“Awesome in its evilness”: How to make GOP pay for its Medicaid nightmare

Obamacare used to be Democrats’ debacle -- but now it’s time to go on offense. Here’s where Republicans are exposed

DAVID DAYEN

Liberal backers of Obamacare have increased their fury in recent weeks over how 24 states, controlled in part or in whole by Republicans, have rejected the law’s Medicaid expansion, which the Supreme Court ruled they could do without consequences back in 2012. This has denied 5 million Americans health insurance coverage. “It really is just almost awesome in its evilness,” said Jonathan Gruber, one of the architects of healthcare reform. “It appears to be motivated by pure spite,” added Paul Krugman. “I am burying my best friend because of the policies of the Republican Party,” remarked one anguished woman in a viral story about Charlene Dill, a 32-year-old from Florida who would have been covered by Medicaid under the expansion, but instead went without the care she needed, and collapsed while working.

People are right to be outraged. These states are turning down full funding for the expansion for three years, and 90 percent thereafter, declining the economic stimulus from the flow of that Medicaid money. And this will lead to somewhere between 7,000 and 17,000 preventable deaths due to a lack of coverage, according to public health researchers. Charlene Dill’s story will unquestionably be repeated throughout the country.

But this outrage is a surprisingly new phenomenon, particularly among leading Democrats. Nancy Pelosi, the day of the Supreme Court ruling, said flat-out, “I don’t think governors will turn that down.” The White House was even more dismissive, as this Kaiser Health News story notes, also from the day of the ruling: “Senior White House officials were asked by a reporter how they would entice states to participate. They laughed.”

As Jim Newell wrote in Salon this week, that didn’t work out. And the complacency was clearly misguided from the start. The fact that these red states sued to overturn all of Obamacare should have been a tipoff that they wouldn’t exactly jump at the chance to expand coverage under the law, if they could opt out instead. Liberals mistakenly performed a cost-benefit analysis, thinking rationally, what state would turn down free money from the federal government to cover their poorest citizens? (In fact, that’s exactly what Jon Gruber admitted he thought initially.) But there’s nothing logical about knee-jerk opposition to anything proposed by the president, which has been the status quo in the Republican Party since Inauguration Day 2009. Indeed, Republicans predictably distorted the share that states would have to pay for the expansion, and highlighted the risk that Congress would at some point stick the states with a higher bill. That was enough of a sliver to give Republicans the talking points they needed to reject the expansion.

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http://www.salon.com/2014/04/16/%E2%80%9Cawesome_in_its_evilness%E2%80%9D_how_to_make_gop_pay_for_its_medicaid_nightmare/