TWO OF the most heavily Republican states, Utah and Wyoming, appear to be moving closer to an expansion of Medicaid under the Affordable Care Act. Other GOP-dominated states, like Indiana and Tennessee, are also looking more closely at it, despite the hostility of their party’s leaders toward Obamacare.
The reasons are no mystery. Conservative governors and lawmakers in those states are acknowledging that it is profoundly illogical to deny the benefits they would reap — both budgetary and humanitarian — by accepting federal funding to provide health insurance for tens or hundreds of thousands of low-income residents.
Meanwhile, Virginia’s Republican-dominated legislature steadfastly refuses any plan, any approach or any modification to Medicaid that would do the same for the Old Dominion’s citizens.
Elsewhere, GOP leaders seek a workable compromise that would sling a safety net under many of their states’ most vulnerable residents. More than half of the states have gone ahead with the expansion. In Richmond, the subject goes all but unremarked — except when House Speaker William J. Howell (R-Stafford) deigns to repeat that Virginia will stand pat.
Elsewhere, Republicans have given Medicaid expansion in their states a different name — the Healthy Indiana Plan, for instance — or rebranded it by including provisions that appeal to conservatives, such as work requirements for those who receive coverage or private insurance carriers. In Richmond, there is no sign that any influential Republicans are at work to fashion a means to help the state’s uninsured — even though expanding Medicaid would cover as many as 250,000 residents.
In other states, Republican leaders have managed to overcome their distaste for Obamacare simply because there is no rational justification, beyond partisan spite, for refusing federal funds that would help so many people.
Gov. Matt Mead of Wyoming, where Republicans hold 78 of 90 seats in the legislature, acknowledged his opposition to Obamacare but said the state had to be realistic by embracing Medicaid expansion in one form or another. “I don’t think we can say to those people in Wyoming who are working [and] who cannot get insurance that we’re not going to do anything,” he said.
While the odds for expansion in Wyoming remain uncertain, Utah seems likely to move in the coming months. There, Gov. Gary Herbert made the case on moral grounds — as a duty to help people he described as “our neighbors, our friends and our family members.”
Republicans hold 163 of 194 seats in the Wyoming and Utah legislatures combined. In 2012, Mitt Romney won 69 percent of the vote in Wyoming and 73 percent of the vote in Utah. (By contrast, President Obama won Virginia with 51 percent of the vote.)
Yet even in such deeply red states, there is no refuting the logic of an expansion for which the federal government has committed to pay 100 percent now, and not less than 90 percent after 2016.
Mr. Herbert said that “turning a blind eye and doing nothing is really not the Utah way.”
Is it the Virginia way?
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