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.
Kerry deserves this and will win if it is God’s will! Please just go on with the next few weeks praying our new president will be President John Kerry!!
Roy: The Gallop credibility refers to their likely voter model. That is what’s being questioned as far as credibility. This poll was a registered voter poll which as far as I know is not in question.
Kerry is up 5 in that poll.
Note in the Likely voter poll, he’s only up 1.
Gallps LV model simply understates Democratic likely voters and is designed for a time when Democrats were pretty much lazy voters and had no ground game. that’s all changed.
So if you see a poll that usually leans toward the right too much like a Gallop LV showing a Kerry lead, YOU SHOULD LIKE KERRY’S CHANCES.
The same would hold true of a Strategic Vision poll that showed Kerry with a lead. You should like Kerry’s chances.
I like Kerry’s chances in Ohio. But we shouldn’t get too confident. IT’s all about GOTV. If we can turn that extra 4% of Registered Voters in that gallop poll for Kerry into Voters, we win.
I wonder why Gallup would poll in Ohio with Nader included. Nader isn’t on the ballot in Ohio.
And for those of you who are sure that Kerry will pull out Ohio, let me warn you that the Columbus dispatch reports people have been calling elderly voters to tell them that their polling places have changed. Combine that with J. Kenneth Blackwell’s resistence to provisional voting, and one might conclude that the GOP “fix” is in in the Buckeye State.
I would bet that Kerry would win Ohio in a fair vote. I’m not sure he’ll be able to win by a large enough margin to overcome the GOP plans to wrest the state away from the voters.
WHATS WITH IOWA AND WISCONSIN
Over the summer, I thought we would be in good shape in both of these states, primarily because they have traditionally been “anti war.” I wonder if there is some demographic change that is going on there that is turning them from a “blue-purple” to a “red-purple.” Forexample, here in West Virginia, the Democratic Party is getting killed by the long term loss of union jobs. I wonder if a similar dynamic is going on in the upper midwest. On the other hand, I dont think either state is seeing the type of demographic change that is helping the party that is described in Ruy’s EDM.
Another possibility is just that Kerry does not “play well” and has not campaigned well in rural areas. Some paper, I think it was the NYT, suggesting this is the case. However, this would not really explain why he is out performing Gore in Ohio.
Any thoughts?
Mark,
The GOP will try anything & everything to steal FL, so don’t count on those 27 EV.
Nonetheless, in keeping with what Cautiously Optimistic said above, if Kerry wins OH he could lose either WI or IA (not both) and still have 270 EV. The way things stand now, I think it is highly likely that Kerry will take OH + (WI or IA). He may well take all three.
Scott
Well, despite the hype posted here, I’m concerned. Bush is up by two nationally on Reuters and 2.5 on Rasmussen, and is winning in Slate’s electoral college forecast. These are all trending Bush in the last few days. I know that the swing states are what matters, but here and elsewhere it seems that Kerry has plateaued. I know that incumbents typically get their approval rating in final votes, but since we’re at war, I think that a good chunk of undecideds will hold their noses and pull for Bush anyway.
One thing I don’t get is the apparent disjunction between the polls in the battleground states and the national horserace polls.
I’m generalizing, and doing some averaging in my head, but it seems that when viewed in state-by-state polls or the polls of “battleground state voters” Kerry does better than he does in the national horserace.
This suggests that Bush’s advantage in the Red states is larger than Kerry’s in the Blue states. It would also suggest that Bush had more “wasted” votes (votes in excess of the margin necessary to win) in large states like Texas.
Is this really true? Kerry seems to be comfortably ahead in more large states than Bush. I’m thinking of Kerry’s lead in New York, California, Illinois, Massachusetts compared to Bush’s lead in Texas.
Any comments?
This morning on Air America (Oct 22) , they had Zogby on the air. In his analysis, he said that one thing seemed sure, and that was that Bush’s support was firmly set. He saw little possibility for Bush to gain much in the polls. He thought that all the undecideds would break for Kerry and possibly before the election.
Remember, Zogby is considered to be the most accurate of pollers, and an incumbant who can’t top 50% is in big trouble. Of course, there’s the Electoral College.
Bush will not win WI (but if he does I’ll have to mover)
Consider:
1) In 2000 Gore won be a mere 5000 some votes but,
2) Nader got 90,000 votes (3.5%). He’d be lucky to get 1/10 that this time around. I live on Madison’s east side in one of the most liberal wards in the state (in 2000 Bush pulled in a whopping 80 votes (5%) while Nader got 337 (23%)) and I don’t know of a single person planning on voting for Nader. I flat out do not believe he will pull the 1-2% of the vote the polls suggest.
