And now for some good news

Via TPM:

Michigan Gov. Rick Snyder (R) signed legislation Monday to expand the state’s Medicaid program under the Affordable Care Act.

The expansion is expected to expand health coverage to more than 300,000 Michiganders in its first year and nearly 500,000 eventually.

When the Supreme Court ruling came out that decided the Feds were offering too good, and therefore too coercive of a deal to expand Medicaid, I guessed that within six to eight months forty or so states would have either expanded Medicaid or been in the process to expand Medicaid.  I figured states that had unified Democratic control would do so quickly for social justice reasons.  I figured split states and states with non-batshit insane Republicans in leadership positions would pass expansion with a coalition of Democrats who were responding to their base and Republicans who could count to eleven with their shoes on. 

I was wrong.

Michigan is what I expected to see in most Republican controlled state governments.  Michigan did the math and figured they would lose a boat load of money and make major donors worse off (and by the way, half a million people) for a stupid ideological stand, so a coalition of Democrats and Republicans who could count to eleven passed a bill. And a governor with budget woes took the money.

The only downside of Michigan’s decision to take the money so late is that the Republican controlled legislature decided to delay the expansion until April 1 out of spite






54 replies
  1. 1
    The Dangerman says:

    Are Tea Party tears especially salty?

  2. 2
    dr. luba says:

    According to an MPR article, ” The Snyder administration says this (delayed implementation) will cost the state about $630 million in lost federal funds.”

    Because the Tea Party is and has always been about fiscal responsibility…..

  3. 3
    Yatsuno says:

    Michigan is what I expected to see in most Republican controlled state governments

    Not after the teatards got their little taste of power and decided they liked it. Arizona almost went into open rebellion when Brewer proposed expansion. She got it, but it’s gonna cost her somewhere down the road.

  4. 4
    dr. luba says:

    @Yatsuno: Even when idiot teatard governors decide to act sensibly (because their medical institutions demand it), they often can’t rein in the legislatures. Michigan got done, but only with great difficulty.

    Consider Rick Scott in Florida….

    Also, too: nice map here. Hard to believe only 20 states are participating so far……but we in Michigan are quite happy to take the non-participating states’ tax dollars and use them to provide medical care to our citizens.

  5. 5
    dr. luba says:

    @Yatsuno: Even when idiot teatard governors decide to act sensibly (because their medical institutions demand it), they often can’t rein in the legislatures. Michigan got done, but only with great difficulty.

    Consider Rick Scott in Florida….

    Also, too: nice map here. Hard to believe only 20 states are participating so far……but we in Michigan are quite happy to take the non-participating states’ tax dollars and use them to provide medical care to our citizens.

  6. 6

    Once difference between Michigan and states like Alabama, is that Michigan actually has a part of the state government which deals with healthcare. At one point they actually did something meaningful for residents there, so they have some infrastructure and expertise to build on. Alabama never did. They rejected these programs from the get-go and do the absolute minimum under federal law, so this is a much heavier lift for them.

    You put Democrats running the show in Alabama, and they’d struggle with it if only for those reasons. You put Republicans running California, and expanding the program would appear easy, if only because we’ve got a huge state-level health agency to handle it.

    A lot of rural states went with split implementations of exchanges for precisely this reason. Even if they supported ACA, they just don’t have that infrastructure – nor did they feel they could afford to build it out during the recession when their revenues were just getting hammered.

  7. 7
    Yatsuno says:

    @dr. luba: A couple of surprises on there. North Dakota expanding is an interesting development. I suspect a few of the nos will flip when the state houses also change in the 2014 elections. And the alternative model states hopefully won’t throw fits if their models are rejected.

  8. 8
    pharniel says:

    The April 1st thing is because they couldn’t get 2/3rds majority because FREEDOM! BEHENGHAZI! otherwise all laws take effect April 1st the following year.

    There are a number of state reps that may wind up in trouble soon – if nothing else for going against West Coast/Grand Rapids GOP priorities. I look forward to the inevitable infighting.

  9. 9
    pamelabrown53 says:

    The only “math” Rick Snyder knows is the voters’ math where he’ll loose the next election unless he gives a slim nod to sanity.

