Think back with me to that time that Nancy Pelosi, the California Democrat who launched a thousand political scare ads, spoke these condescending words about the Patient Protection & Affordable Care Act: “I think it would be healthy to get a bill passed and then actually educate the American people about what that specific bill actually does over time because right now, there’s a lot of fearmongering going on.”
Wait, scratch that. Those weren’t Pelosi’s words about the ACA. That’s what Rep. Tom MacArthur of New Jersey said about the American Health Care Act, which he and his fellow House Republicans passed in 2017 and celebrated with President Trump in the White House Rose Garden despite the fact that it would never pass the Senate.
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But Pelosi did say something similar about Obamacare back in 2010: “We have to pass the bill so that you can find out what is in it, away from the fog of the controversy.” The midterm election brought fresh evidence that she knew what she was talking about.
The most obvious evidence was the Republican desperation to rewrite history on dozens upon dozens of House votes to repeal the ACA and its guarantee of affordable coverage for people with pre-existing conditions. President Trump, in a slip that he recognized almost immediately, delivered an ominous warning at one of his lovefest rallies that Democrats would “obliterate Obamacare” — the very thing that Republicans spent seven years promising to do.
Trump also said that “all Republicans” favor protecting people with pre-existing conditions, which is (warning: euphemism ahead) at odds with objective reality. The White House’s preferred legislation would certainly price people with pre-existing conditions out of the insurance market. Twenty Republican state attorneys general — including our own Leslie Rutledge — are suing to have Obamacare, including its coverage for pre-existing conditions, declared unconstitutional with no replacement in sight.
Wisconsin’s AG, a lead plaintiff in that effort to kill Obamacare, lost his re-election bid to a Democrat on Nov. 6. In addition to a left tilt to most partisan elections nationally, liberal policies and Obamacare specifically triumphed in several statewide initiatives in the conservative heartland.
That includes raising the minimum wage here in Arkansas (with 68 percent of the vote) and in Missouri. Missouri also voted to legalize marijuana for medicinal use — as Arkansas did two years ago, although you wouldn’t know it from a practical standpoint. Medical marijuana was also legalized in Utah, one of the most conservative states in the country.
Here’s another liberal-ish thing Utah voters did this month: They voted, by a comfortable margin of more than 7 percentage points, to expand Medicaid to low-income households as contemplated by the ACA. And they voted to pay for the state’s share by raising the state sales tax by 0.15 percent — that is, 15 cents for every $100 spent.
Voters in a couple of other conservative states also voted to get in on the Medicaid expansion part of Obamacare: Nebraska by more than 6 points and Idaho by 22 points.
Most blue states, of course, didn’t have to be forced by voters to expand Medicaid. Maine voters demanded expanded Medicaid in 2017, but their Republican governor refused to implement the voter mandate. Now he’s planning to join Mike Huckabee as a resident of Florida, and one of the seven new Democratic governors elected this month will implement Maine’s Medicaid expansion.
The only electorate, so far, to reject Medicaid expansion is in Montana, where legislators had agreed to the expansion for four years. Permanent expansion, as presented on the ballot this month, would be paid for with a hefty tax on cigarettes and e-cigarettes, and the tobacco industry spent some $17 million to successfully defeat the initiative.
Arkansas, of course, expanded Medicaid in a unique way — by using the federal dollars to buy private insurance under a program currently called “Arkansas Works.” It covers a quarter-million of our neighbors and has helped preserve rural hospitals in our state — and there is early evidence that states that expanded Medicaid reduced infant mortality more than states that don’t. Perhaps seeing how popular insuring the working poor has become even in red states will make it easier to preserve.
Meanwhile, I keep thinking about our former senators Blanche Lincoln and Mark Pryor. Both laid down their political lives for Obamacare. Now that the fog of controversy has mostly lifted, tens of millions have already benefited and hundreds of thousands of additional low-income families in red states soon will.
Email Gwen Moritz, editor of Arkansas Business, at GMoritz@ABPG.com and follow her on Twitter at @gwenmoritz.