When the Supreme Court upheld Obamacare in a landmark ruling last year, they also weakened a key provision by allowing for states to opt-out of the Medicaid expansion. Of course, the truth is that the Medicaid expansion is a no-brainer move for any state that with a high number of uninsured people because the Federally paid portion of the increased Medicaid costs is 90%. That isn’t stopping about a dozen or so Republican governors from flatly refusing to take advantage of the Affordable Care Act’s Medicaid expansion, but as The Rand Corp reported in their recent study, that decision could be quite costly both in terms of dollars and in terms how many poor people in their state will have access to health insurance.
So why are the Republican governors acting like this? I don’t know; but here are my five best guesses.
#5. They Love Spending Government Money
Not expanding Medicaid will cost states billions of dollars. Not only because they won’t get additional Medicare funding that Obamacare provides for, but also because they’ll have to take on even more health care costs for those who are uninsured in their states. Estimates are that denying the ACA’s Medicaid expansion will cost states roughly a billion dollars. And here we thought TeaPublicans were all about not spending tax payer money.
#4. Poor People Don’t Need Health Insurance
Oh sure, if you’re speaking from the standpoint of logic and reasoning, it’s absolutely stupid to deny coverage to 3.6 million people — which is what denying the Medicaid expansion will do. And sure, if you’re speaking from a morality and ethics standpoint it’s atrocious to make poor people suffer because you incorrectly conflate this health care reform law with anything remotely resembling true, universal health care. Apparently though, in Teapublican Land, poor people just don’t need to worry about their health, because you know, in Teapublican Land small government means paying more for health care with less market influence on the costs themselves.
#3. They Want More Federal Involvement In Their States
You might think that tea-swilling governors would actually be against Big Brother coming in and taking things over. You might think that, but you’d be wrong, at least from in the sense that every state who refuses to play ball with Obamacare will wind up inviting even more Federal activity in their state as the Feds work to set up insurance exchanges in states whose governors are acting like petulant children and denying access to affordable health for millions of Americans. So much for “small government” conservatism.
#2. They Hate Math
As best I can tell, modern day Republicans just don’t like math, because the simple math of the situation is that it makes far more sense to expand Medicaid under Obamacare, insure millions more people, and start sharing the cost of insuring the truly poorest among us with the Federal government. The more people who are in the exchanges the better for everyone. Perhaps in a few years when other states have fully implemented the ACA’s Medicaid expansion and are doing well with it, that will inspire other red states to boot their intransigent Teapublicans in their capitals, that’s the hope anyway. Until then, we can only assume that Teapublicans hate math. We already know they hate science though, so it’s not so much a stretch.
#1. They’re Unsympathetic Jerks
Perhaps it’s best to just call the facts as they are. Maybe Rick Perry and Bobby Jindal aren’t sociopaths. One has to assume since they have spouses and children that they at least have a modicum of compassion and warm feeling in their hearts. Clearly though, that warmth and compassion doesn’t translate into policy making. If Obamacare directly helped big business or the Department of Defense, I have no doubt that every single Republican governor would sign on in a heartbeat. Instead, they choose to stand on largely debunked and farcical economic principles and wind up screwing over the people who need help the most.