There’s another turn in a story we’ve all been following for over a decade, so I wrote it up at New York:
The Affordable Care Act was signed into law 13 years ago, and the Medicaid expansion that was central to the law still hasn’t been implemented in all 50 states. But we are seeing steady, if extremely slow, progress in the effort to give people who can’t afford private insurance but don’t qualify for traditional Medicaid access to crucial health services. The U.S. Supreme Court case that upheld the ACA also made Medicaid expansion optional for states. Twenty-four states accepted the expansion when it became fully available at the beginning of 2014, and that number has steadily expanded, with the most recent burst of forward momentum coming from ballot initiatives in red states like Missouri, Nebraska, Oklahoma, South Dakota, and Utah. Now a 40th state is in the process of climbing on board: North Carolina. As the Associated Press reports, legislation is finally headed toward the desk of Governor Roy Cooper:
“A Medicaid expansion deal in North Carolina received final legislative approval on Thursday, capping a decade of debate over whether the closely politically divided state should accept the federal government’s coverage for hundreds of thousands of low-income adults. …
“When Democratic Gov. Roy Cooper, a longtime expansion advocate, signs the bill, it should leave 10 states in the U.S. that haven’t adopted expansion. North Carolina has 2.9 million enrollees in traditional Medicaid coverage. Advocates have estimated that expansion could help 600,000 adults.”
So what changed? Basically, over time the fiscal arguments North Carolina Republicans used to oppose the expansion began sounding increasingly ridiculous, AP suggests:
“GOP legislators passed a law in 2013 specifically preventing a governor’s administration from seeking expansion without express approval by the General Assembly. But interest in expansion grew over the past year as lawmakers concluded that Congress was neither likely to repeal the law nor raise the low 10% state match that coverage requires.
“A financial sweetener contained in a COVID-19 recovery law means North Carolina also would get an estimated extra $1.75 billion in cash over two years if it expands Medicaid. Legislators hope to use much of that money on mental health services.”
In other words, the GOP Cassandras warning that the wily Democrats would cut funding for the expansion in Congress once states were hooked turned out to be absolutely wrong. Indeed, the very sweet deal offered in the original legislation got even sweeter thanks to the above-mentioned COVID legislation. States like North Carolina appeared to be leaving very good money on the table for no apparent reason other than partisanship, seasoned with some conservative hostility toward potential beneficiaries. In this case, GOP legislators finally reversed course without much excuse-making. The AP reports:
“A turning point came last May when Senate leader Phil Berger, a longtime expansion opponent, publicly explained his reversal, which was based largely on fiscal terms.
“In a news conference, Berger also described the situation faced by a single mother who didn’t make enough money to cover insurance for both her and her children, which he said meant that she would either end up in the emergency room or not get care. Expansion covers people who make too much money for conventional Medicaid but not enough to benefit from heavily subsidized private insurance.
“’We need coverage in North Carolina for the working poor,’ Berger said at the time.”
That, of course, has been true all along. Final legislative approval of the expansion was delayed for a while due to an unrelated dispute over health-facility regulations. And the expansion cannot proceed until a state budget is passed. But it’s finally looking good for Medicaid expansion in a place where Democrats and Republicans are bitterly at odds on a wide range of issues.
There remain ten states that have not yet expanded Medicaid; eight are Republican “trifecta” states (Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, Texas, and Wyoming) and two others have Republican-controlled legislatures (Kansas and Wisconsin). Perhaps the peculiar mix of stupidity and malice that keeps state lawmakers from using the money made available to them by Washington to help their own people will abate elsewhere soon.
So what if Iraq HAD WMD and a way to deliver them. . . so did Russia for so many years. So why didn’t they zap us when they had the chance?
Because we have the enormous power to retaliate, that’s why. Therefore, it dosen’t wash that Saddam would’ve delivered WMD to the USA.
WMD was nothing but a pretext from Bush and Co. to grab a significant oil producing country AND scare the heck out of us so he can do what he pleases in the name of national security.
Big John
Sorry, I intended to paste the address, but the site wouldn’t let me . It is:
http://www.electoralvote.com
Bush won Nevada by just under 4% in 2000.
Bush 301,575 49.52%
Gore 279,978 45.98%
What in the world is the MoE for these polls, especially the FL one. I have trouble believing Bush surged that much so fast. I could believe Bush is up, but within or just barely outside the margin. Also, I agree with the general sentiment that if millions of people don’t have TV or electriticity or are generally displaced, polling is worthless for another couple weeks in the sunshine state.
