Monday, December 28, 2015

Medicaid expansion fight reflects larger rift in Republican Party

The latest Republican governor to flirt with Medicaid expansionis South Dakota's Gov. Dennis Daugaard. Sen. John Thune, the number three Republican in the Senate, voted last month to repeal Obamacare all the way down to Medicaid expansion. As The New York Times details, South Dakota is just one of many states where reality conflicts with irrational hatred of the law among elected Republicans.

In state after state, a gulf is opening between Republican governors willing to expand Medicaid coverage through the Affordable Care Act and Republican members of Congress convinced the law is collapsing and determined to help it fail. […]

But in Arizona, Arkansas, Indiana, Iowa, Michigan, Nevada, New Jersey, New Mexico and Ohio, Republican governors have expanded Medicaid under the health care law or defended past expansions. In South Dakota, Tennessee and Utah, Republican governors are pressing for wider Medicaid coverage. And Republican governors in a few other states, including Alabama, have indicated that they are looking anew at their options after rejecting the idea in the past.

All the reasons for taking the Medicaid expansion—providing coverage for tens of thousands more people, providing critical funds to hospitals, helping to balance state budgets—are leading Republican governors to accept reality and reject the insane politics that have driven congressional Republicans for the past nearly six years. Insanity that's been fueled by the Koch brothers and other extremist groups who can make or break legislative candidates. And it's led to real conflict within the party.

It's a reflection of the larger fight the Republicans are having, on full display in the pure ideological crazy of Donald Trump's candidacy. But the Medicaid fight is a reminder that there are real life or death ramifications of the Republicans descent into mayhem. What remains to be seen if actual Republicans will finally recognize that and do something to save their party.

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