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Tsitrian Sees Safe Political Landscape for Daugaard to Expand Medicaid

Republican blogger John Tsitrian agrees with me that the spectacular, tremendous triumph of ObamaCare over TrumpCare signals that South Dakota should finally get on with expanding Medicaid:

The general consensus is that about 50,000 South Dakotans will become eligible for Medicaid benefits under Daugaard’s expansion plan, which in the governor’s words last year had the support of “80 hospitals and clinics, as well as 50 other organizations in South Dakota.” There’s no organized opposition that I can find coming from the healthcare industry in the state. On the second front, political opposition seems to be focused on ideological and partisan issues, which on a broader scale turned out to be hopeless when the entire ACA came under consideration in Congress. The same was true when Medicaid expansion specifically was adopted by so many GOP governors, Pence of Indiana included, around the country. Rejecting literally billions of dollars of federal Medicaid disbursements that will support this plan over the next few years makes no sense to me, especially as our Governor Daugaard’s proposal makes it revenue-neutral for state budgeting purposes [John Tsitrian, “Okay, Back to Medicaid Expansion in South Dakota,” The Constant Commoner, 2017.03.28].

Tsitrian makes a good point about the lack of political consequences for Republicans who back ACA-Medicaid expansion. Republican governors who have expanded Medicaid have generally seen their party hang onto their governor’s seats post-expansion. Terry Branstad of Iowa, Rick Snyder of Michigan, Brian Sandoval of Nevada, Chris Christie of New Jersey, Susana Martínez of New Mexico, John Kasich of Ohio all expanded Medicaid and then won reëlection.

Voters have rejected some Republican governors who resisted Medicaid expansion. Republican Tom Corbett of Pennsylvania supported an alternate, limited expansion plan but then lost to Democrat Tom Wolf, who put in motion a standard, broader Medicaid expansion. Republican Pat McCrory considered but rejected Medicaid expansion, then lost last year to Democrat Roy Cooper, who is pushing expansion. After Republican Bobby Jindal refused to expand Medicaid, the state legislature passed a veto-proof expansion plan, and Louisianians elected an expansion-favoring Democrat to replace Jindal.

Dennis Daugaard is done running for office. But, beyond doing the right thing for health and the economy, if Daugaard wants to bolster his party’s nominee for his job win in 2018, he should take away one big stick from the Democrats and expand Medicaid.

11 Comments

  1. John Tsitrian 2017-03-28 14:22

    The GOP-heavy (31-9) KS state senate yesterday voted to bring it in by a 2-to-1 margin. Their House voted it in, too, also with a big margin. Both majorities are just under veto-proof numbers. As fiscally and desperately challenged as KS has been thanks to the “Brownback Miracle,” Kansans may be as inclined as their GOP legislators to consider the surge of money that Medicaid expansion will bring into their state, political ideology notwithstanding.

  2. mike from iowa 2017-03-28 14:49

    Brownsnake vetoed tax overhaul that would have helped Kansas immediately. Pols fell short of override. But they are getting the message that Brownsnake’s austerity measures do not work.

  3. Roger Cornelius 2017-03-28 16:15

    It is pure speculation on my part but I think most if not all republican states that don’t have Medicaid Expansion will now fall inline now that the administration has stated clearly that Obamacare is the law of the land.
    I’d also speculate that if South Dakota does pass Medicaid Expansion is will be the last one to do so.

  4. bearcreekbat 2017-03-28 17:24

    The Trump administration already has attempted to weaken the ACA by executive orders and by removing White House online consumer support for ACA exchanges.

    https://www.washingtonpost.com/national/health-science/white-house-stops-ads-outreach-for-last-days-of-aca-enrollment/2017/01/26/a2f92682-e420-11e6-ba11-63c4b4fb5a63_story.html?utm_

    Further sabotage seems likely. Apparently this threat has spooked some insurance companies enough to consider declining to participate in the exchanges. See e.g.

    http://www.oregonlive.com/opinion/index.ssf/2017/03/trump_can_still_undermine_the.html

    This raises the question whether the Trump administration will attempt similar tactics to undermine Medicaid and discourage further expansion by the states.

  5. grudznick 2017-03-28 20:06

    Does not the Governor, Mr. Daugaard, need the approval of the legislatures to appropriate to him in a law bill the permission to spend these monies which will rain from the sky when the Governor declares Medicaid expanded? If you watched the legislatures this year, you might agree with me they have gone even more insaner than most as a collective group.

  6. Jeff Barth 2017-03-29 00:12

    Expanding Medicaid in South Dakota will save lives and save money. Hundreds have died prematurely due to our delay in implementation.

    Obamacare opponents have seen the “death panel” and it is them.

  7. mike from iowa 2017-03-29 08:16

    Good luck to you, Me Barth, should you run for Mayor of Soo Falls. I’d vote for you if I was a citizen.

  8. Cory Allen Heidelberger Post author | 2017-03-29 09:43

    Kansas expands? That’s huge!

    A Medicaid expansion would have been a much more substantial Veto Day bill than Novstrup’s meager pare-down submission to the Governor’s veto of his juvenile justice bill.

  9. Cory Allen Heidelberger Post author | 2017-03-29 09:44

    Barth for Mayor? Come on, think big: Barth for Governor.

    I’m inclined to agree with Roger: our Legislature will muster a veto-proof majority to allow permitless concealed carry and guns in the Capitol before it gives in to the superior intellect of Barack Obama and expands Medicaid.

  10. jerry 2017-03-29 16:52

    Medicaid Expansion would do wonders for the healthcare system as John T points out. There may even be another diamond in the rough, utilize some of the money to put into our aging water systems that Cory reported on with the WEB and other water needs for the citizens of South Dakota.

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