Debate Over Medicaid Reflects Divide Among Governors, Congressional Republicans
The New York Times
December 27, 2015
WASHINGTON — John Thune of South Dakota, the No. 3 Republican in the Senate, voted earlier this month to repeal major provisions of the Affordable Care Act and to end its expansion of Medicaid, arguing that the health law was “unpopular and unaffordable.”
A week later, his state’s Republican governor, Dennis Daugaard, announced that he wanted to make 55,000 additional South Dakota residents eligible for Medicaid under the law.
“I know many South Dakotans are skeptical about expanding Medicaid, and I share some of those sentiments,” Daugaard said. “It bothers me that some people who can work will become more dependent on government.”
“But,” Daugaard said, “we also have to remember those who would benefit, such as the single mother of three who simply cannot work enough hours to exceed the poverty line for her family.”
In state after state, a gulf is opening between Republican governors willing to expand Medicaid coverage through the Affordable Care Act and Republican members of Congress convinced the law is collapsing and determined to help it fail. In recent months, insurers have increased premiums and deductibles for many policies sold online, and a dozen nonprofit insurance co-ops are shutting down, forcing consumers to seek other coverage.
But in Arizona, Arkansas, Indiana, Iowa, Michigan, New Jersey, Nevada and Ohio, Republican governors have expanded Medicaid under the health care law or defended past expansions. In South Dakota, Tennessee and Utah, Republican governors are pressing for wider Medicaid coverage. And Republican governors in a few other states, including Alabama, have indicated that they are looking anew at their options after rejecting the idea in the past.
That has created tension with Washington that some lawmakers can no longer ignore.