  10. 10
    CONGRATULATIONS! says:

    I had been looking forward to the Teatards splitting the GOP, destroying the party. It appears they may be dying off in such numbers that this might not happen.

  11. 11
    tuna says:

    No spite here. The 4/1 start date probably has something to do with the Detroit bankruptcy. The sale of the public hospital comes to mind.

  12. 12

    @👾 Martin:

    You put Republicans running California, and expanding the program would appear easy, if only because we’ve got a huge state-level health agency to handle it.

    It would appear easy, but I have faith that the Republicans would find some way of screwing it up. It’s what they do best.

  13. 13
    boatboy_srq says:

    states with non-batshit insane Republicans in leadership positions

    Your first mistake is that (anytime after 2009) this condition exists. In November 2008 Teahadist rabies bit the entirety of the GOTea leadership (and a good portion of the card-carrying membership): expecting the “non-batshit insane” to somehow remain immune, especially after watching the disease spread for the last five years, is overoptimistic and underinformed. Scott Walker, after all, was elected based on this misconception; he’s had plenty of time to prove that regardless of his apparent marketability he’s as nutty as the next Bircher/Birther/Tenther/whatever. The “non-batshit insane” GOPers of 2008 either left the party (Crist), retired (Snowe), were forced out (Bennett/Lugar) or drank the infested Kool-Aid (Alexander/Graham). The rest were obviously BSI to begin with.

  14. 14

    @Roger Moore:

    It would appear easy, but I have faith that the Republicans would find some way of screwing it up. It’s what they do best.

    Well, yeah, of course. Politics are the first-order effect – at least with the GOP in charge, but the infrastructure challenge is a not-insignficiant second-order effect both ways.

  15. 15
    Kay says:

    I still think it’s going in eventually in Ohio.

    We have one for-profit hospital and a ton of low wage workers. The hospital CEO is a horrible person who gets rant-y letters published in the WSJ but I also know he lobbied Sherrod Brown for rural health care dollars the week after he trashed the health care law in the local newspaper. His complaint about the health care law was, he’d have to offer better insurance to his employees than the garbage plan they get now. He is LITERALLY in the top 1% of earners in this town, but he’s whining about covering his employees.

    The Ohio Tea Party falls apart as a “movement” without Obamacare because they have no other issue, that’s it, Obamacare, which is why I think the GOP are terrified; that’s the only energy they have in the Ohio GOP.

    It’s negative, the Tea Party energy, the regular GOP loathe them, but the Tea Party at least have a pulse.

    They want the money. I still think that wins. How long is the fed offer on the table? Knowing Ohio Republicans they’ll put it in at midnight on the last day.

  16. 16

    CNN reporting that the Senate is going on lockdown as a precaution.

    These are the same people who voted against background checks.

    Just sayin’.

  17. 17
    askew says:

    @dr. luba:

    Why isn’t NH participating? Hopefully, the Dems will pick up some governorships in 2014 and bring some of the red states in line. I think ME will be one of them for sure.

  18. 18
    Yatsuno says:

    @askew: PA too. I don’t see a lot of the teafolk keeping their jobs in the statehouse after 2014.

  19. 19
    Davis X. Machina says:

    @askew: The NH legislature had veto-proof GOP majorities after the 2010 elections. The House flipped back D in 2012 but the Senate is still GOP-controlled. Maine has both Houses in D hands, but can’t reliably override LePage’s vetoes.

  20. 20
    askew says:

    @Yatsuno:

    Yeah, PA should definitely flip in PA. Corbett is one of the most unpopular governors in the country. I think we are going to have a harder time with the statehouses though as the teapartiers passed gerrymandered maps in 2010 that might be too much for us to overcome.

    @Davis X. Machina:

    Ah, thanks that explains NH. Damn, the 2010 election will be haunting us for years it seems.

  21. 21
    Villago Delenda Est says:

    Republican controlled legislature decided to delay the expansion until April 1 out of spite

    This is why I feel putting these motherfuckers up against the wall is a very reasonable solution to the problem.

  22. 22
    Mary G says:

    I wonder if many poor people will try to move to states implementing the ACA in any numbers. If they have medical problems, I suspect they will.

