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  That is, in states where Republicans hold power. Sure, it's a key part in extending healthcare to people with little or no money. Sure, the expansion is fully funded by the Federal Government not the states. Sure, the states can't lose the money they get now if they don't expand their medicaid programs, thanks to the Supreme Court decision. Sure, they'd be crazy to leave so many of their own people behind when other states will be taking advantage of it.

     So what? We already know they're crazy and they don't give a damn about their own people. More past the Orange Omnilepticon.

   It's clear that the Romney and the Republicans are going to make the campaign all about Obama shoving a giant tax onto the middle class via Obamacare. They're already calling it the largest tax increase in history. Given the absolutely abysmal way Democrats are content to sit back and let the Affordable Care Act sell itself over the next two years as it comes into full effect, they may even get away with it - especially if the White House doesn't come up with a compelling counter narrative.

     With that framing in place, every Republican governor has an incentive to drag the issue out for the next for months at the latest, in hopes a Romney White House and Rovian Congress in January 2013 will immediately repeal everything - or at least gut it to uselessness. They will do nothing to set up the insurance exchanges called for by the act, leaving that up to the Federal government. Then they'll use that to buttress their narrative about Washington taking over healthcare. They'll fight health care reform in every way they can. And expanding Medicaid?

     Free money from Washington to pay for expanding Medicaid to the poor? They won't touch it. They'll use the same arguments they used to turn down money for infrastructure improvements, like an additional tunnel under the Hudson River from New Jersey, rail improvements in Florida, etc. etc. They'll claim it's a trap, that they'll just be setting up the states to get stuck with the bills when the Feds someday cut the funding but insist on the mandate. They'll warn the money will be wasted on freeloaders and fraud. They'll speak darkly of the loss of freedom as people become addicted to the government for everything. They'll speak of hordes of disease-ridden illegals coming to the U.S. for free medical care. They'll condemn the entitlement culture (so long as it doesn't include the rich.) They'll talk about moral hazard and people who should suffer because they don't live healthy lifestyles. They'll rant about Broccoli-Apocalypse now! They'll do everything they can to sabotage the whole program - and then say that 'proves' it doesn't work. They'll scream TAX! TAX! TAX! from sun up to sun down and all the hours between.

      In short they'll lie and just make shit up. Just like they've been doing all along.

     For the hardcore conservative tea party GOP rogues, reprobates, and reprehensibles, expanding Medicaid is the last thing they want to do. Poor people are not their base. Making government provide any service for anyone is not in their interest as the party of small-government-you're-on-your-own-teabaggian-randian incoherence. The voters that put them in power don't give a damn about other people dying for lack of healthcare. (That changes real fast when they get sick of course.) They'll eat this rhetoric up.

      Even the argument that the tax dollars they refuse to take from the Federal government for their state means their tax money will go to Washington to help other states doesn't matter. The dirty secret of the GOP is that many of the states that are their base get more money from Washington than they ever give back. The worst thing that could ever happen would be if the Federal Government really did 'get off their backs' and stopped propping them up.

     Bottom line: even 'free money' from Washington will not be enough to make some of these states go ahead with Medicaid expansion. They'll fight it every step of the way.  These are the same people who left New Orleans to drown, the same people who want to 'save' Social Security by raising the retirement age and cutting benefits, the same people who want to turn public schooling into a race to the bottom with vouchers, the same people who are terrified of people of the wrong color, the same people who blundered us into two wars they couldn't finish.

     Why should we expect them to behave any differently now?

4:34 PM PT: UPDATE: Checking the Rec List, John Perr aka Avenging Angel has a diary about this topic with charts and numbers.  Take a look at: "GOP governors fight to preserve dismal red state health care"   It's happening - the question is how long they'll keep it up.

http://www.dailykos.com/...


Poll

On blocking Medicaid Expansion:

0%0 votes
12%3 votes
16%4 votes
32%8 votes
32%8 votes
8%2 votes
0%0 votes

| 25 votes | Vote | Results

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Comment Preferences

  •  Tip Jar (6+ / 0-)

    I don't think it's a question of if - just which GOP governor is going to be first to go there.

    "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

    by xaxnar on Sat Jun 30, 2012 at 03:34:10 PM PDT

    •  I don't think rethug govs will do anything (0+ / 0-)

      until it hurts there own pocket or threatens their own job. When Obamacare is successful and states that have worked with it are doing much better because businesses and workers are better off, then we might see them come around. More likely they will start to lose elections as people want to get the advantages it brings.

