June 30, 2018

Another state does the right thing

In case you missed it, there was a pretty major victory for working people and for social justice recently. The Virginia legislature voted to expand Medicaid under the Affordable Care Act, with the full support of the governor.

Of course, this could have happened four years ago and helped a lot more people a lot sooner, but a different team was running their legislature at the time. All that changed after the 2017 election. Since then, the measure even gained bipartisan support.

In the parlance of our time, this is a YUGE deal for more than one reason. The first, obviously, is that many more low-income people, most of whom live in working families, will be eligible for health care, including treatment for people trying to recover from addiction. To the tune of 400,000 people.

In addition to covering more people, the Commonwealth Institute for Fiscal Analysis estimates the expansion will bring over $2 billion in federal funding to the state, create 18,000 jobs and increase state tax revenues by $88.6 million.

I’d say congratulations are due to everyone there who fought the good fight.

West Virginia fortunately made the decision to expand Medicaid back in 2013, thanks to then-Gov. Earl Ray Tomblin. As of now, around 165,000 West Virginians are covered by it. In any given year, that could be as many as 200,000 people, or one out of nine adults, including tens of thousands in recovery. That decision has also created jobs, boosted local economies and helped keep rural hospitals and community health centers afloat here.

That decision is probably Tomblin’s greatest legacy as governor and one that will be hard for any other governor to match, past, present or future.

Which leads to another reason why Virginia’s decision is a big deal: the more states that take advantage of the expansion, the tougher it will be to undo it at the federal level (and the more likely West Virginia will continue to benefit from it). So far, 33 states and the District of Columbia have expanded Medicaid.

Interestingly, no state that has flipped to Republican since deciding to expand it has reversed the decision. And several more conservative-leaning states are moving in that direction.

Last year, Kansas’ Republican legislature passed expansion, only to have it vetoed by Gov. Brownback. That could be revisited. Maine voters supported expansion last year in a ballot measure. The governor there has refused to implement it, but he faces term limits and it’s likely the next governor will be less indifferent to human misery. Utah will vote on a further expansion in November, while efforts to get the measure on the ballot are in progress in Idaho and Nebraska.

During North Carolina’s massive teacher protests, educators called for Medicaid expansion in addition to better funding for schools.

And to think that only a few months ago it looked like all that would have been wiped out by the Trump administration and the oligarchs in Congress.

That was a long, tough fight, and it's not over yet. It's likely that the Trump administration will keep pushing states to apply for waivers restricting coverage and cutting people off. It’s anyone’s guess as to whether officials here will take the bait. But they'll have a tough time pulling the plug on the whole thing.

Obviously, while Medicaid expansion is a great advance, it doesn’t cover everyone who needs health care. Many are still uninsured or have poor or unaffordable coverage.

We still have a long way to go to get to truly universal and affordable health care, possibly with something like an improved version of Medicare available to all. But it’s important to defend the ground we’ve gained and resist all efforts to roll them back even as we prepare to move forward again.

That may have gotten just a little bit easier.

(This appeared as an op-ed in the Charleston Gazette-Mail.)

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