When Texas Republican Gov. Rick Perry announced that he would reject the Medicaid expansion included in the Obamacare health law, he claimed that the decision was for budgetary reasons. "It would benefit no one in our state to see their taxes skyrocket and our economy crushed as our budget crumbled under the weight of oppressive Medicaid costs," Perry opined.
But rejecting the expansion due to cost has always been an argument that rings hollow. After all, the Obamacare expansion would open Medicaid – meant to provide health insurance to low-income Americans – to those with incomes 133 percent of the poverty level, with the federal government picking up 100 percent of the tab in the first few years and 90 percent after that.
On its face, that seems like a good fiscal deal for the states, not a crushing burden, as more low-income Americans receive health insurance instead of depending on the emergency room. Indeed, a new study shows that there's much more politics than purse strings behind Perry's choice.
According to the nonpartisan RAND Corporation, Perry and 13 other governors who are turning down the Medicaid expansion will see $8.4 billion less in federal funding through 2016, leaving 3.6 million more people uninsured, while spending $1 billion more on care in 2016 alone. So those states will be spending a lot more money while providing insurance to far fewer people.
"State policymakers should be aware that if they do not expand Medicaid, fewer people will have health insurance, and that will trigger higher state and local spending for uncompensated medical care," said Carter Price, the study's lead author. "Choosing to not expand Medicaid may turn out to be the more-costly path for state and local governments."
But this has never been about health care or cost for Perry and the other governors, including South Carolina's Nikki Haley, Oklahoma's Mary Fallin or Pennsylvania's Tom Corbett. Instead, they are using the opportunity to score political points with a conservative base that wants nothing to do with anything that looks, smells or feels like Obamacare.
Not every Republican governor, though, is on board with the GOP cutting off its collective nose to spite its face. Arizona's Jan Brewer has gone to the mat to get her state to accept the Medicaid expansion, while Ohio Gov. John Kasich invoked the ghost of GOP hero Ronald Reagan to justify his move to accept the funds. "When we consider what Reagan would do, let's also remember what he did do — expand Medicaid," Kasich wrote in a USA Today op-ed.
But Reagan would almost surely be a pariah in today's GOP, treated as a tax-raising, government-expanding socialist. Instead, Republicans now believe that everything the government does is so despicable that providing health care to the poor is just one more big Obama scheme, even though the fact of the matter is that Medicaid saves lives and makes people healthier, pure and simple.
And ultimately, those who will be hurt by the intransigence of Perry and co. are the Americans forced to go without health insurance so that some Republican governors can prove their conservative bona fides.