      Constitutions should consist only of general provisions; the reason is that they must necessarily be permanent, and that they cannot calculate for the possible change of things. Alexander Hamilton (1755-1804) Just A Real Nice Guy, thinking out loud.

      by arealniceguy on Sat Jun 30, 2012 at 05:57:42 PM PDT

      [ Parent ]

      •  Actually, they're already doing this (1+ / 0-)
        Recommended by:
        antirove

        My prediction was already history before I wrote this.

        "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

        by xaxnar on Sat Jun 30, 2012 at 06:45:40 PM PDT

        [ Parent ]

  •  The cost of ACA (2+ / 0-)
    Recommended by:
    xaxnar, Gooserock

    will, sadly, go down.

    there will be deeper savings against the deficit as a result.

    •  If most of those people ended up (0+ / 0-)

      with insurance from the exchanges with quite substantial subsidies the cost of ACA might go up instead of down.

      •  You are assuming that the newly insured (2+ / 0-)
        Recommended by:
        xaxnar, antirove

        will run up expenses comparable to what they have been doing in Emergency Rooms, which has been gradually driving ERs out of business for the last twenty years.

        You are assuming no public health savings from people not getting communicable diseases treated.

        You are assuming no other economic benefits, such as people being able to change jobs due to the difficulty or impossibility of getting covered elsewhere, or people being able to start new businesses.

        I could go on.

        Hands off my ObamaCare[TM]

        by Mokurai on Sat Jun 30, 2012 at 06:44:54 PM PDT

        [ Parent ]

        •  I am assuming that Medicaid will be (0+ / 0-)

          less expensive (for the federal government) than insurance subsidies on the exchanges will be.

          I don't have any idea what people starting new businesses has to do with Medicaid for households under 133% of FPL.

          What are you going on about?

  •  I actually think this gives local Dems something (5+ / 0-)

    o run on. One big question that is often asked is "how do we motivate Texas Latinos to vote?" If Texas Latinos voted at the same rate as California Latinos, Texas would be purple.

    Well the last Pew poll I saw showed health care (not immigration) was the second most important issue to Latino voters. So imagine running in Texas on a plan to insure hundreds of thousands of Latino and their kids WITHOUT raising taxes by just excepting the Federal grants? Combine that with a plan to increase school funding and maybe you have a way of turning out Latinos with a positive message not just "the Republicans want to deport you" (even though that's second message maybe also be close to being true).

    Democrats in general have a much weaker state level game than the Republicans, the GOP uses initiatives, and state focused think tanks (like ALEC) to gin up their base. This may actually be a good fight to have!

    Even though we lost in Wisconsin one positive is that this was one of the first in what I hope are many local battles progressive wage in state house. The problem in Wisconsin was it was only one battle being waged so all the far right money in America was able to pour in. I think to be effective we will need to simultaneously push this in 4-5 red states at once. It will take coordination but it's doable.  

    -1.63/ -1.49 "Speaking truth to power" (with snark of course)!

    by dopper0189 on Sat Jun 30, 2012 at 03:53:19 PM PDT

    •  I think you've hit upon it. (1+ / 0-)
      Recommended by:
      Gooserock

      The ACA was not about truly helping the most desperate among us, but about helping the Democratic Party.

      There are so many ways that's true, and this is only one of them.

      •  Maybe so, but... (0+ / 0-)
        The ACA was not about truly helping the most desperate among us, but about helping the Democratic Party.
        Once upon a time those two objectives weren't seen as exclusive.

        "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

        by xaxnar on Sat Jun 30, 2012 at 04:26:18 PM PDT

        [ Parent ]

      •  Why is it that people think... (1+ / 0-)
        Recommended by:
        xaxnar

        1) That the ACA is the end of healthcare reform and not the beginning? I didn't realize that because the ACA was passed that Dems can in the future never pass a public option? It sort of how it only took one law to pass civil rights in the this country.... oh wait it took a constitutional amendment (24th), 6 separate laws (Voting rights, fair housing, etc) and 3 executive orders (desegregation of the military, etc)

        2) Why is it that some people seem to think that all battles need to be fought in DC? I thought Howard Dean with his 50 states strategy had helped to squash that idea. But it keeps cropping up. Conservatives use the state level amendment process consistently to push their ideology on us, the NRA used the power state legislature to threaten congressmen with redistricting (the real source of their power), heck conservatives have even used the Texas school board to influence how 1/3 of public school text books in the entire USA are written, and none I repeat NONE of that required them to control any of the Federal government.

