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One Republican governor has finally given up his opposition to expanding Medicaid under Obamacare, while another is steadfastly fighting his legislature, vetoing an expansion bill.

The former is Iowa's Terry Brandstad who has finally signed off on a compromise the state Senate worked out. It's a variation of the privatized Arkansas model, in which the Medicaid money will subsidize the purchase of insurance either in a new state plan or on the new insurance exchange. Even with Brandstad's approval, though, the proposal faces two more hurdles: the state House and the federal government. Like Arkansas, it would have to obtain a waiver from the Department of Health and Human Service to use Medicaid funds in this way. A potential problem with the proposal is that it would require some of the 150,000 new recipients, who earn between 101 percent and 133 percent of poverty, to follow health directives from their physician or risk paying a percentage of their costs.

Then there's Maine, where crazy Gov. Paul LePage has vetoed the expansion passed by the Democratic legislature. The legislature linked the Medicaid expansion to a plan to pay the state's share of $484 million in debt owed to Maine's hospitals.

“Democrat leadership has spent the past week forcing this bill through the legislative process, over the objections of both Republicans and Democrats alike,” the veto letter reads. “This unadulterated partisanship tied two different issues together in a quest to force welfare expansion upon the Maine people. I have said all along this bill would receive a veto when it reached my desk, so this letter should be no surprise.”
So much for health care for 70,000 more Maine citizens. Democrats in the legislature have vowed an override attempt.

Originally posted to Joan McCarter on Thu May 23, 2013 at 02:38 PM PDT.

Also republished by State & Local ACTION Group and Daily Kos.

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Comment Preferences

  •  Tip Jar (19+ / 0-)

    "There’s class warfare, all right, but it’s my class, the rich class, that’s making war, and we’re winning." —Warren Buffett

    by Joan McCarter on Thu May 23, 2013 at 02:38:32 PM PDT

  •  The Iowa House passed the Medicaid plan (11+ / 0-)


    Good point about HHS. Not sure if they have said anything. My guess is they grant the waiver.

    •  asdf (5+ / 0-)
      One of the controversial measures in the bill involves Medicaid funding for certain abortions, which was strongly opposed by some House Republicans. The abortion provisions only affect the University of Iowa Hospitals and Clinics in Iowa City, where 22 Medicaid-funded abortions were performed in the last state budget year. Of those abortions, 15 were for severe fetal anomalies, two were for rape, and five were to save the life of the mother.

      House and Senate conferees agreed to abortion language which does not change the process or the scope of a woman's right for reproductive health options, Hatch said. But the reimbursement for the abortion procedure, which normally goes to the Department of Human Services administrators for approval, will now go to the governor’s office for approval.

      Rep. Matt Windschitl, R-Missouri Valley, who strongly opposes abortion, said he personally negotiated the Medicaid abortion provision with Senate Majority Leader Michael Gronstal, D-Council Bluffs.

      Windschitl said that by placing reimbursement decisions in the hands of a "solidly pro-life governor," he is hopeful Branstad will decide not to provide payment for taxpayer-funded abortions. But the provision will not restrict abortion services in any way, Windschitl said.

    •  It passed the Republican controlled IA House (1+ / 0-)
      Recommended by:

      with a solid bipartisan majority, 80-17 yesterday. On Wednesday it barely passed the Democratic controlled Senate 26-24 on a party line vote with the Rs voting no.

      I think you're right about HHS granting the waiver.

      This was a reversal for Gov. Branstad. Until this week, he was refusing to accept federal funds for Medicaid expansion. That was a losing position with the public and all the relevant interest groups (except the Tea Party).

  •  This in a state where the Democrats (8+ / 0-)

    have yet to trot out a candidate to run against Le Page.

    Eliot Cutler has a firm grip on the number 1 spoiler position, Chellie Pingree has said she won't run amd Mike Michaud is still thinking about it. Maybe Attorney General Janet Mills is available...?!? Anybody?  Bill... ? Debbie...?

