Wednesday, October 9, 2013

Opting Out of ObamaCare's Medicaid Expansion: Protecting America's Freedom or Contempt for Obama?

Last year, the Supreme Court upheld the constitutionality of the Affordable Care Act (aka "ObamaCare").  However, in that same Supreme Court opinion, Chief Justice John Roberts ruled that the federal government could not force the states to opt in to ObamaCare's expansion of Medicaid if they did not choose to be a part of it.  Medicaid is health insurance for certain groups of people (kids, pregnant women, the blind, the elderly, the disabled, and the poor) which is paid for by the States who are, in turn, reimbursed by the federal government.  ObamaCare expands Medicaid to include ALL adults under the age of 65 whose annual salaries fall below a certain level (133% of the federal proverty line)...that is if the State in which they reside agrees to opt in to ObamaCare's Medicaid coverage.  The Supreme Court having finally laid to rest the infamous "individual mandate" debate in favor of President Obama, opponents of ObamaCare were thrown a bone it seemed -- albeit a small one -- that allowed them to continue their anti-ObamaCare campaign.  Today, over a year after that decision was handed down, the country stands divided: 24 states have opted in to ObamaCare's expansion of Medicaid while 26 states have opted out.  But which states have opted out and why?  A closer look at the political map may provide us with the answer.

Take a good look at this map.  According to Health Reform GPS, it shows the states which have opted out of ObamaCare's medicaid expansion as of this month:

Notice anything familiar?  No?  Well compare the map above with the map below which shows the political party of each state's governor:

Now do you see the pattern?  With few exceptions (Missouri, Montana, and New Hampshire), every single state that has chosen to opt out of ObamaCare's Medicaid expansion is run by a Republican governor.  And of those three (3) exceptions, Missouri, Montana and New Hampshire each have Republican-controlled state legislatures. (see both chambers of the Missouri House and Senate; both chambers of the Montana House and Senate; and the New Hampshire Senate).


Maybe.  Perhaps there is another explanation as to why those particular 26 states have opted out of the Medicaid expansion.  Perhaps those 26 states do not need the Medicaid expansion for their respective residents.  Maybe their residents already have health insurance.  If that's the case then it would make sense for those particular states to turn the program down.

If only that were true.

The truth of the matter is, "The 26 states that have rejected the Medicaid expansion are home to about half of the country’s population, but about 68 percent of poor, uninsured blacks and single mothers. About 60 percent of the country’s uninsured working poor are in those states." (source)  Moreover, when we view the county-by-county map of where America's uninsured live, the majority of them are located primarily in the southern states of the old confederacy (Texas, Louisiana, Mississippi, Alabama, Georgia, Florida, South Carolina, North Carolina and Tennessee). The residents of these 9 states, above all others, have the most need for Medicaid. All 9 of these states are controlled by Republican governors and, coincidentally, all 9 of these states have opted out of the Medicaid expansion that would help their own residents who need it most.

When you add all of that up, these facts would tend to suggest that the opposition to ObamaCare's Medicaid expansion is less about "protecting America's freedom" from some world-ending, job-killing, socialist takeover of health care and more about continuing an irrational hatred of President Obama and his signature piece of legislation.

What do you think?

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