        But please keep ignoring this and acting like it doesn't matter. Lets keep crapping all over the Democratic Party. Sorry I've been fighting in state capitals and helping to push states to pass marriage equality in my state, and I strongly believe that pushing it in the states helped push it on to the national stage enough to influence the President and national leaders. That's only one issue, those of us who fight at the local level really wish we had more help.

        -1.63/ -1.49 "Speaking truth to power" (with snark of course)!

        by dopper0189 on Sun Jul 01, 2012 at 03:31:50 AM PDT

        [ Parent ]

    •  Is it Latinos not voting or gerrymandering? (1+ / 0-)
      Recommended by:
      xaxnar

      Rethugs are keeping dems down in large part due to rejiggering districts methinks. Also the Latino population here to a large part stays in spanish speaking areas and speak mostly spanish at home.

      Go into a Micky D's here in North Texas and their English is basic only. If you ask for a dozen packets of sugar or equal many times you get a blank stare or they just give you some and you have to tell them a dozen is twelve. The word condiments throws them too.

      I can understand their problems. Texas education is not addressing their issues. I know one city in this area that will stop older cars with latino or black drivers much more often than new luxury cars. I have watched them do it time after time. So since the word is out latino and black drivers avoid the area, staying inside their safer neighborhoods, speaking spanish.

      Constitutions should consist only of general provisions; the reason is that they must necessarily be permanent, and that they cannot calculate for the possible change of things. Alexander Hamilton (1755-1804) Just A Real Nice Guy, thinking out loud.

      by arealniceguy on Sat Jun 30, 2012 at 06:17:37 PM PDT

      [ Parent ]

  •  In a FEW states where Republicans hold power. (1+ / 0-)
    Recommended by:
    Yastreblyansky

    In fact, only in the select few where Republican governors have been extraordinarily vocal in their opposition to the ACA.

    You phrase your poll to imply they're blocking it, which they obviously aren't. They're merely ignoring it. Another important point is that when the ACA gains traction, people in red states who are too poor to afford insurance even with the subsidies will either be leaving to get Medicaid in another state or punishing their lawmakers at the ballot box rather than paying the penalty.

    "A man doesn't save a century, or a civilization, but a militant party wedded to a principle can." - Adlai E. Stevenson

    by Zutroy on Sat Jun 30, 2012 at 03:55:21 PM PDT

    •  That would be 26 states (3+ / 0-)
      Recommended by:
      Keith930, Losty, Gooserock
      •  Yep I Doubt the Medicaid Target Demographics (1+ / 0-)
        Recommended by:
        xaxnar

        fund many campaign attack ads.

        We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

        by Gooserock on Sat Jun 30, 2012 at 04:21:47 PM PDT

        [ Parent ]

        •  Hospitals and doctors can (2+ / 0-)
          Recommended by:
          xaxnar, arealniceguy

          Emergency Rooms have been closing all over the country for the last 20 years under the financial pressure of having to provide services to the indigent without adequate reimbursement. Any governor or legislature that turns down this money is going to hear from the AMA, AHA, and other well-funded national medical groups, plus local groups.

          Hands off my ObamaCare[TM]

          by Mokurai on Sat Jun 30, 2012 at 06:49:55 PM PDT

          [ Parent ]

          •  Let's hope so. (0+ / 0-)

            "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

            by xaxnar on Sat Jun 30, 2012 at 07:09:10 PM PDT

            [ Parent ]

          •  Excellent point Mokurai (1+ / 0-)
            Recommended by:
            xaxnar

            Not for profit hospitals are feeling the pinch too as they get nothing or very little for emergency treatment for low income patients. I'm sure they would rather those patients were in one of their in house wellness groups where the hospital can get paid for keeping the patient healthy and every one is better off. Don't you know they will be putting pressure on the states to join so they can reap some of the federal dollars. Money is money to them.

            Constitutions should consist only of general provisions; the reason is that they must necessarily be permanent, and that they cannot calculate for the possible change of things. Alexander Hamilton (1755-1804) Just A Real Nice Guy, thinking out loud.

            by arealniceguy on Sat Jun 30, 2012 at 07:26:21 PM PDT

            [ Parent ]

      •  I highly doubt all of those states are going to (0+ / 0-)

        actually get on board with rejecting the expansion. When I used the wording extraordinarily vocal, I was referring to administrations such as Rick Perry's and Rick Scott's -- ones that have gone above and beyond the complaints of the 26 state litigation in their rhetoric.

