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.
I think many of you are overreacting to this.
Generally, the poll has a small sample and probably
isn’t reliable. But if we take it at face value,
it gives roughly the result we should expect.
Maine is a state that is a few percent better for
Kerry than the national average, so he will win Maine
by a few percent if the national result is very close (and
by more if he has an edge nationally); with
current polls showing that Kerry is a few percent behind nationally, it is not surprising that Maine would be close.
I think Maine was expected to lean Kerry’s way, but not overwhelmingly. A Bush victory there is possible, but I don’t think very likely. My guess (and like all my predictions is only a guess) is that Kerry will win statewide but Bush might get an extra electoral vote.
Was this expected to be a battleground state?
Apparently the mere mention of ancient text killed the thread.
Back on topic:
Maine has 4 electoral votes and they split.
Kerry will outpoll Bush, there, however.
Publius,
Nom de plume of John Jay, Alexander Hamilton and James Madison in their excellent 87 essays, published in the colonies as support and explanation for the newly created Constitution of 1787.
That type of thoughtful written argument by politicos in power is seldom if ever seen these days.
Every time I hear some Republican start talking about what the founding fathers wanted, I always ask if they have read the Federalist Papers. Anyone who is serious about original intent must read and assimilate them.
It’s one poll, taken not too long after the GOP convention. It doesn’t mean we have to “fight for Maine”.
Maine was always “in play” to the limited extent that, because of the electoral vote allocation, there is the possibility that Bush could get one electoral vote corresponding to the Second (more rural) district. The First District, which includes Portland, is a solid Democrat District, which should give Kerry a wide enough margin to carry the state overall.
Considering the high number of French Canadians in upper Maine, it’s hard to see how an administration with such utter francophobia could have much support in this neck of America.
Yeah, ME is not a liberal state. It is very libertarian. Hell, Ross Perot almost won it in 1992. So, this is no surprise for this Dem.
Pardon my ignorance regarding Maine, but aren’t we basically talking about one or two electoral votes here? According to http://www.electoral-vote.com, “Maine is one of the two states that does not use a winner-take-all system for allocating its votes in the electoral college (Nebraska is the other one). The winner of each of the two congressional districts gets one, and the statewide winner gets the other two.”
Personally, I think the Colorado proposition which would do the same thing, and take effect immediately, might be a bigger threat to JFK ’04 than Maine.
Ryan, try not to post unless you have something to say.
As Alan R. correctly observes, Maine went for Gore by only 5 points, with Bush getting 44.6% of the 3-way vote, It’s not surprising that he’s at 43% now.
Ryan — It’s true that Kerry shouldn’t have to work on Maine, but at the same time, who would have thought Bush wouldn’t have locked down Virginia, Nevada, Colorado, Arizona, Tennessee, and Arkansas?
The Zogby poll is undeniably bad news for Kerry-Edwards.
Maine should be a safe blue state, not in play 45 days out from Election Day.
If Kerry-Edwards has to work to lock-down Maine, hard to see KE ’04 winning.
Maine was actually pretty close (Gore by 5) in the 2000 election, the same margin by which he won Michigan and Pennsylvania. Perhaps because Kerry is from New England, people expect Maine to be a slam-dunk for him, but it really should be more in the “lean Kerry” category than “safe Kerry.”
Having said that, Bush’s 43% for an incumbent, at a highly opportune time for him (shortly after the RNC convention), suggests that Kerry should ultimately prevail in Maine.
2000 results:
http://www.infoplease.com/ipa/A0876793.html