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.