  23. 23

    Just keep in mind that Amish is a MI US House Rep…

  24. 24
    Davis X. Machina says:

    @Mary G: It costs money to move. Key money, first and last month’s rent, the price of a truck. Utility deposits. Maybe waiting periods on other social safety-net programs.

    Some folks can move hobo-style, or crash on a friend’s couch. But to move for reals — that’s a middle-class thing.

  25. 25
    Tone in DC says:

    @Southern Beale:

    Funny how that works, isn’t it.

  26. 26
    brantl says:

    And they want to do their standard knee-jerk of taking people off of it in 4 years, as though health care is somehow like graduating college..

  27. 27

    @Mary G:

    I wonder if many poor people will try to move to states implementing the ACA in any numbers.

    A few might. But the bigger impact will likely be all of the people that are currently in jobs with employer-provided coverage (even if it’s shit) that feel empowered to leave their job because they can still get health coverage. And that’s going to vary a lot depending on how the employer mandates come down, and the strength of the state’s exchanges. Many employees overvalue their healthcare – they’re willing to trade too much salary away because the cost of the benefit is well hidden. That’s going to change and many employers are going to have to put salary on the table to attract/retain employees. Others that pay well but don’t provide benefits (a lot of smaller businesses) may have an easier time attracting/retaining employees. It’s going to shake things up a bit and that’s good.

  28. 28
    gypsy howell says:

    @Southern Beale:
    Well, as long as THEY’RE safe from gun violence, I guess the rest of us can just suck it.

  29. 29
    brantl says:

    @tuna: Bullshit.

  30. 30

    @tuna:

    No, it’s spite, and the fact that in Michigan we must obtain 2/3rds vote for a bill to have “immediate effect” (IE). Without IE, the bill does not kick in until 90 days after the end of the legisaltive session, which is the end of the year.

  31. 31
    Mike E says:

    @👾 Martin: And thank Zardoz it’s a Dem legis in CA, so there’s that. Here in NC, parting Gov Perdue left the split option on the table only to have it completely rejected by our new Gov McCrory and his supermajority of umm, rejects. Good times.

  32. 32
    Redshift says:

    @brantl: Well, you know, if they don’t force people to make it on their own, they might become dependent on having healthcare! /sigh

  33. 33

    @👾 Martin:

    The biggest impact of all will be if we actually manage to bend the cost curve on Medicare. The whole push for “entitlement reform” is based around problems with Medicare. If we can get Medicare costs under control, the rationale for gutting the welfare state evaporates.

    And, of course, all the people who won’t die of preventable health problems. That’s a big deal, too.

  34. 34
    Redshift says:

    We should get it here in VA if we can get voters to vote for governor in proportions matching the polls. McAuliffe has said on the stump that he’ll veto any budget that doesn’t include Medicaid expansion, drawing a whine from Republicans in the legislature that he’s “drawing a red line” (snerk!) and “not willing to compromise,” and hoping we won’t remember that they blocked a budget that did include it. (They couldn’t block it completely, so we currently have a distract-and-delay process involving a legislative commission, with the outcome as yet uncertain.)

  35. 35
    The Other Chuck says:

    @Roger Moore:

    If we can get Medicare costs under control, the rationale for gutting the welfare state evaporates.

    That is of course operating under the charmingly quaint assumption that the rationale has anything to do with, well, rationality.

  36. 36
    aimai says:

    @Kay: Such an interesting point and one that I think the Republicans know is true, on a larger level, with Obama hatred in general. That is: they’ve spent so much time demonizing Obama and the Democrats as the “party of black resssentiment” that they will have a hard time whipping enthusiasm when the “face” of the party shifts back (temporarily) to a white standard bearer. I mean: they will definitely haul out the hate on women, minorities, and illegal immigrants but they’ve really staked a whole lot of visceral politicking on Obamacare and the Obamanation of the black people at the white house horror. I think Boehner et al know that some fairly large part of their hysterical base will go back to being largely apolitical and apathetic when the contest is between two white guys, or even a white guy and a white woman.

  37. 37
    boatboy_srq says:

    @Southern Beale: Guess they were distracted by foreground cheques.

  38. 38
    Mike E says:

    @aimai: See Bill Maher’s bit on “black-tracking”, where GOPers who were for it are now against it because…Obama.

