Louisiana has been atwitter about the topic of Medicaid Expansion for years now. Ever since the passage of Obamacare (and the subsequent Supreme Court decision making expansion optional), states throughout the country have been slowly coming around the idea that expanding Medicaid is a good idea.
This summer has been no exception. No fewer than 5 red states have been inquiring about how to submit to the horror that is the Affordable Care Act’s Medicaid Expansion, including known liberal enclaves such as Wyoming and Tennessee.
A funny thing keeps happening though: As more states inquire, some of the places most in need of expansion continue to hold out. TPM explored this topic here:
Pennsylvania Gov. Tom Corbett, a Republican powered to office in 2010 by the tea party wave, struck a deal with HHS last week to expand Medicaid. Indiana, led by Republican 2016 dark horse Gov. Mike Pence, is already negotiating with the administration on its own plan. Tennessee, a state like Wyoming where there’s no real Democratic threat to Republican dominance that would drive expansion talk, plans to submit a proposal for Medicaid expansion to HHS this fall.
Wyoming is perhaps the prototype for how Medicaid expansion might happen now that most of the easy states — either Democratic-led or with more moderate GOP leadership — have come around. It is a combination of selling conservative lawmakers on the financial benefits of expansion and crafting an alternative plan that is more palatable to conservative ideals in the 23 remaining states that have not yet accepted the expansion.
Yet, states most in need of the expansion seem to be holding pat. Where are these states? Why in the deep south, where the uninsured rate is among the highest in the nation:
A map of Medicaid expansion leaves out the five states that, at least by thestandard definition, comprise the Deep South. You can tack on two huge adjoining states — Florida and Texas — and go by the “original Confederate States” definition. Arkansas and Kentucky are the most Southern states so far to expand, and both are led by Democrats. GOP-led Tennessee is working on it.
In a June op-ed for Reuters, Lichtenstein used the South’s obstruction of Medicaid expansion as “Exhibit A” in his argument that the region was reverting to the “New South,” formerly the description of the period between the Civil War (or Reconstruction, more precisely) and civil rights.
“A ruling white caste (is) now putting in place policies likely to create a vast economic and social gap between most Southern states and those in the North, upper Midwest and Pacific region,” he wrote. “Of course, such regressive social policies… are supported by a fierce white partisanship.”
Among these deep south Governors fighting tooth-and-nail against Medicaid Expansion? Bobby Jindal, of course.
Oh, nothing to see here. Just a funny coincidence. States with historical racism are certainly not avoiding expansion just to withhold progress from lower-socioeconomic class minorities. Never.