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.
During the first month after the election, we were all seemingly in agreement that despite having lost, we’d managed to stay united as a party, and avoid the traditional Democratic circular firing squad. Times were gonna be rocky ahead, but we were going to face the enemy as one.
Then Beinart had to aim his guns at Moore and MoveOn, and Al From had to go on the attack against everyone who wasn’t as conservative as him without actually being a Republican.
These guys are a cancer on our party; they’ve got to go. I’m willing to debate ideas with whoever. But when the GOP puts Coburn and DeMint in the U.S. Senate, and worships at the feet of Limbaugh, Norquist, and Pat Robertson, anyone of *either* party has got a lot of damned gall to say our problem is that we tolerate extremists. Compared to the wingnuts I’ve just mentioned, Michael Moore is a freakin’ moderate. And, FWIW, he’s an honest-to-God patriot. If they try to kick him out of the party, I go too. Fercryinoutloud, we didn’t even kick GodZella out when he decided to campaign for Bush.
From: Gone. Beinart: Gone. (His ideas are actually good. But the penalty for starting a circular firing squad should be that you’re the first one shot. Then the rest of us all get to live.) Zell: gone. DLC: Gone. Being a conservative Dem is fine; being a traitor to the party isn’t.
You are very eloquent Aaron….but you are wrong. The Democratic Party MUST go back to its roots. If they don’t they will remain in the wilderness. I for one will not put my efforts into another election that dosen’t embrace a National Healtcare System again, (and again and again until we get it for ALL the American people), withdrawl from Iraq, investment in other energies, stem cell research (government sponsored), Choice and common sense.
If the DLC ignore Howard Dean for DNC Chair, millions will look for another leader in another party. Then the Democratic Party will be finished.
Beluumregio, you have profoundly misread Marshall. As the Dems adjust to the defeat and gather the reins to battle on, there will be much talk of restructuring the army.
But I don’t see any major commentator, certainly not Marshall, Black, etc. who will tolerate the sins of the Rupublican administration, much less endorse them. If you think Marshall supports Bush’s prosecution of Iraq, I’d suggest nothing else shows how badly you’ve misunderstood him.
I disagree with Jason Bradfield. There should be no purge and there will not be one. We cannot become Deaniacs until we have more PR infrastructure. Mr Rove has already made it clear that a sharp distinction between the parties is desirable. Since Republicans control the national imagination through their coordinated communications and public relations campaigns and have strong brand identity we would loose. We should (and must) do the hard thing by addressing the conservative issues in a liberal manner (as Marshall prescribes) and invest the public discourse with issues (and strategies) that put Republicans in a corner (which Marshall does not prescribe). The DLC is helpful but it should not be the Democratic brain trust.
I used to be a conservative Republican activist and I used to think the DLC was great because they forced the debate into a conservative frame of reference.
Now that I am a liberal I shocked that any Democrats, even centrists, take the DLC seriously. They are not centrists, they are conervatives. Every single one of their ideas puts the political debate on turf conservatives can win on.
The purge that is needed in the Democratic party is a purge of conservatives, just as the GOP successfully purged its Rockefeller Republican moderates.
The more a party can stay on message the better party discipline is. With DLC types running around the American public gets easily confused trying to figure out what Democrats stand for.
The sad truth is that, even if the public is not well enough educated, we don’t get to vote them out and elect new people. We work with the only Americans there are, or we lose elections.
The DLC would have us adjust our party platform to get to where the voters seem to be politically. The progressive alternative is to BE LEADERS and to make an effective case for our vision–such that the voters come around to our view. The Republicans have taken the leadership role, and brought the voting public where they want them to be, while the progressive Democrats have not led; they have instead insulted those voters who were following the GOP, calling them sheep, and focusing on attacking the GOP agenda rather than articulating a better alternative.
