November 12, 2017

HAVING LOST THE BATTLE DOESN'T REQUIRE YOU LOSE THE WAR:

Take Heed, GOP: Voters Like Medicaid (Paul Waldman, 11/12/17,  The Washington Post)

If you're looking for a microcosm of the national picture on what has become one of the most important functions the government serves, you couldn't do much better. The public wants Medicaid, but Republicans hate it and will do everything they can to undermine it.

Both sides of that coin have never been more apparent than they are now. Just Tuesday, Seema Verma, the Trump administration official who oversees Medicare and Medicaid, announced that the administration will now encourage states to adopt work requirements for the program, even though most Medicaid recipients already come from households where someone is employed.

The real point of this is to make recipients jump through more hoops and reduce the number of people on the program. In fact, the Trump administration is explicitly rejecting the idea that the purpose of Medicaid is to make sure people have health insurance. In Verma's speech, she said she wants to get people off Medicaid. "The thought that a program designed for our most vulnerable citizens should be used as a vehicle to serve working age, able-bodied adults does not make sense," she said. Allowing states more flexibility to kick people off the program will enhance "the dignity and respect of high expectations."

That's the GOP position, and Republicans do have reason to be worried about it. They've been alarmed by Medicaid's growth in recent years, since the program (along with the Children's Health Insurance Program, which is essentially a Medicaid subsidiary) now provides insurance to more than 74 million Americans. Since many Republicans would literally rather see someone have no insurance than get health coverage from the government, they find that to be an abomination.

Yet the public does not share these views. Polls show that Medicaid is spectacularly popular, even with Republican voters. In Kaiser Family Foundation polls, 74 percent of Americans have a favorable view of the program (including 61 percent of Republicans) and 87 percent want its funding increased or kept the same (including 76 percent of Republicans). In states that refused the expansion of Medicaid, 73 percent have a favorable view of the program. It was the fact that their bills would have slashed Medicaid as much as any other factor that led to their demise.

That brings us to the implications of the Maine vote for the future. Even though Republican officials in 19 states refused the expansion -- in which the federal government would pay for almost all the cost of insuring their poor citizens -- voters in those states don't seem to agree with the choice their representatives made. Which means that if activists can put measures on the ballots in those states to accept the expansion, they may succeed not only in changing the policy but also in shaping the debate and getting more Democratic-friendly voters to the polls.

Just because every electorate in a developed democracy considers health care a right does not mean the GOP can't craft a conservative universal health care system. It does mean that failure to do so will give us National Health.

Posted by at November 12, 2017 6:06 PM

  

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