    Some have suggested that Democrats should talk to Cutler and pledge their support if he runs against Susan Colllins instead of Le Page.

    Critical Insights President MaryEllen Fitzgerald says the results showed a statistical dead heat between Cutler and LePage, at about 30 percent each. The Democrat would get 16 percent.

    Just over one in five respondents said they didn't know who they were going to vote for. Fitzgerald says those are the voters everybody is going to be targeting.

    "These are very early days, so that could change," she says. "I think it will be a very spirited election if things continue in the direction that they're going."

    The Critical Insights Tracking Survey was conducted between May 1 and May 7. It has a margin of error of 4 percentage points.  

    Ben Grants Selection from Wikipedia

        Steve Woods, businessman, Chairman of the Yarmouth Town Council and Independent candidate for the U.S. Senate in 2012[3]


        David Slagger, former Maliseet representative to the Maine House of Representatives (running in the Maine Green Independent Party primary)[4][5]


        Justin Alfond, President of the Maine Senate[6]
        John Baldacci, former Governor of Maine[7]
        Emily Cain, State Senator[6]
        Matthew Dunlap, Secretary of State of Maine[6]
        Mark Eves, Speaker of the Maine House of Representatives[6]
        Jeremy Fischer, former member of the Maine House of Representatives[6]
        Mike Michaud, U.S. Representative[6]
        Janet T. Mills, Maine Attorney General[6]
        Karen Mills, Administrator of the Small Business Administration[8]
        Hannah Pingree, former Speaker of the Maine House of Representatives[6]


        Chellie Pingree, U.S. Representative[9]

    In Heads up polling anybody beats LePage

    In the threeway Republicans have Democrats pegged
    with all the privileges of the short straw.

    Three-way race
    source Date(s) admin Sample size Margin of error    
    P Le P (R) Dem (D) Eliot Cutler (I)     None Undecided
    Critical Insights     May 1-7, 2013     600     ± 4%     30%     16%     28%     4%     21%
    P Le P (R)John Baldacci(D) EliotCutler(I) Other Undecided
    Pan Atlantic SMS     March 11–16, 2013     403     ± 4.9%     36.5%     21.1%     27%     —     15.4%
    Public Policy Polling     January 18–20, 2013     1,268     ± 2.8%     36%     27%     29%     —     8%
    P Le P(R) Mike Michaud (D) EliotCutler(I) Other Undecided
    Pan Atlantic SMS     March 11–16, 2013     403     ± 4.9%     33.5%     22.8%     25.6%     —     18.1%
    Public Policy Polling     January 18–20, 2013     1,268     ± 2.8%     34%     30%     26%     —     10%
    P Le P (R) JanetMills (D)EliotCutler (I) Other     Undecided
    Public Policy Polling     January 18–20, 2013     1,268     ± 2.8%     37%     19%     32%     —     12%
    P Le P (R)EthanStrimling (D)EliotCutler(I)Other Undecided
    Public Policy Polling     January 18–20, 2013     1,268     ± 2.8%     37%     15%     32%     — 16%

    Live Free or Die --- Investigate, Incarcerate

    by rktect on Thu May 23, 2013 at 04:07:21 PM PDT

    •  I will never pledge support to Cutler (3+ / 0-)
      Recommended by:
      Nautical Knots, JBL55, bluesheep

      Policy-wise, he is no Dem - merely a better behaved LeRage.

      •  I'm in complete sympathy. (2+ / 0-)
        Recommended by:
        Debbie in ME, salmo

        But that idea (support him in a race against Collins) has much to recommend it.  I'd open to practically anything to ensure we don't have another four years of the former mayor of Waterville.

        Given the current crop of contenders and our recent political history (not even endorsements and campaign appearances by/with Bill Clinton could save Libby Mitchell in 2010), this is how I see our choices based on the Dems supporting (or at least not hindering) him against Collins:

        Potential #1:

        Maine governor - Democrat
        US Senators from ME - King (I) & Cutler (I), both caucusing w/Dems

        Potential #2:

        Maine Governor - LePetomaine
        US Senators from ME - Collins (R) & King (I, caucusing w/Dems)

        A third one featuring a Democratic senator would be nice, but "Our Susie" would seem to have it nearly locked up.  I couldn't get a single Dem I called in 2008 to opine against Collins, not even when I mentioned her violation of her term limits pledge and her insulting justification for same.

