From one perspective, it was a glorious day in New Hampshire yesterday as state senate Republicans did their part to put the state in the same (sinking economic) boat as Texas, Oklahoma and Wisconsin and other states by rejecting Medicaid expansion as part of Obamacare. If you listened to the ideological sheep bleating of those who derailed the plan to provide coverage for as many as 58,000 of their fellow uninsured citizens, create thousands of new jobs and pump $2.4 billion into a stagnant state economy, it was a triumph that protected taxpayers from the evil tentacles of the Obamacare monster.
The Republican-controlled Senate rejected multiple attempts at compromise by the Democratic-controlled House and Democratic Gov. Maggie Hassan. The first term governor is as moderate and even-keeled as they come but even Hassan was stunned by the triumph of ideology over economic common sense.
"We offered Senate Republican leadership nearly everything they asked for; all we wanted was a plan that would actually work from day one and for the long term. But Senate Republicans refused to budge, putting ideology first and the people of New Hampshire second," Hassan said. "Because Senate Republicans have blocked health care expansion, beginning January 1, thousands will continue to go without the health coverage they need and the State of New Hampshire will be losing at least half-a-million dollars per day that we can never recover. That is unacceptable."
Actually, it was always going to be hard sell because the Obamacare Derangement Syndrome has been especially virulent here among the Mad Hatter crowd. The hangover from the disastrous 2010 Tea party election wave has been hard to shake. We have been bombarded about the evils of Obamacare and how it really can't be depended on and that the funding is a mirage and a deficit buster. And of course, lets let the private sector do its job to cover the poor (a job it has never done and can never do in the health care sector). None of this has a remote connection to even a generous definition of factual basis but no matter.
Derailing Obamacare was necessary, according to a pair of imaginative Republican House members, to spare taxpayers from subsidizing 50-year-old yacht owners who live in splendor because they are smart enough to have a low-income, high-asset lifestyle. Yes, folks it's a revival that old favorite cliche of the Cadillac-driving welfare queen now transformed to the yacht set.
Even better, those state reps proved to be profoundly (and perhaps even proudly) ignorant about the economics of how health care actually works as opposed to their fantasy projections. They think it's unfair that people who pay their premiums and work hard should have to subsidize those who don't. Of course, those premium payers already are paying higher premiums to cover hospital costs for treating the uninsured. You can expect those costs are only going to rise which was why the state's top business organization supported expansion and New Hampshire hospitals begged for Medicaid expansion. As part of Obamacare, hospitals are going to quickly lose their federal reimbursements for uncompensated care. This will lead to higher premiums for businesses and individuals and even more tough financial times ahead for NH hospitals.
Like the dedicated but inept crack suicide squad in Monty Python's Life of Brian, GOP senators proved it was better to turn the ideological sword on their own state than give into a foreign invader they don't understand.
Of course, the usual suspects shouted with glee that the special legislative session for Medicaid expansion did not come to an agreement. The local branch of American for Prosperity of the Koch Brothers hailed the lack of agreement.
"The vote against expansion today sends a clear message that the New Hampshire Senate is not going to bring ObamaCare here," said Greg Moore, AFP-NH State Director, in a statement. "This means that over 20,000 people will continue to stay on their employers’ health insurance and not get dumped into a poor quality Medicaid program. In addition, nearly 12,000 people who are currently uninsured will now get the chance to buy heavily subsidized care through the exchange for $15-20 per month starting in January, because the state did not expand Medicaid."
This is beyond credulity and contempt (I guess the poor do get the "poor quality Medicaid" coverage they deserve). Obamacare is here (I know because I enrolled). The 20,000 dump employee coverage figure is made up and the folks who could get heavily subsidized coverage is also a fantasy (if they fall into the proposed Medicaid expansion coverage range they won't qualify for any subsidy: it's a sad but true trap in the law because who thought any sane legislative body or governor would turn this down). It's a good thing we have such low expectations for any Koch Brothers organization because they care nothing about the truth or the consequences of their propaganda.
The good news for New Hampshire Mad Hatters is that they can stand proud and join back-to-the-19th-century visionaries such as Texas Gov. Rick Perry who took pride in rejecting Medicaid expansion coverage for 6.3 million uninsured citizens of Texas (including 1.2 million children). Perry loves to hear himself quoted on the subject of Obamacare which he compares to the Titanic.
Actually, it could be the Texas state economy that threatens to run into an iceberg of its own making. "By refusing to expand health care for the working poor through Medicaid, which is paid for by the federal government under Obamacare, most of the old Confederacy is committed to keeping millions of its own fellow citizens in poverty and poor health," said columnist Timothy Egan in the New York Times today. "They are dooming themselves, further, as the Left-Behind States."
Honestly, which large state do you think will be in better economic position and become a more attractive business destination in five years: California which has embraced Obamacare with an almost religious fervor or Texas which is making fine strides to create a state ready for the demands of 1865?
Michael McCord is a New Hampshire-based, award-winning journalist. The former political editor and columnist for the Portsmouth (NH) Herald, he is the author of the recently-published political satire The Execution Channel: A Political Fable. Rick Perry would be an enthusiastic citizen of the Real America in the book, in part because providing health insurance to workers is considered "coddling the help" and economically inefficient.