“My focus is to create a red-state model that allows the Republican ticket to say, ‘See, we’ve got a different way, and it works,’ ” Kansas Gov. Sam Brownback said in 2013.
Brownback was talking about the massive supply-side tax cuts at the center of his policy agenda, which he had promised would provide “a shot of adrenaline into the heart of the Kansas economy.” Instead, it led to a deep hole in the state budget, a downgrade in the state’s credit rating and weak economic growth compared with neighboring states. As top income earners and business owners pocketed their tax cuts, Kansas’s poverty rate went up.
The failure of Brownback’s plan has made headlines not only because of its consequences in Kansas but also because of its potential impact on national politics. Brownback explicitly intended his plan to inform the policy debate in 2016 and beyond, but his gambit didn’t work as planned. As The Post’s editorial board wrote last year, “Mr. Brownback’s Kansas trial is rapidly becoming a cautionary tale for conservative governors elsewhere who have blithely peddled the theology of tax cuts as a painless panacea for sluggish growth.”
However, Kansas’s budget woes have overshadowed another important element of Brownback’s red-state experiment: his refusal to expand Medicaid under the Affordable Care Act. In the latest issue of The Nation, features editor Kai Wright reports on the devastating consequences of that decision.
As Wright explains, Kansas has some of the most restrictive Medicaid eligibility requirements in the country. The program is available only to non-disabled adults earning less than 32 percent of the federal poverty level, and most childless adults don’t qualify, regardless of income. The Affordable Care Act was supposed to raise that threshold to 138 percent, but Brownback declined to implement the Medicaid expansion. As a result, thousands of poor Kansans who would qualify for Medicaid in other states remain uninsured.
Brownback has often characterized his opposition to expanding Medicaid and other poverty programs, in Wright’s words, as a “moral rejection of dependency.” Last June, for example, Brownback told the Heritage Foundation’s Daily Signal Web site that Kansas had not expanded Medicaid because “We’re trying to push people that are able-bodied right now to get a job.” Similarly, Brownback pledged in his State of the State address this year to continue “helping people move from dependence on the government to independence.”
But, in practice, Brownback’s resistance to Medicaid expansion is causing some people to move from independence to desperation. Wright spoke with several Kansans who are suffering because of Kansas’s severe eligibility requirements. Far from the right-wing caricature of lazy moochers, they are hard workers who aren’t looking for a handout. One woman, RaDonna, is too sick to hold down food, let alone a full-time job. Yet, as a childless adult, she doesn’t qualify for Medicaid — and the state rejected her application for disability benefits. While RaDonna now lives with her sister, Cathy, she insists on helping with the laundry and dishes to earn her keep. “She can’t do the whole sink full of dishes without stopping and sitting down for a while,” Cathy says.
The stories from Kansas are heartbreaking, but unfortunately they are not unique. According to the Kaiser Family Foundation, “Nationally, nearly four million poor uninsured adults fall into the ‘coverage gap’ that results from state decisions not to expand Medicaid.” Republicans have full control of the legislature in all 21 states that have not expanded the program.
As with his tax cuts, Brownback’s stance toward Medicaid expansion is a reflection of the Republican Party’s national agenda. In fact, the roster of likely Republican presidential candidates includes three governors — Scott Walker, Rick Perry and Bobby Jindal — who also opted out of the Medicaid expansion. Likewise, former Florida governor Jeb Bush expressed opposition to expanding Medicaid in Florida. And another prospective candidate, Ohio Gov. John Kasich, has come under attack from his fellow Republicans for embracing the expansion in his home state.
For most Republican leaders, opposing Medicaid expansion is simply a matter of ideological faith. “Why is more people on Medicaid a good thing?” Walker asked last year. Echoing Brownback, he added, “I’d rather find a way, particularly for able-bodied adults without children, I’d like to find a way to get them into the workforce. I think ideologically that’s a better approach, not just as a conservative but as an American. Have more people live the American dream if they’re not dependent on the American government.” More recently, Walker framed his position in religious terms. “My reading of the Bible finds plenty of reminders that it’s better to teach someone to fish if they’re able,” he said.
This “real live experiment,” as Brownback once put it, has resulted in the pain and suffering of many Kansans. And yet, instead of acknowledging those consequences as a warning sign, the Republican presidential candidates have embraced them as a blueprint. It’s all part of the same GOP pattern — a continued retreat away from reason and toward a blind ideology — one that always comes with a body count.