        Of course, that might have been due to a failure of  persuasive powers on my part.  :-)

        "War is not the answer, for only love can conquer hate." ~ Al Cleveland & Marvin Gaye (1970)

        by JBL55 on Fri May 24, 2013 at 08:26:16 AM PDT

        [ Parent ]

        •  what you say makes sense, (3+ / 0-)
          Recommended by:
          bluesheep, salmo, JBL55

          but Cutler makes my skin crawl and could never pledge to support him without lying.

          If others do, and it keeps him out of the gubernatorial race, great (he won't beat Collins), but I can't say the words "I support Cutler".

          •  Sometimes not opposing someone has the same effect (1+ / 0-)
            Recommended by:
            Debbie in ME

            And you make a good point -- there is also Potential #3:

            Maine Governor - Democrat
            US Senators from ME - Collins (R) & King (I, caucusing w/Dems)

            Not the worst outcome, and with Cutler a mere also-ran, a not unsatisfactory one.  :-)

            "War is not the answer, for only love can conquer hate." ~ Al Cleveland & Marvin Gaye (1970)

            by JBL55 on Fri May 24, 2013 at 10:40:40 AM PDT

            [ Parent ]

    •  Hmmm (0+ / 0-)
      Some have suggested that Democrats should talk to Cutler and pledge their support if he runs against Susan Colllins instead of Le Page.
      I hadn't heard that but it has great potential.

      Our only other hope would be the possibility of President Obama offering him an ultra-plum appointment, perhaps as ambassador to a friendly country, something to stroke his considerable ego but with which he would be unlikely to do much harm.

      "War is not the answer, for only love can conquer hate." ~ Al Cleveland & Marvin Gaye (1970)

      by JBL55 on Fri May 24, 2013 at 08:07:44 AM PDT

      [ Parent ]

    •  thanks (1+ / 0-)
      Recommended by:

      what we really need is automatic runoff.

      Maybe just maybe our foremothers and our forefathers came to this land in different ships. But we're all in the same boat now. - John Lewis

      by bluesheep on Fri May 24, 2013 at 08:19:23 AM PDT

      [ Parent ]

      •  I could not agree more (0+ / 0-)

        Cutler is both a spoiler and a symptom of a larger problem.  The lack of a run-off requirement means that we get preening independents who refuse to submit to the primary process, and so weakens the insurgents within the Democratic Party (which needs a good insurgency).  Simultaneously, we get weaker Democratic candidates (because they will be marginalized) and worse Republican candidates (because Republicans seek the most conservative candidate who can be elected, and in a plurality, it is clear some pretty crazy people are potentially electable).  An instant run-off, derived from a preference ballot would be the most efficient system, but any run-off would be a far superior system to what we have now.    

  •  Thanx (4+ / 0-)

    for posting this , and great comments , we are looking for a good progressive to run for governor in Iowa also , and we are a 50/50 red / blue state also

  •  Paul is really a toad isn't he? (4+ / 0-)
    Recommended by:
    The Lone Apple, JBL55, bluesheep, salmo
    •  Why Is He Such A Nasty Jerk? (3+ / 0-)
      Recommended by:
      mdmslle, JBL55, bluesheep

      Did a Democrat steal his puppies?

      "Look here," he was yelling. "Look here, the bunglers—"

      by The Lone Apple on Fri May 24, 2013 at 06:34:39 AM PDT

      [ Parent ]

      •  This is just my personal opinion. (3+ / 0-)
        Recommended by:
        bluesheep, salmo, The Lone Apple

        He is one of those people who grew up in poverty, got lucky in his connections, and now identifies solely with the one percent, a group to which he does not belong but seems to feel he owes absolute loyalty.

