From DAVID ATKINS
Remember how Republican states were certain to accept the Medicaid money because hospitals would insist on it? And how establishment Democrats in D.C. were certain the states would accept the bargain? Well, the biggest Republican state isn’t having any of it:
Texas turned down an expansion of Medicaid coverage and said it will not create a state-run healthcare insurance exchange, joining the chorus of states that are rejecting two key proposals of the Obama administration’s healthcare overhaul measure.
In a letter to U.S. Health and Human Services Secretary Kathleen Sebelius released on Monday, Texas Gov. Rick Perry, whose bid for the GOP presidential nomination fell flat this year, rejected both healthcare proposals. The move, which had been widely expected, echoes similar pronouncements by other conservative Republican governors as well as the GOP’s overall opposition to the heathcare law.
“If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare,” Perry stated. “I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our constitution and our founding principles of limited government.
“I stand proudly with the growing chorus of governors who reject the Obamacare power grab. Neither a ‘state’ exchange nor the expansion of Medicaid under this program would result in better ‘patient protection’ or in more ‘affordable care.’ They would only make Texas a mere appendage of the federal government when it comes to health care,” Perry said.
Digby already covered Florida’s and South Carolina’s insistence on making poor people in those states get sick and die quickly while overburdening the state’s emergency health system. I’m sure the Neville Chamberlains in the D.C. Democratic establishment are scratching their heads over this.
Remember: it’s not just about the corporate money for these people. Accepting federal dollars for Medicaid helps their big dollar contributors, with very little downside. Ezra Klein thinks states will eventually come around, and he may be right. After all, some states resisted Medicaid when it was initially introduced. But even Ezra notes that the federal government forced states to take a much larger share of the burden for Medicaid and children’s health insurance. This expansion is basically gravy for the states, as the federal government foots the entirety of the bill at first, and 90% of it in coming years.
It’s not just about giving rich people more money. The modern Republican establishment is most obsessed with enforcing a cosmic law of reward and punishment wherein poor people suffer and die early because they didn’t pull themselves up by their bootstraps enough to be rich. It’s a matter of principle, and they’re more than willing to anger their allies in the hospital, health insurance and pharmaceutical industries to make it happen.
The Ayn Rand nonsense isn’t just rhetorical cover to enrich their already wealthy friends. These people really believe in it. They cannot be bargained with and cannot be reasoned with. It’s clear that pity and remorse are off the table, and they don’t even fear the retaliation of the electorate.