During the fight to pass the Affordable Care Act — and ever since — Republicans have warned of a government takeover of health care. This has always struck me as odd for several reasons.
First, many of the ideas for Obamacare originated with the Heritage Foundation, a conservative think tank, back in 1989. Not only that, but in 2006, Mitt Romney passed a health care law in Massachusetts that is virtually identical to Obamacare — albeit on a smaller scale. We saw in the 2008 election that Romney had the difficult task of campaigning without running on one of his key accomplishments as governor.
Second, while the law originally compelled states to expand Medicaid, the Supreme Court weakened the law in 2012, giving states the opportunity to opt out of this requirement. Many of them, including Idaho, did just that.
According to a report in The New York Times, the decision to not expand Medicaid leaves 8 million people without insurance nationwide.
Finally, if this was a government health care takeover, we would have single-payer. But that’s an issue for a later column, but for now back to the states.
Although it isn’t as much of an issue now, the federal exchange had a rocky start. Even now, state exchanges are helping to drive enrollment numbers. California led enrollments with 424,936 between Oct. 1 and Dec. 31. This puts them well on track for their goal, which is just a hair under 700,000 enrolled by March 31.
But let’s be honest, it isn’t surprising that California embraced Obamacare. The largest state in the nation is also one of the most liberal. California has been pushing for single-payer health care for years — it even passed both legislative chambers twice while Schwarzenegger was governor. There is one state currently embracing Obamacare wholeheartedly that few would have anticipated, Kentucky.
The bluegrass state, home to Sen. Mitch McConnell — one of the most ardent opponents of Obamacare and the president himself — is deeply conservative and would be expected to reject the ACA soundly. That probably would have happened were it not for Kentucky’s Democratic governor, Steve Beshear.
Beshear’s Kentucky is one of the poorest and unhealthiest states in the nation, and he sees it as a moral issue to expand Medicaid.
“This is a moral issue. Every person in the country deserves access to affordable health coverage. The Medicaid expansion is part of the way we can do that,” Beshear said in an interview with The Washington Post.
According to a November article in The Washington Post, Kentucky had enrolled 56,422 people in new health insurance. The article takes a close look at Breathitt County and the efforts of Courtney Lively to enroll people in new plans. Breathitt County has a per-capita income of about $15,000 a year, and the health of its population is so bad that it has earned the nickname “Coronary Valley.”
In the article, Lively talks about how some conservative Kentucky residents needed some convincing, but when they saw what the law can do for them they get behind it. One of the residents even joked about becoming a democrat after getting covered.
Beshear also mentions this phenomenon.
“Just the phrase ‘Obamacare’ in states where the president isn’t popular brings a very negative reaction,” Beshear said.
Beshear thinks if Democrats stand behind the law, it will not be something that hurts them in 2014.
Clearly, the law can work in even the most conservative states in the nation, even if it does take a bit of marketing trickery. It is high time that Republicans stop playing politics and play ball because, in the absence of new ideas, Obamacare is here to stay. We may as well embrace the good, and work together to fix the bad. The law has plenty of both.
Andrew Deskins
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