        Like a broken clock, he gets one thing right, and that is his consistent outspokeness against domestic violence.

        Other than that, he is a sock puppet for the one percent, and not even a very effective one at that.

        Here is a thumbnail sketch from Wikipedia:

        Early life and education

        LePage was born in Lewiston, Maine, the eldest son of eighteen children of Theresa B. (née Gagnon) and Gerard A. LePage, both of French-Canadian descent.  He grew up speaking French in an impoverished home with an abusive father who was a mill worker.  His father drank heavily and terrorized the children; and his mother was too intimidated to stop him.  At age eleven, after his father beat him and broke his nose, he ran away from home and lived on the streets of Lewiston, seeking shelter wherever he could find it, including in horse stables and at a "strip joint".  After spending roughly two years homeless, he began to earn a living shining shoes, washing dishes at a café and hauling boxes for a truck driver. He later worked at a rubber company, a meat-packing plant, and was a short order cook, and bartender.

        LePage applied to Husson College in Bangor, but was initially rejected due to a poor verbal score on the SAT, a result of English being his second language. He has said that Peter Snowe – the first husband of former U.S. Senator from Maine Olympia Snowe – persuaded Husson to give LePage a written exam in French, which allowed LePage to show his comprehension and be admitted.  At Husson, LePage improved his English skills and became editor of the college newspaper.  He graduated with a B.S. in Business Administration in Finance and Accounting, and later earned an MBA from the University of Maine.

        "War is not the answer, for only love can conquer hate." ~ Al Cleveland & Marvin Gaye (1970)

        by JBL55 on Fri May 24, 2013 at 07:55:39 AM PDT

        [ Parent ]

  •  What strikes me, when he calls Medicaid expansion (5+ / 0-)

    "welfare" is the contempt that he feels for people without sufficient means needing medical care.  It's quite prevalent among the GOP, this labeling of the poor and the needy as undeserving of the bounty of the country--whether food, or medical care, or decent schools, or anything that might make their lives better.  What a cramped, ugly view of the world.

    "Why reasonable people go stark raving mad when anything involving a Negro comes up, is something I don’t pretend to understand." ~ Atticus Finch, "To Kill a Mockingbird"

    by SottoVoce on Fri May 24, 2013 at 06:39:26 AM PDT

    •  It's disgusting. I caught that too and it pissed (3+ / 0-)
      Recommended by:
      SottoVoce, JBL55, bluesheep

      me off.

      It's time to replace these sons of bitches. Period.

    •  What's worse is that LePage knows (2+ / 0-)
      Recommended by:
      JBL55, SottoVoce

      that many of those who would qualify for Medicaid are working poor. During the 2010 campaign, LePage described on of his employees at Marden's, a chain of odd-lot stores:

      LePage describes this employee, one of the best he has, as 21 or 22 years old, with two little kids, a single mom. Marden’s pays her $10 an hour, or $400 a week or $1,600 a month, should she work 40 hours a week.

      Following the living wage calculator, she would have to be making at least $15 an hour – and probably more like $18.50 an hour – to be able to get by on her own. And that’s a living wage, one that allows people to meet their current needs, not future ones.

      So when LePage laments that he can’t give this woman a 50 cent an hour raise because it will affect her eligibility, what he is really highlighting is how Marden’s relies on State Social Services to provide for her what his company does not. If she were to receive a five dollar an hour raise, that would amount to $800 a month in additional income, which will certainly cover much of what she receives from HHS.


      Form follows function -- Louis Sullivan

      by Spud1 on Fri May 24, 2013 at 07:43:07 AM PDT

      [ Parent ]

      •  Thanks for that telling anecdote. (0+ / 0-)

        I avoided much of his campaign rhetoric in 2010 so I missed this gem to which I would make just one teensy modification:

        when LePage laments that he can’t give this woman a 50 cent an hour raise because it will affect her eligibility, what he is really highlighting is how Marden’s relies on State Social Services to provide for her what his company does will not.

