I haven’t seen any snap polls showing the impact, if any, of Bush’s big Iraq speech last night, but the circumstantial evidence seems pretty negative.1) Here he was doing a highly emotional speech, full of tributes to the troops, at Ft. Bragg, and he got one ovation other than at the end.2) Republican praise of the speech tended to focus on its rejection of a fixed timetable for withdrawal from Iraq, but rarely mentioned its other alleged functions, such as laying out a clear strategy for victory and reassuring the American people that he knows what he’s doing.3) I checked out National Review’s The Corner, a reliable Bush Amen Corner (at least on national security issues) which offers near-24/7 commentary, and was impressed by the subdued tone. Sure, the tireless Kathryn Lopez tried to break out the pom-poms once or twice, but most of the discussion focused on attacking media criticism of the speech, and some regular posters actually expressed concern about Bush’s “strategy” for Iraq.4) Most ominously for Bush, his speech pretty much uniformly exasperated the “Blair Democrats,” those who supported the war initially and who now oppose a fixed timetable for withdrawal. Indeed, some of the harshest criticism of the speech came from this quarter.In this connection, you should check out the DLC’s take on Bush’s effort, which may be the most thorough critique I’ve seen to this point.One point it makes is a really interesting question: why didn’t Bush appeal explicitly to anti-Iraq-war Americans to put aside their disagreements over his original decision to invade Iraq and focus on the broadly accepted negative consequences of abandoning the country to chaos? He could have quoted a long string of Democratic opponents to the original war resolution, including Howard Dean, who are on record as emphatically saying we can’t accept defeat in Iraq now that we’re there, rightly or wrongly. He could have helped marginalized the fixed-deadline advocates. He could have been a “uniter, not a divider.” And he could have probably bumped up support for his current Iraq policies, not just for a moment but for a while, by decisively severing the link between support for past Bush policies and support for what he’s doing now.Instead, Bush strengthened the link between past, present and future Iraq policies by repeatedly returning to a rationale for the original decision to invade that, frankly, is losing credibility every day: it was all about 9/11. Yes, yes, I know, that was his strategy for deflecting criticism about Iraq in the 2004 campaign, but now Bush isn’t trying to get re-elected; he’s supposedly trying to avoid a nosedive in public support for what he’s doing in Iraq today. And the fact that he still cannot let go of his dubious ex post facto rationalizations of the Iraq venture is a bad sign about what we can expect between now and the day he finally goes home to Crawford.UPCATEGORY: Ed Kilgore’s New Donkey
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By Ed Kilgore
March 24: The Republican Case Against Medicaid Expansion Continues to Crumble
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.