I was just on a conference call where Governor Martin O’Malley (D-MD) was asked whether he thought Republican governors might opt out of the Medicaid expansion in light of the Supreme Court’s ACA ruling yesterday. He replied, “I don’t know. Some of our colleagues would like to get out of being members of the Union.” I think that’s the right way to look at it. These are an ideologically extreme set of characters, and they’re not going to go quietly, meekly accepting funds that expands health care for poor people. That goes against their worldview.
O’Malley did take the persistent view, on three separate occasions, that states which fail to implement that and other elements of Obamacare will find themselves at a competitive disadvantage. Touting Maryland as an “early implementer, O’Malley said that “We believe that covering our people, bringing down health costs long-term, that makes our states more competitive.” He in particular singled out potential Romney VP picks Bobby Jindal and Bob McDonnell, his gubernatorial counterpart in neighboring Virginia. In a memorable line, he said that McDonnell has problems with his legislature in Virginia, because “the only health care mandate they can embrace is trans vaginal ultrasounds for women.”
Again, this is the mentality. It’s not logical or rational in the short term. But it’s pretty clear that will be their perspective. Especially because those who would be left on the other side of the divide, in the event of rejecting the Medicaid expansion, would so clearly be on the side of the “other”:
For people of color, the impact of the mess that the court just rolled down Pennsylvania Avenue and out into the country cannot be understated. Blacks, Latinos and Asians are up to three times less likely to have insurance than whites. Half of the nation’s uninsured are people of color.
The Center for American Progress estimates that this racial gap in health care coverage costs the country $415 billion a year in lost productivity.
For black and brown America, affordable, quality healthcare is key to closing a wider economic gulf […]
Medicaid is a mitigating force in this lopsided system. Blacks and Latinos are enrolled in Medicaid at twice the rate of whites. Half of those in the program are children. As the Kaiser Family Foundation has bluntly concluded, “Medicaid enables Black and Hispanic Americans to access health care.”
The recession has made this more true than ever. Three out of four people who lose their job, also lose their insurance. As a result, the number of people in Medicaid has soared to 60 million.
That final fact will be used as proof by Republican governors that we cannot expand Medicaid any more. It’s single-payer health care, after all. It’s the road to serfdom. And the beneficiaries are those dreaded minorities, who by the way don’t really vote at the same rates as “real Americans,” either.
I just don’t see this crop of Republican governors, for the most part, accepting expansion funds. And that’s bad news for black and brown America.