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.
The McCain campaign is shameless. Consider this idea; it may be over the top, but so is the Republican commerical about sex education:
A few video clips of John McCain in ill health. A newspaper headline about his melanoma.
A clip of Sarah Palin saying something silly. A headline of her election as mayor of Wasillia, population 6000 [or whatever].
Voiceover: John McCain says he has the judgment and experience to be president. But despite his health history, he chooses an inexperienced new governor as his running mate. Why? To try to win over Hillary Clinton supporters.
I suggest this because I think the Republican willingness to put inexperienced mediocrities like Dan Quayle, Clarence Thomas, Harriet Miers, Heckuvajob Brownie, et al., into high office is unpatriotic. They select on the basis of tactical advantage and ideological submission rather than merit.
“MILF” and “bimbo” — those are sexist terms when applied toward any woman. When you imply that Palin’s success is based primarily on her looks (“failed beauty queen” “second-rate beauty queen”), that’s sexist. She did legitimately win election to mayor and governor. It’s fair to question her qualifications for the vice presidency; it’s not fair to label her a “bimbo.”
When did Bill Clinton call voters “lazy, short sighted, shiny object watching dullards”? When did Bill Clinton express contempt and hatred toward his opponents? When did Bill Clinton call Pat Robertson a “Jew-hating Nazi he-devil”? You may have thought those things yourself, but Bill Clinton never uttered those words (or anything close to them). Bill Clinton did, however, stick to his core message “It’s the economy, stupid.”
You mistake lack of contempt and vitriol as weakness. You accuse people who don’t share your aggressive, denigrating tone as “lacking a spine.” I read Naomi Foner’s article; she’s arguing that we go after Palin’s positions. Hit her hard with her hypocrisy. Absolutely. But your language is way beyond Foner’s.
“Leave the political commentary to those who are not afraid of a bloody nose.” Tough talk. There’s a big difference between a solid right hook and a sucker punch, head butt or knee to the groin. My problem with your approach isn’t the fight itself; it’s how you fight. This isn’t some ultimate fighting cage match. It’s not a silly playground game of one-upmanship. It’s a fight to get more people on your side. And there are lots of ways to do that.
Stop panicking. You’re like the soldier who can’t hold his fire and gives away his position. Have some confidence in a candidate and a campaign that has done pretty damn well so far. So McCain is getting a good bump in the polls. If you thought that the country was just going to reject McCain out of hand and lovingly embrace Obama, then you completely misunderstand Americans (but of course you do, because you hold them in such contempt).
And by the way, though I do not expect anyone to believe what I or anyone says simply because we say it, I’d like to point out this article..written by a WOMAN…
She does not seem to have a whole lot of trouble hitting Palin where it should hurt either. And she is just one of many women who undoubtedly feel the same way.
And she, unlike me, actually gets paid to say this stuff.
I’m no frothing lunatic from the woods, people. I am someone who, like many many others, is beginning to see how much Obama is in trouble. Very serious trouble….owing a lot to what I have been talking about…not enough attacks, and too much cerebral dancing.
That is the second time you have accused me of sexism..either grow a spine and come after what I say with an actual argument, or leave the political commentary to those who are not afraid of a bloody nose. But I am not about to give the MILF a pass simply because she happens to be a woman..anymore than black candidates should get a pass because they are black, or anyone should get a pass simply because of race or gender.
If wanting to hit Palin hard, because she deserves to be hit hard because of her extremism, her lies, and her positions makes me a sexist, you have a warped definition of the word. There are plenty of able women out there…Palin is not one of them, and if I see her weakness as the fact that she is a failed beauty queen with an empty head, i will say so, just as much as I will come after McCain for being a foul tempered old fool.
And you want a name? Bill Clinton. For all his many many faults, he was not afraid to hit back dirty and often during campaigns, and he is the only Democrat elected to the White House twice in the last 30 years.
I am not sure what polls or studies you are reading my friend, but we are losing this race, and the Democratic Congress that we control has the lowest aggregate approval rating in the history of Congress. The reason? They are all being led be milquetoast diplomats like yourself afraid of getting scratched in a real, honest to God fight with Republicans…the ones who actually know how to attack and..say it with me…WIN.
Just who do you think is going to be persuaded by your sexism, contempt and hatred? The “John Q. American” you mock? Women (who just LOVE the term “MILF”)? Independents?
Please show me one Democrat who has won an election using your suggested tactics. Democrats have won, and are continuing to win, local, state and Congressional elections because they’re finally begin to understand the “lazy, short sighted, shiny object watching dullards” that most us more reasonably — and correctly — call our neighbors, co-workers and friends. Sorry all those folks aren’t up to your standards. But they’re the ones you have to win over if you want to be elected to national office.
Not sexy enough.
We Democrats are getting skinned alive in this election, despite all of history and all of the numbers a mere six months ago giving us a free ride to take the biggest electoral vistory in a generation. And the reason why? Sexiness.
You got a gone toting MILF and a lying mean spirited POW on the other ticket. You think ads that talk about issues and graft from Wasilla are going to speak to John Q. American, (aka. John Q. Redneck) no.
The voting public, as it proved by the re-election of Bush, are lazy, short sighted, shiny object watching dullards. If we do not hit back with as much venom, we will lose, as we always do.
How about an ad showing Palin as the second rate Beauty Queen, Jew Hating nazi she-devil that she is? This is what we need to do, because everyone else is doing it.
Define her as the evil that she is.
Spot on. And here’s the ad I would propose:
The idea is to mimic the MasterCard “priceless” ads in tone, structure and imagery. [All claims and figures need to be rigorously fact-checked.]
Opens with an establishing shot of Wasilla, Alaska, cut to interior shot of an ice hockey rink with kids playing on the ice. Ends with graphic overlay with sound and visual FX: WSJ headline “Palin’s Hockey Rink Leads to Legal Troubles: Misstep leads to years of litigation and at least $1.3 million in extra costs”
VO: “Cost overruns caused by Mayor Sarah Palin’s mismanagement of a major city project: $1.3 million dollars.”
Still shots of “Washington lobbyists” shaking hands (ideal would be a picture showing Palin shaking hands with one of the lobbyists she hired). Ends with graphic overlay with sound and visual FX: Washington Post headline: “Palin’s Small Alaska Town Secured Big Federal Funds” $26.9 Million Dollars for a town of 6,700 people.
VO: “Amount that lobbyists, hired by Mayor Palin, secured in federal earmarks for her town of 6,700: $26.9 million dollars.”
Moving overhead shot of Ketchikan, Alaska airport, zooming in to proposed location of “bridge to nowhere.” Ends with graphic overlay with sound and visual FX: headline from Anchorage Daily News: “Palin touts stance on ‘bridge to nowhere,’ doesn’t note flip-flop”
“Amount of taxpayer dollars Gov. Palin kept for the ‘bridge to nowhere’ she initially supported and was never built: $223 million dollars.”
Clip of Gov. Palin from Republican Convention “In politics, there are some candidates who use change to promote their careers.” Ends with graphic overlay with sound and visual FX: universal “no” sign (red circle with diagonal line) stamped over still image of Palin at podium.
VO: “A candidate who says one thing and does another: absolutely unaffordable.”
VO and graphic: “Barack Obama and Joe Biden: Change We Can Trust.”
Can do a companion version for John McCain.