  39. 39
    Davis X. Machina says:

    @aimai: There will be other, individually less potent, but more numerous resentments to play on, so a simple substitution of a tapas-bar-of-hate for the present all-you-can-eat-main-course-of hate is likely.

  40. 40

    I saw that the president was needling the Republicans again about their fetish of doing away with the A.C.A., telling them that there was an election last year, but the candidate who ran on repealing the law lost. And it just depressed me how many fucking times we’ve been over this shit already now. What is it, 40 times they’ve voted in the House to repeal it? 35? 50? Who the fuck knows any longer?

    But it hit me that maybe what the president should do is to take some of the Republican leaders aside and advise them that they should just begin telling their neanderthal base that it was the Republicans who passed the A.C.A. and the Democrats who fought it at every turn. Their base will believe anything if it comes from somebody it trusts. They would believe that Josef Stalin was a conservative Republican hero and that Karl Marx is the Republican Party’s most important political intellectual theorist if they told them to, so they won’t have any trouble spinning on a dime and believing something that they knew to be untrue 3 seconds before.

    And, poof! Everybody wins! Ted Cruz and Mike Lee and rand Paul get to take credit with their base for a program that will end up helping their drunk, fat, stupid base; the Republican leaders like McConnell and Boehner can get out of this mess they’ve gotten themselves into, stuck between Cruz, et al., and reality; and the Democrats will get to stop having to hash over this fucking fight that they’ve already won 137 times, and get the system up and running. I know this sounds like a joke, but I don’t see why Republicans wouldn’t crawl on their lips through busted glass to get this behind them, and this would be a way to do it.

  41. 41
    scav says:

    @boatboy_srq: v. good! Alternative is backhander checks.

  42. 42

    @Roger Moore:

    If we can get Medicare costs under control, the rationale for gutting the welfare state evaporates.

    Well, let’s not get ahead of ourselves…

    But yes, bending the cost curve is already happening. Should go faster once the mandates fully kick in and fewer people defer treatment until they’re 65.

  43. 43
    Chat Noir says:

    @Mike E: The “black-tracking” thing was excellent. We saw Bill Maher in concert this summer and he was awesome — his show clocked in at 1 hour, 45 minutes and he was LOL funny from the get-go.

  44. 44
    Kay says:

    @aimai:

    Such an interesting point and one that I think the Republicans know is true, on a larger level, with Obama hatred in general.

    My sense here is “normal” Republicans, people who actually are active in the state or county Party (as opposed to ranty Tea Partiers) are dispirited, even a little sheepish.
    Except! This has happened before. At the end of Bush II they were like this. They were “politics suck, it’s just us commonsense conservatives”
    Then they went stark raving mad for a while after Obama’s election, and now we’re back to exhaustion or whatever this is.
    I do know they hate the Tea Party here. We actually had some Tea Party-style government. They won city council and board of public affairs races. They created this big debacle over purchase and renovation of an empty supermarket. The plan was to turn it into a city-county building. They fought so long over spending the renovation money the building they purchased fell into disrepair. There was water damage and it’s costing twice what it should have cost to renovate. It’s across from my office. There were birds nesting in there at one point. It took them three years to allocate money to rehab it.

  45. 45

    @The Other Chuck:

    That is of course operating under the charmingly quaint assumption that the rationale has anything to do with, well, rationality.

    Perhaps “justification” or “scare tactic” would be a better description than rationale.

  46. 46
    StringOnAStick says:

    Hi everyone, just checking in here from flood-ravaged NE Colorado, where they are now describing some areas as having just suffered through a 1,000 year flood event. The town of Lyons has been entirely evacuated because no power, no water, no cell service, no roads; some National Guard troops were stranded there over last night because the last bit of rain ran the river up again. Boulder’s a mess, and Estes Park only has access from the west, which is a national park road that is not open in the winter because it is over 12,000′ and gets horrific conditions/avalanche danger. The latest estimate is that some of these roads (all major highways) won’t be fully repaired before winter hits. Boulder got over 21 inches of rain in the last seven days, and this is more than the average annual precipitation.

