Today’s news brings a true blast from the past: Ronald Reagan’s legendary budget director and former Congressman, David Stockman, has been indicted on charges of conspiracy, securities fraud and obstruction of justice in connection with his operation of an auto parts firm that went bankrupt in 2005. He faces up to thirty years in the hoosegow, along with fines that could reach over a billion dollars. Many younger readers may have never heard of Stockman, who masterminded the massive budget and tax bills that characterized the core of Reaganomics. But he was virtually a pop culture figure in the early 80s, before losing power and eventually being forced out of office after incautiously admitting to journalist William Greider that the Reagan budgets were creating a fiscal disaster, mainly because Republicans had caved in to special interest demands while lavishing unnecessary hundreds of billions of excess dollars on the Pentagon.Shortly after leaving the administration, Stockman published what still stands as one of the best political “insider” books ever written, The Triumph of Politics, which expanded on his Greider interviews in fascinating detail. As the title indicates, the book chronicled the abandonment of the lofty objectives of Reagan’s initial budget blueprint thanks to an orgy of vote-buying and constituency-tending by GOP pols. Two sections of the book particularly stand out in my own memory: Stockman’s angry account of then-Defense Secretary Cap Weinberger’s exploitation of an accounting error to secure a vast increase in the Pentagon budget above and beyond what Reagan had originally proposed; and his graphic description of the bipartisan special-interest bidding war that made the first Reagan tax bill fiscally and morally ruinous, eventually requiring a big fix in the 1986 tax reform legislation. Aside from its historical value, Stockman’s book remains relevant because he so clearly anticipated and analyzed the political dynamics that ultimately produced the systemic fiscal profligacy and corruption of the Bush/DeLay-era GOP. Indeed, it was Stockman who coined the phrase “starve the beast” for the cynical conservative argument that unfunded tax cuts and huge deficits could restrain big government down the road without the political pain associated with specific budget cuts. The Bush-DeLay era of corruption, which pervaded corporate as well as political circles, led among other things to enactment of the Sarbanes-Oxley legislation. In a special twist of fate, that’s the law under which Stockman has been indicted. I have no idea whether Stockman is guilty as charged, but it would be highly ironic if the man who offered the first and best analysis (and confession) of the moral rot infecting latter-day conservatism succumbed to corruption himself.
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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.