June 20, 2018
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Republicans in the way of Medicaid expansion

File photo of Gov. Rick Snyder, R-Mich.


After pressing for months, Gov. Rick Snyder, R-Mich., finally convinced his legislature last week to expand the state’s Medicaid program as part of the national restructuring of the health care system known as the Affordable Care Act.

According to calculations from the Urban Institute, some 212,000 uninsured people of Michigan now stand to obtain health care coverage.

It’s a sad fact that Snyder deserves congratulations for this accomplishment. You wouldn’t think state leaders would need convincing to accept mountains of federal cash to help people with meager incomes obtain health insurance. But many Republican leaders and activists have waged a disruptive and harmful campaign to complicate, delay and undermine the Affordable Care Act.

The most prominent efforts have been in Congress, where conservatives’ latest move has been to insist on holding the government budget process hostage to obtain cuts in funds intended for Affordable Care Act implementation. But the most disruptive activity has been at the state level. Twenty-one states have refused to expand their Medicaid programs, blowing a large hole in the Affordable Care Act’s coverage strategy. The Urban Institute estimates that 5 million people won’t get coverage as a result.

As The Washington Post’s Sandhya Somashekhar reported last week, Republicans at the state level also have applied a variety of less visible measures to impede the law’s implementation. Some won’t enforce consumer protections, including a ban on insurance companies rejecting patients with pre-existing conditions. The result will be illegal discrimination. Another tactic has been restricting the work of federal “navigators,” consumer assistants who help people understand their options and get coverage. The result will be more people without health insurance.

Though some analysts offer explanations for why state governments might make one or another of these decisions, states taking these steps are unwise at best. To the extent they represent a deliberate policy to derail the law, such steps are worse than misguided.

Georgia’s state government is doing “everything in our power to be an obstructionist,” Ralph Hudgens, the state’s insurance commissioner, boasted.

Republicans are not entitled to obstruct and flout the laws of the United States. On the contrary, they have an obligation to cooperate in good faith with wholly legitimate laws duly passed and reviewed by all three branches of government.

The Washington Post (Sept. 4)

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