Donald Trump and his Republican cohorts may have tried to get rid of President’s Obama signature legacy….
But THAT has not happened….(More states are expanding their coverage )
The thing that they used to whipsaw Obama with is actually MORE popular than it ever has been and is expanding in its scope….
The RealClear Politics approval average for Obamacare is at 49% vs 41% against….
The calls for Repeal have been packed away….
As Joe Biden put it a little differently when Barack Obama signed the Affordable Care Act eight years ago, Virginia’s expansion of Medicaid on Wednesday is a big dang deal. And not just because 400,000 low-income citizenswill now have access to government health insurance.
It’s another nail in the coffin for efforts to repeal Obamacare and a fresh reminder of how difficult it is to scale back any entitlement once it’s created. Many Republicans, in purple and red states alike, concluded that Congress is unlikely to get rid of the law, so they’ve become less willing to take political heat for leaving billions in federal money on the table.
Years of obstruction in the commonwealth gave way because key Republicans from rural areas couldn’t bear to deny coverage for their constituents any longer, moderates wanted to cut a deal and, most of all, Democrats made massive gains in November’s off-year elections.
As President Trump steps up efforts to undermine the law, from repealing the individual mandate to watering down requirements for what needs to be covered in “association health plans,” the administration’s willingness to let states impose work requirements on Medicaid recipients has paradoxically given a rationale for Republicans to flip-flop on an issue where they had dug in their heels….
The Virginia Legislature on Wednesday, despite very narrow Republican majorities in both chambers, voted for the piece of Obamacare that the Supreme Court had made optional for the states. After Virginia, there are only 17 holdouts — including Texas and Florida.
What’s really important is that no state has gone in reverse, even those states that switched from Democratic to Republican governments after implementing expanded Medicaid. I’m going to take a short victory lap on my prediction from five years ago:
The future of this is now pretty clear: It’s going to work just as the original Medicaid roll-out did. That was also optional for states, and many of them declined the first time around, but eventually all 50, no matter how conservative, found themselves participating. The key — and I expect this to be true of the ACA Medicaid expansion as well — is that the decisions were one-way. Over time, some of the decliners decided to join, but no state walked away.
Why? For one thing, it’s always very difficult to take government benefits away from large groups of citizens. They tend to notice! And, for another, the Affordable Care Act set out a pretty good deal for the states, so it doesn’t make much financial sense to drop out (or, for that matter, to resist in the first place). It’s true politicians don’t always do what’s in a state’s fiscal interests, but it’s a pretty big factor making it hard to drop out.
It is true that the Donald Trump administration has granted looser waivers for state variations — the idea of waivers were part of the original law, which was designed to allow state experimentation — that have, in the eyes of Obamacare supporters, undermined Medicaid expansion to some extent. Still, those who follow this closely don’t think it’s equivalent to actually shutting down the program…..