        "A man doesn't save a century, or a civilization, but a militant party wedded to a principle can." - Adlai E. Stevenson

        by Zutroy on Sat Jun 30, 2012 at 04:25:31 PM PDT

        [ Parent ]

    •  Look again (0+ / 0-)

      The poll is asking people how likely they think blocking will be. I'm making a prediction here, and I'm pretty sure none of the GOP crowd will move any faster than they absolutely have to, for at least the next four months. After that, it depends on who holds the White House and Congress.

      As for people moving to other states for medical care, it's not cheap even for people who have money to relocate, let alone people with medical problems and little or no money.

      They can punish lawmakers at the ballot box - but will they make the connection? Let's hope so, because elected officials willing to let people die for political gain are ipso facto unfit for office.

      "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

      by xaxnar on Sat Jun 30, 2012 at 04:20:39 PM PDT

      [ Parent ]

      •  Further..... (0+ / 0-)

        Going by other diaries posted about this, it's already happening.  The Republican governors are going there, especially in the reddest states.

        "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

        by xaxnar on Sat Jun 30, 2012 at 05:43:48 PM PDT

        [ Parent ]

  •  They will try, but (4+ / 0-)
    Recommended by:
    xaxnar, ahumbleopinion, Mokurai, We Won

    will not succeed for long.  Under current law, and under the ACA, people will still, by law, have to be treated at emergency rooms.  The hospitals that have to treat these people will be balking at not receiving payment for their treatment and will be pushing their state government to take the money and get these people covered under medicaid...these are corporations after all...and red state governors luvs them some corporations and corporate campaign donations.  Make no mistake...this is not a hill they are going to die on...they will come around eventually.

    •  Some suggest Roberts was thinking that way (0+ / 0-)

      That is, the business community or most parts of it, weren't that opposed to the ACA. Deciding for it let Roberts avoid trouble with his real base. If corporations scream loud enough about ACA not being implemented where it helps them, you can bet the politicians and the courts will jump.

      "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

      by xaxnar on Sat Jun 30, 2012 at 04:23:30 PM PDT

      [ Parent ]

  •  Republican governors are traditionally (1+ / 0-)
    Recommended by:
    xaxnar

    nowhere near as crazy as the Washington ones, and take all the federal money they can get, even while they scream about jackbooted thugs. Having said that, this year's crop have talked themselves so far into the corner that you might well be right. Since Democratic states typically send Washington more money in tax receipts than they get back in programs, and Republican states vice versa, as a New Yorker I'm looking forward to it.

    What did you do in the class war, Daddy?

    by Yastreblyansky on Sat Jun 30, 2012 at 04:00:48 PM PDT

  •  Only in the Short Run (3+ / 0-)

    In the long run, the pressure to get free funds from the federal government for a few years, and then to get most of their residents health insurance for few state dollars will pressure the red states next governors to expand medicaid. In the end, just like the present medicaid program, if not all then almost all states, will participate.

    Of course, this will only occur if Obama can win reelection.

  •  IS there a list of states that: (0+ / 0-)

    Have Exchanges up,
    Have the Federal Exchange up
    Don't, but are
    Have Repubs in control and won't

    •  Good Question - Anyone got this? (1+ / 0-)
      Recommended by:
      Gooserock

      Most of the ones that are going ahead are still a ways from getting it running. The deadline is 2013 I think? - and it's taking a while because it's complicated. (Another argument for Medicare buy-in.)

      "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

      by xaxnar on Sat Jun 30, 2012 at 04:14:03 PM PDT

      [ Parent ]

    •  In spite of the title, (1+ / 0-)
      Recommended by:
      xaxnar

      GOP governors fight to preserve dismal red state health care

      actually has a bit of good news among the statistics on all 50 states.

      Some have pointed out that states like Texas, which caps Medicaid at 50% of poverty, are being offered a lot more money than the states that presently have more generous systems. They may feel even bigger pressure from certain demographics and also from the medical industry to accept the money.

      Hands off my ObamaCare[TM]

      by Mokurai on Sat Jun 30, 2012 at 06:58:35 PM PDT

      [ Parent ]

  •  They may talk big now, but (4+ / 0-)
    Recommended by:
    xaxnar, ahumbleopinion, Mokurai, We Won

    they will get a lot of pressure from hospitals and providers who would not be reimbursed for care provided to low-income, uninsured patients.  Their hospitals and health care providers want the expanded Medicaid coverage.

  •  They can try, but (1+ / 0-)
    Recommended by:
    xaxnar

    if this really does help states that go along with it and the people find out there will be hell to pay for these guys. Everyone loved medicare right? Yeah, even if they don't publicly admit it many of them will still try to take the money under the radar.

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