers' business, this doesn't have anything to do with Medicaid expansion, which is a separate part of federal law.
Besides, if the governor is concerned about a policy "doing more to kick people off of insurance," how can he rationalize forcing many of his state's uninsured to stay that way on purpose?
Mead seems to believe the federal commitment to finance Medicaid is unreliable because, well, it's not quite clear why. Maybe it has to do with an improving website, maybe it has something to do with a small sliver of the population running into trouble in the individual market. Either way, Medicaid is a separate policy.
None of this justifies punishing low-income Americans out of partisan spite. We've spent the last six weeks or so dealing with an environment in which the political world is desperate for news of some kind of health care "scandals." But as we discussed a couple of weeks ago, Republican governors rejecting Medicaid expansion is the far more serious scandal that generates far fewer headlines.
As E.J. Dionne Jr. recently explained, "President Obama apologized ... after all the criticisms of what's happening in the individual insurance market. 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."
But since we're dealing with struggling families with little political capital, their plight is apparently less exciting.