Flux Schmux—Expand Medicaid Now!

In our latest podcast (published last night!), Spencer Dobson and I talk about the door that the failure of TrumpCare opens for South Dakota to get back on the Medicaid-expansion horse. Tony Venhuizen says his boss the Governor still sees too much “flux” in Washington to fiddle with covering more low-income South Dakotans. (Tony is off by just one extra consonant.)

But come on, Tony! Dennis! Washington’s failure plus the success of Medicaid expansion elsewhere gives you the best opportunity you’ve had to sell this plan:

Medicaid historically had been reserved for only the poorest and sickest, but the ACA opened it up to the lower middle class. States that expanded the program have experienced many benefits. For example, uninsured rates dropped — dramatically in some states — as did uncompensated care.

“Medicaid is such a fabric on the health system. Now, there are very few — if any — policy reasons not to expand,” says Adam Searing, associate professor at Georgetown University’s Center for Children and Families.

Medicaid expansion has been a highly partisan issue. But the debate at the federal level has revealed that there’s more bipartisan support — among voters and policymakers — for expanding Medicaid than previously thought. Republican governors arguably scored the biggest win with the demise of Paul Ryan’s plan because now they will likely take less political heat for expanding Medicaid and can claim credit for insuring more of their residents [Mattie Quinn, “Failed Health Bill Fuels New Momentum for Expanding Medicaid,” Governing, 2017.03.29].

I’m going to keep saying it because it’s gosh-darned right: for health, jobs, and the state budget, expanding Medicaid is slam-dunk good policy.