Our job as progressives is to give the voters an attractive vision of why what we want to do is best for them. If we do that effectively, then they will vote for us. If we’re not willing to do it, then the DLC is right and the only remaining way to win is to offer the people what they believe they want now, at the expense of our beliefs to the contrary.
I’m one of those rare believers in both the Beinart thesis (Democrats lost this election on national security grounds, and need to make Arab democracy the centerpiece of their foreign policy) and that the DLC is almost wholly irrelevant on domestic issues.
With a few notable exceptions, the DLC red state strategy has been a certifiable failure. Five out of six decent corporatist DLCish red state senate candidates went down in flames last month, and in at least two of those cases to complete lunatics. The only red states this strategy works in have large Democratic bases, and large quantities of white, professional, moderate, suburban swing voters (as in Colorado and New Hampshire.) This doesn’t describe most red states today.
Democrats need to recover their losses with the white working class if they want to have any hope of becoming a majority party again in the next thirty years, and economic populism is their best shot at that end. Combined with a program of democracy promotion abroad and you have not only a winning formula for the next generation, but you have again the party of FDR and Truman.
When I think of the DLC, I think of the smarmy, smug Evan Bayh who is a prominent member.
I think about how as a Democrat in the state of Indiana, one needs to go about being elected it’s US Senator. My best guess would be to position yourself just to the right of Joe Lieberman, and just close enough to Zell Miller without being laughed out of the party.
There is a reason why during our annual summer confrontation with hate groups here in the Chicago area, we had to bus them in from Indiana.
I disagree with the last poster Joe, as he is under the wrong assumption that the Democratic Party has been actively turning away or purging those of ‘faith and conscience’, which is exactly what the Republicans have been doing to gays and pro-choice members.
We are dealing with an American electorate where still today, 44% percent think that a ‘stable democracy’ is possible in Iraq.
There is nothing wrong with our message or our messengers. The problem is the truth does not translate well into the language of fear, intolerance and hate.
“The DLC is full of smart people who have many good and useful ideas about the road forward for Democrats.”
Perhaps they could work for Democratic institutions then? There’s more than a few on the rise, and they actually believe Dems should be… Dems.
Seriously though, I think MoveOn’s response was, while blunt, accurate. The DLC came up because they were successful at raising money via large corporate donations. Dean, MoveOn, TrueMajority, and Kerry in their wake showed that we can reach financial parity with the right with “trickle up” fundraising, and none of those efforts involved foresaking Democratic values to curry favor with big business. How thrilling was it, amongst the grief on Nov. 3rd, to see and hear all the responses of “Okay, I’m ready to keep fighting, where do I send the check and when do the ’06 campaigns get under way?”
I wouldn’t worry about all the truly smart and skilled people at the DLC. There is an upsurge of Democratic institutions afoot, there will be plenty of room for the good ones to get in and contribute, and hopefully working for those institutions won’t entail wincing when the bosses decide to berate the grassroots in the pages of the Wall Street Journal.
Worse things could happen than to have From and Reed fade into obscurity.
John Kerry lost to George Bush because the latter was successful in scaring the hell out of the American people and the former was not convincing enough that he could protect them as well as the guy who proved he couldn’t on 9/11.
Go figure.
The Dems don’t need to move to the center. Kerry did and he outscored Bush among independents and still lost. We turned out more voters for the Democratic party than any previous winner from either party ever got and still lost.
The Democratic party simply needs to open itself to people of conscience and faith while still voicing a progressive theme on economics, health care etc. and forget gun control, abortion rights and other social issues that Repubs use to bolster their base through identity politics.
Bush won because Rove grew the Republican base. The Dems will win when they field a candidate who grows their base and caters to it.
hmmm…
I’m not sure that the DLC and Clinton didn’t lead the Democrats down the garden path to near-oblivion. Clinton is a political genius, but with the republican party lurching off to the ideological gamma quadrant, the Democrats need to keep their distance from them, now more than ever.
The Republican party is simply crazy now, but the Democrats don’t win because they are still playing Clinton’s games.