        "War is not the answer, for only love can conquer hate." ~ Al Cleveland & Marvin Gaye (1970)

        by JBL55 on Fri May 24, 2013 at 07:59:27 AM PDT

        [ Parent ]

  •  “Democrat leadership has spent...." (2+ / 0-)
    Recommended by:
    mdmslle, JBL55

    He of course can't pass up the opportunity to use "Democrat" when "Democratic" is correct usage. It'a a sure tell that it pretty much doesn't matter what the legislature proposes, he's not interested in listening.

  •  Hmm, why am I not all that surprised (2+ / 0-)
    Recommended by:
    JBL55, cocinero

    that the "compromise" involves sending more public money to private sector?

  •  Ohio's participation is still up in the air too (1+ / 0-)
    Recommended by:

    Kasich accepted it. The House blasted it. Now they're "negotiating."

    Knowing Ohio Rethugs like I do, I don't anticipate there will be much real help left when the showboating stops.

    Meddle not in the affairs of dragons... for thou art crunchy and good with ketchup.

    by Pariah Dog on Fri May 24, 2013 at 06:55:01 AM PDT

  •   "to follow health directives from their" (1+ / 0-)
    Recommended by:

    physician, why bother going to the doctor if you aren't going to follow their directives? Hmmmm  On the other hand
     "risk paying a percentage of their costs."  sounds pretty close to coercion, especially if he is a charlatan and a quack, but everybody in the legislature "loves" his mandates of invasive procedures of women.  

    Oh and wait, what about death panels, "risk paying a percentage of their costs." what if grandma doesn't want to be thrown under the bus????

    "To argue with a person who has renounced the use of reason is like administering medication to the dead." Thomas Paine

    by My two cents worth on Fri May 24, 2013 at 06:55:53 AM PDT

    •  Depends on the "health directives" (0+ / 0-)

      Just for one scenario: Homeless person collapses on street, gets taken in to ER with diabetes out of control. Well-meaning doctor counsels on eating a better diet and testing sugar levels frequently and adjusting insulin accordingly -- all entirely reasonable, but all very difficult to do when you are eating in shelters, soup kitchens, etc. and don't even have a clean place to bathe much less to keep test strips and the gizmo to read them.

      The likelihood of that person being able to "comply with health directives" is very low -- not because they're stubborn and resistant (although some are), but because their life-situation makes it almost impossible to comply.

      Punishing folks like this just makes no sense -- in addition to which, the hospital can send them a bill the next time they land there, but there's no way to collect anything unless you want to take away their shopping cart and the clothes off their backs.

      What we seem to be back to is viewing poverty as a moral deficiency rather than a financial one -- reminds me of the 1730s.

      •  Exactly right. (0+ / 0-)

        There are as many reasons a person doesn't follow the MD directives as there are poor people.  Rich people can be deliberate about not following but at least they can afford the bill, unless of course they play golf with the doc. or sail with the hospital CEO.  

        Now Vitter is picking and choosing who he wants to get food stamps.

        "To argue with a person who has renounced the use of reason is like administering medication to the dead." Thomas Paine

        by My two cents worth on Fri May 24, 2013 at 02:25:16 PM PDT

        [ Parent ]

  •  The MEdicaid expansiion is the only really (3+ / 0-)
    Recommended by:
    Spud1, JBL55, cocinero

    progressive piece of the ACA - so the failure of that makes much of the ACA really shaky.  I am happy for the millions who will get some coverage, but it becomes a very small victory without Medicaid.

  •  Add South Carolina (1+ / 0-)
    Recommended by:

    The Thugs aren't going to allow it here either.  The state that gave us Mark Sanford, the criminal, is going to crap all over poor people, and children.  Amazing.

  •  Governor LePetomaine ... (0+ / 0-)

    ... is an embarrassment, not just to Maine but to governors everywhere.

    "War is not the answer, for only love can conquer hate." ~ Al Cleveland & Marvin Gaye (1970)

    by JBL55 on Fri May 24, 2013 at 07:45:59 AM PDT

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