At TAPPED, Matt Yglesias wrote a typically acute reaction to my post about the very different perceptions among Democrats of Joe Lieberman, the “D.C. Democratic Establishment,” and the Clinton legacy. Matt thinks the disconnect is primarily generational.I agree in part. It has certainly occurred to me before that people coming of political age in recent years have experienced a truly weird series of events: (a) the first impeachment of an American president since 1867; (b) the first presidential election to go into overtime since 1876; (c) the first quasi-military attack on the continental U.S. since 1812; (d) the first successful presidential candidacy since 1948 wherein the winner eschewed the political center and appealed mainly to his ideological base; (e) two consecutive midterm elections that broke all the rules about the performance of presidential parties; (f) the first unsuccessful major U.S. military engagement since Vietnam; and of course, (g) the rise of a whole host of hyper-partisan media outlets, from Fox News to the blogosphere.But I have to dissent in part as well. It’s not the reaction to recent events that gives me pause about the netroots interpretation of political life; it’s the ex post facto take on much older political developments. There are two tenets held fiercely in the netroots that are particularly suspect: (a) the development of the “right-wing noise machine” of conservative think tanks and media outlets was the primary reason for the conservative ascendancy associated with the rise of George W. Bush; and (b) Clintonian “centrism” was primarily responsible for the loss of congressional and state-level Democratic majorities in the 1990s.This is not the time or place to supply a systematic smack-down of these two premises, beyond the observations that (a) both the rise of the GOP and the decline of the Democratic Party in the 1990s were rooted in an ideological realignment of the two parties that favored the Right, and (b) the pre-Clinton Democratic orthodoxy had much more to do with the decline of down-ballot Donkey fortunes than anything Clinton did or did not do.But the big point is that even if you think us old guys don’t get it in terms of the current political climate (as a consistent chronicler of GOP responsibility for polarization, I plead nolo contendere), when it comes to the netroots pre-history of how Democrats got to where they are today, my g-g-g-eneration deserves a hearing.
TDS Strategy Memos
Latest Research from:
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.