By: Yasmin Coonjah,
on 11/4/2015
With elections just about a year away, Americans can expect to hear a lot about regulation during the next twelve months—most of it from Republicans and most of it scathing. Republican frontrunner Donald Trump typifies the GOP’s attitude toward regulation.
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By: Alice,
on 12/8/2014
The national headlines following the 2014 Midterm elections trumpeted the Republican success in seizing the majority in the US Senate and expanding its strength in the US House to record numbers since 1929. These wins were striking but hardly surprising given the tsunami of polls. The big news that continues to elude commentators are the Republican wins in gubernatorial elections – wins that may well have more impact on everyday lives than the Washington battle that pits a Republican Congress against President Barack Obama’s veto pen. Republicans not only pulled out wins in hotly contested battles in Florida, Kansas, Maine, and Wisconsin, but they also invaded Democratic strongholds by prevailing in Illinois, Maryland, and Massachusetts.
Will the GOP gubernatorial wins sweep in a revolution that, among other things, wipes out Obamacare’s centerpiece – the state’s decision to expand Medicaid? Many commentators are predicting just that – repeal or blockage of health reform. They often point to the fiery partisanship in Washington.
The talking heads are wrong. The raw partisanship in Washington cools in the hands of governors facing the nitty-gritty job of running their states – searching for revenues to design budgets and addressing the pressure from doctors and hospitals and advocates for the vulnerable.
Partisanship has been a tractor beam on many states. Democratic states have moved faster and further towards expanding Medicaid than their Republican counterparts, providing some credence to the recent reports that new Republican governors will hinder reform. What is striking, however, is that partisanship – and particularly steadfast GOP opposition to reform — has often been moderated or overridden by the real-world circumstances facing governors. What could possibly convince a politically skilled GOP governor to take on their party on such a high profile issue?
Carrots. The decision to adopt the expansion of Medicaid rests with states. The federal government has served up an enticing financial package: 100% of the costs for the first three years of the program and 90% afterward.
Hospitals that serve the uninsured and poor are facing dramatic reductions in federal government funding, leaving many to worry about dire financial crises. Medicaid expansion is a lifeline for these providers. It also may help state budgets by picking up the cost of caring for the uninsured, what is known as “uncompensated” or charity care.
Here is one of the most striking patterns in our era of partisan polarization: states with Republican governors in Arizona, Ohio, Michigan, Iowa, New Mexico, Pennsylvania, New Jersey, and others embraced Medicaid reform. In Arizona for example, conservative firebrand Governor Jan Brewer forced Medicaid reform through the state legislature as an imperative to create jobs, save hospitals, and ensure coverage for Arizona residents. Governor John Kasich passed it by going rogue on his Republican legislature by circumventing them altogether and risking a constitutional crisis.
The Republican recent romp has elected a new crop of pragmatic governors. Maryland Governor-Elect Larry Hogan and Illinois Governor-Elect Bruce Rauner seem poised to find a path forward to implementing reform. Florida’s Scott has supported Medicaid expansion in the past and may find more support in the GOP legislature now that the election is over. Some Republican governors favor reform in a modified form so they can publicly frame it as a “conservative model” that fits their states.
A new normal is arriving. The uncompromising push to repeal Obamacare is being replaced with a pragmatism geared to solving real problems. The irony of the GOP gubernatorial success in 2014 is that it may mark the turning point from vitriolic partisanship to real-world problem solving.
Headline image credit: Election vote. CC0 via Pixabay.
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