Still, NV is good news, 4 points is probabbly w/i MoE. Kerry needs to do another trip out to Vegas and the Vegas burbs to help the house candidate there (get some $) and raise the spirits of his Nevada campaign.
I would say Kerry needs NH WV and then try to get either FL or OH for good measure; right now, it looks like FL is a better bet than OH.
Looks like Nevadans definitely want the nuclear dump in their state. I’m beginning to think may be we deserve this moron as the president.
and more good news, A judge threw Nader off the ballot yet again.
Anyone know a URL that has a good discussion of why RoboPolls suck?
I got into an extended and heated argument with a local TV station’s news director over his use of Survey USA in the last mayor’s race.
The Poll was off by over 12% in the event and prior to the last polling round, was off by a similar margin from a highly respected normal poll
About what states are needed. If Kerry were to win all the Gore 2000 states, and Bush retain all the Bush 2000 states, then Bush wins 278-260.
Using that as a baseline, if the only change is Kerry winning Ohio, he wins 280-258. If Wisconsin also changes (to Bush), Kerry still wins 270-268. So…Kerry doesn’t need to win both Florida and Ohio, assuming he can hold all of the Gore states, or that he loses no Gore state worth more than 10 electoral votes. [That is, if he gets Ohio, he can lose any one of Minnesota, Iowan, Wisconsin, Maine, Oregon, or New Mexico.]
Florida is worth 27 electoral votes, so if Kerry were to win there, that would add another 7 electoral vote buffer.
And he has the lead in New Hampshire, which also gives him another 4 electoral votes.
So…Going back to Nevada….If Kerry can keep Pennsylania and Michigan and pry away either Florida or Ohio, there’s a good change Nevada won’t matter.
But…if the only changes from 2000 are Kerry getting New Hampshire and Nevada, the election ends up deadlocked at 269, throwing it to the House and Senate to pick President and VP. If the Dems can pry away the Senate, that could well leave us with a Bush/Edwards tandem. That’s not what I’d prefer, but better a half loaf than nothing, so I want Nevada to go Democratic.
The Florida poll must favor northern Florida, since that’s the part that isn’t evacuated/reeling re: the hurricane. It’s also the more GOP-heavy part of the state. It’s a crappy poll.
Florida polls can’t be worth much right now, with the hurricane and all. (If South Florida got evacuated this week, but the Panhandle’s evacuating this week, I’d expect gains for Kerry next week based solely on who will be home to answer their phones.) The NV results are unfortunate, but we don’t need that state to win: we do, I think, need either CO or WI or BOTH FL and OH.
I think this poll is worthless, with all the hurricane stuff the past two weeks, does anyone realistically believe an accurate poll would come out of that mess at least until Ivan blows past.
Never mind. I just checked, and there are no RV figures. I wish to hell they would stop taunting us with figures that are likely imaginary.
What is the percentage of Registered Voters?
Nader is back on the FL ballot. So, it probably is worse for Kerry. And yet, I know we will win. I took a poll in the mirror this morning and Kerry is doing fine. Thank you zanex.
Two things to point out:
(1) all of these polls report likely voters, which isn’t necessarily incorrect, but does employ certain assumptions about voter turnout.
GOTV efforts, obviously, can make a huge difference, and this is an area in which the Dems have been losing ground to the GOP over the last two decades. Hopefully the DNC is developing an effective field machine, gathering corps of volunteers to phone Democratic voters less likely to vote (i.e., those below the median income) as well as undecided voters on election day and offer rides/baked cookies/lemonade etc.
(2) in the FL poll for the SAME RESPONDENTS there is quite a bit of ticket-splitting, as Castor (D) is ahead of Martinez (R) in the Senate 49 to 45.
Now this suggests to me that there remains about 5-6% of voters in FL who are seriously in play.
In general, Kerry needs to make better use of local politicians who are (sometimes) more popular than he is in their states–not merely FL but elsewhere, esp. in swing states that have popular Dem governors, i.e., AZ, WI, MI, PA, NC, etc. I know that some coordinated campaigning has been done, but not nearly enough. And there are some governors (e.g., Mike Easley in NC) who do not seem to want to share the stage with Kerry.