    So, rough times for many folks around here. Ask me how hard it was to not come unglued on a winger today who was justifying his not wanting to help, donate, or pay taxes because “I’m sorry, if you build on the river you takes your chances”. If you are going to decide on what is buildable land based on the 1,000 year or 500 year flood plain, then the amount of developable land in the mountains around here approaches zero, dumbass, and the plains to the east (just now getting the flood waters) are about as bad. Jesus, some people….

  47. 47
    Kay says:

    @aimai:

    Oh, and I saw this more than once at the county fair.

    T-shirt. Nothing else but this:

    Christian
    Constitutional
    Conservative

    My husband had to stop me from asking what it’s like to be “constitutional” :)

    I don’t get that. It was an honest question! I think I’m constitutional, too, but I’m not 100% sure. We could have found common ground.

  48. 48

    @StringOnAStick:

    Hi everyone, just checking in here from flood-ravaged NE Colorado, where they are now describing some areas as having just suffered through a 1,000 year flood event.

    That’s interesting, because ISTR the 1976 Big Thompson flood (which my family was fortunate to dodge) being described as a 1000 year event. Now they’ve had a second 1000 year flood less than 40 years later. But there’s no way any of this could have anything to do with climate change, no siree Bob. And if nobody is allowed to build anywhere that’s prone to natural disaster, there isn’t going to be much country left to build in.

  49. 49

    @Kay:

    My husband had to stop me from asking what it’s like to be “constitutional” :)

    Code for birther, which itself is code for white pride.

  50. 50
    StringOnAStick says:

    @Roger Moore: Well, Roger, the volume that ran down the Big Thompson this time exceeded that of the 1976 flood, significantly. All the engineering that was done to harden that roadway against such things is now on it’s way to Nebraska.

    I used to work in consulting engineering re: rivers and groundwater studies, and my office did a lot of delineation of the various flood event boundaries for the Big Thompson, Cache la Poudre and St Vrain rivers for FEMA in the late 1980’s. Even deciding if the model is being reasonably accurate for a 50 or 100 year flood is hard enough, but 500 year and 1,000 year events are basically impossible and not called for in the contract anyway since no one, insurance or otherwise, does things based on flood boundaries greater than 100 year events. That isn’t even considering how you come up with what the flow would be for events that big, or if the methodology is even reasonably accurate for this hydrographic regime or for the amount of rainfall data we have from the last 100 years or so. It is just full of hard to fill holes.

    I do have to ask if all those people in the NE plains of Colorado who wanted to secede recently are going to wait until after they get every dime they can from FEMA for the flooding that is now working its way through their area. Because only recently they were damned sure they didn’t need the federal gubmint for anything.

  51. 51

    @StringOnAStick:

    Well, Roger, the volume that ran down the Big Thompson this time exceeded that of the 1976 flood, significantly.

    Egad. I took some coworkers through Big Thompson Canyon a few years back (we were taking a weekend trip after a conference in Denver) and showed them the remains of the power plant in Viestenz-Smith park. It’s hard for me to imagine a bigger flood than the one that wiped it out. Fortunately, my parents are on high enough ground that the flood is only an inconvenience to them, but I have a friend from highschool who lives in Estes Park and works in tourism. I guess she’ll have some extra time for her side business in the coming year.

  52. 52
    Richard Mayhew says:

    @boatboy_srq: Re: rational or at least not bat shit crazy Republicans — they exist — see Utah, see Idaho and see North Dakota. Hell, even see Arizona. I am not stating that this species of Republican make up a local majority of the party, but a sufficient faction controlling enough veto points that they could get what they wanted with a coalition of Democrats and other Republicans who can count to eleven with their shoes on.

  53. 53
    billB says:

    There is a beautiful spit of land on the Oregon coast, with nothing on it, and if you pull over to read the historic marker, it says that a fancy east coaster came in and built an amusement park and many homes here. In her grace, Mother Nature felt compelled to take it all away. So for all of you that build in sight of moving water, don’t do it. Water will always rise, especially in the Time of Global Warming. And if you expect the rest of us to pay for you to keep re-building your property in the face of engineering and logical warning signs, #%$^&*%##$^^&&

  54. 54
    rachel says:

    @Richard Mayhew: Mike Lee is from Utah. :(
    By the way, I have been meaning to ask you: what’s up with those guys over at Insureblog? I have never once seen them discussing any benefit the ACA will give people. Quite the contrary.

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