3) Turnout is clearly key, but the Kerry base of Milwaukee and Madison is more densely popluated than the rural Bush base so it should be easier to drag the lazy-but-probably-Kerry voter to the polls than their Bush counterparts
4) Polls are all over the place in WI just as they
were in 2000. See this article from Oct 24, 2000 in the Milwaukee Journal-Sentinal:
http://www.jsonline.com/news/metro/oct00/poll24102300a.asp
Sounds a lot like this year
5) Its our turn dammit!
This is not a suggestion that KE should back off on Florida…but we absolutely must have an electroal edge that allows us to win without FL. The Leninists on the GOPpie side can and will pull out all the stops there, and have the established infrastructure to get away with it.
A small data point in support of that argument. My 80-something y.o. in-laws live in Piniellas County. M-in-law is registered Dem, F-in-Law a Repug.
Her absentee ballot comes without a pre-paid addressed envelope, his comes with. She ends up mailing in hand addressed that gets returned for insufficient postage. She resends. She checks around their home to see if others got or didn’t get a return envelope. 2 Repugs and 1 Dem did, 2 Dems did not, and 1 of those 2 Dems got theirs back for incorrect/no-such address.
Not even remotely a definitive study, but 3-of-5 Dems didn’t get a return envelope, and 2-of-5 geriatric Dems had the opportunity to just let it slide and skip resending. If an eighth of the 2-of-5 don’t bother to resend or screw up again, that’s 5% of the intended-Dem absentee vote.
Moreover, there’s the liklihood of other schemes to be put into play.
Again, not suggesting we blow it off…way too many popular and electoral votes. But we’d better nail it without needing it. How about AZ, AR (send Clinton, Clark & Edwards full-time) & IA. Or VA & NC.
Zogby today is reporting that Kerry and Bush are basically even among seniors. Zogby calls this another “ominous” sign for Kerry. I admit language like this gives me a chill. But is that something of an exaggeration given that Zogby is showing the two of them statistically tied (I think it’s 47-45 Bush). I would think there are more than a few “ominous” signs he could find for Bush, too, but doesn’t seem to want to discuss them.
Gotta love Gallup. There’s just no way Bush is doing better in Colorado (my home) than Wisconsin. No way. Also, I’ve been in WI recently. The independent groups and the Dem party is so wired and organized I felt like I was in Marine boot camp. They’re going to pull it out. Iowa is not looking good, but I’m pretty confident that will be our only Gore-state loss.
Quinnipac now has Kerry 5 points ahead in Pennsylvania. There can be no doubt now — the momentum is clearly in Kerry’s direction. Ahead in Ohio, ahead in Pa., tied or ahead in Florida, ahead in Iowa, closing in on Wisconsin and poised to “steal” New Hampshire, Colorado, Nevada and perhaps other states from the Red column.
http://www.quinnipiac.edu/x11379.xml?ReleaseID=486
If Kerry is roughly even nationwide, but running ahead by 6-7 points in the battleground states, where are all Bush’s extra votes coming from?
RUTS, baby! (Running Up The Score, to borrow a college football term)
The numbers I’ve seen for the Solid Red and Blue states (2.004k.com, as of this morning) generally show Kerry up by 10-15, and breaking 20 in only a few strongholds like RI, NY, and over 30% only in DC, a 20%+ total of 38 EVs. In CA, Ill, he’s not over 20, and in MA he doesn’t clear 15!
Bush, on the other hand, is RUTSing like Kansas State. Against Army. At Home. On national TV. For Homecoming. He has leads of 20 or more in a baker’s dozen states totalling 106 EVs. In four states, UT, WY, OK, and NE, he’s at 30% or more. Bush has successfully mobilized his red state base – too bad it doesn’t count for much beyond national telephone surveys.
EVs by (Mar)gin, for (Bu)sh and (Ke)rry
Mar Bu Ke
30+ 20 3
20+ 86 35
10+ 41 105
6+ 48 84
Florida is the big one. If Kerry wins Ohio he can still lose. If he wins Florida, he wins.
Mark
With all the polls coming out now, here are my feelings.
I don’t see any way Bush wins Wisconsin. I know the polls there are showing a close race, but I think Kerry will pull out Wisconsin.
I’m feeling much better about Ohio. Everything seems to be trending Kerry’s way there.
–Scott
“Will vote early, wish I could vote often.”
brit hume (fox special report with britte hume- thursday)interviewd republican pollster john mccaughlin on LV v. RV.
mccaughlin stated that in determining who is a LV his firm simply asked polled party if they were a likely voter. he admitted this was a very loose “screen” and went on to criticze LV screens in general as being unrelaible.
Ruy, I’m no fan of Bush, but I have to ask why this Gallup poll showing Kerry leading 50-44 among RV’s in Ohio is credible, while practically every other Gallup poll has been discounted at this site?
It’s worth noting that if Bush wins FL, WI, and IA, then Kerry loses, even if Kerry wins OH & PA. So, we can’t focus all of our attention on OH. Nevertheless, I think Kerry will ultimately win both OH and WI (and perhaps IA too).