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.
Yes, mobilization is KEY and it’s not too late for anyone to get involved. Here are easy ways to do SOMETHING, complete with links to get you started NOW. Please pass on to your friends, especially those in swing states, or who know people in swing states.
http://www.helpkerrywin.com/
Hey, how about the Libertarian factor? You gotta think that there are some Repubs that will vote Libertarian this year b/c they can’t stomach voting for a ‘liberal’ but they hate the Justice Department’s promotion of the Patriot Act.
In regards, to Nader, I’d be surprised if he gets half of what he got last time (approx. 2.7% of the vote). Look, the only people that will vote for Nader are the anarchist, hemp-advocate types that don’t vote Dem anyway. Even Chomsky is recommending that people vote Dem in swing states.
Nader is not a factor for the remaining UNDECIDEDS.
He will have minimal impact on the states in which he remains on the ballot, but I do not believe his total will have relevance this election.
Kerry is going to win big, so it won’t matter.
As *possible* evidence of my previous point about Fla, see today’s WP… there’s a story about how Dems are turning up in larger proportions than Repubs in early FLA voting so far… i.e., a county has 35% registered Dems, but Dems make up 40% of all early voters there…of course, that might not statistically mean anything…But at the least, it reflects energy, I would think…
eric…
…in the end, I really think Kerry will win Florida… Recall they projected that the minimum wage initiative would churn out a 5% turnout increase — people on the low end who come out to vote themselves a pay increase are going to be overwhelmingly Democrat…
Also, Nevada has a similar referendum on the ballot…My guess is that the Kerry people see some internal polling out there predicting a similar surge (like the one possible in Fla)… Having Kerry speak there last night to energize canvassers may push him over the edge…
Any comments?
Thanks!
eric…
The best thing the Democrats could ever do (in preparation of the 2008 election of course) would be to embrace Nader and follow his lead for reform. His specific analysis is invaluable and will provide the Democratic party with a road map for winning the 18-35 progressive block of young voters. This is the age group that will be most politically savvy, most informed (due to growing up with the Internet), and most difficult to attract to the Democratic circle with “Business As Usual”. The tactics of Clinton and the “run to the middle” methods will not work in 2008. Reform is on the horizon.
For some time, the site has taken note of the fact that Democrats have historically been better at GOTV efforts than Republicans, noting this as a reason to discount LV polls that show a seemingly disproportionate Bush lead.
That wasn’t the case in the 2002 midterms, however. Karl Rove took the lesson from Gore’s 2000 effort, and spent a lot of time and money on his “72 Hour Project,” which many credit with the R’s surprisingly sound victories.
This year’s efforts make ’02 look like chump change – the R’s have spent unprecedented millions in organizing their ground game, including both their standard voter suppression/intimidation efforts and the D’s standard phone banks and other GOTV efforts.
I’d be interested in hearing some thoughts about how this might effect the standard curve re: high voter turn out – why would things be the same as 2000 this time around?
There are now states with early voting, at which exit polls could be done. However, early voters may be atypical. At least, I have had described to me such data for one state, expected to go for Kerry, with Kerry where he was expected to be in the lead, Bush lagging, and largish (6% each) numbers for Badnarik and Cobb. As I said, early voters may be atypical.
I said (http://deep_blade.tripod.com/journal/index.blog?entry_id=233424) just this when Nader announced. Here in Maine, our state Democratic Party wasted countless hours and alienated thousands of Green voters (most of whom could be convinced to vote for Kerry with the right persuation) with an ill-conceived and ultimately failed attempt to deny Ralph Nader ballot access. Meanwhile, we can’t even get Kerry/Edwards lawn signs. Couldn’t some of that lawyer money have helped the ground campaign?
http://www.econ.umn.edu/~amoro/Research/presprobs.html#basic
Andrea Moro’s work from UMINN. She is calling it 51.4% probability of victory with a 6 EV margin towards Kerry for the final vote(Simulation study)
Basic work Bush 271.
MOBILIZE the troops! Her website has some really interesting visuals. It looks like bush is trending negative but we must keep up LTE’s to counter his prevarications.
Electoral Vote.com had 271 Bush 267 Kerry tonight. Bush is beatable!
The trendlines are running Kerry’s way but it is absolutely important that we sell our man to every undecided voter!
three of the four electoral vote predictors on 2004k.com were calling it for Kerry tonight. It is Kerry’s to lose! We need to help him put it away!
Kerry is not going to lose WI. Did you see the picture of the rally? I think the recent Strategic Vision polls (plus SUSA) has given the picture that WI is vulnerable. I don’t think this is going to happen. IA I could see Kerry losing. If it ends that way, Kerry wins with 2 out 3 big state strategy. No doubt about it, it’s going to be a rough fight in OH, FL, IA, and WI. I think PA is a lost cause for Bush. NH is going Kerry. Don’t even worry about NJ. NM is gonna be Kerry. NV, I’m not sure if Kerry’s time there is well spent. CO will probably go Bush. If this holds, Kerry wins!
I’ve spent a lot of time this year doing craft-registration of voters (craft = small number…17 this year…but maintaining contact and getting them to mobilized and to the polls and in many cases registering people themselves).
A lot of the population I deal with are natural Nader supporters, so I’m familiar with the demographic in this specific region.
Very few Nader supporters will vote Nader this time and will vote for Kerry. Reason: They believe Kerry is campaigning as what they view as a Democrat, while they didn’t vote for Gore Junior in 2000 because believed herwas campaigning as Kinder, Gentler Republican.
The Nader voters I meet now are more frequently not Nader supporters — they are “perfect voter” types who are conservative and generally vote Repub but will not vote for Bush Junior. And yes, there are some militant Nader supporters in the remainder, too.
But the Greenberg Fade effect will most probably happen, and especially in states perceived as close races.
The only problem with the current “Three State Theory” (whoever wins 2 out of 3 between OH, PA, FL wins the election) is that Bush is doing better in both WI and IA and that KE could win PA and OH, lose FL, IA, and WI, and lose the election. That may be why Kerry is campaigning in NV right now.
Some other potential areas for stumping may be NC, VA and WV. At least make Bush defend these.