The politics of health care in a pandemic

In a recent post about health care, I suggested that Oklahoma's ballot measure on Medicaid expansion would be one to watch. Well, sure enough, voters in that heavily Republican state approved the measure by a little over 50 percent. Considering the dark money that went into opposing it, I'd call that a landslide. Dollars seem to count more than votes most days.

Interestingly, Oklahoma was the first state to expand Medicaid during the COVID-19 pandemic. But it may not be the last. Missouri is scheduled to vote on the measure August 4. And so far, expansion has passed in every state where it was put on the ballot.

As I've argued many times before, it's good news any time a state takes advantage of this best provision of the Affordable Care Act. First, it improves and saves lives. Second, it creates jobs and generates a lot of economic activity. Third, it helps more people stay in the workforce. Fourth, each expansion makes it a bit harder to get rid of the whole thing.

Back to Oklahoma. This is also the state that took up the Trump administration's horrible idea of accepting a cap on Medicaid spending. Looks like that ain't gonna happen.

This article from Politico argues that the pandemic has upended the Trump/Republican dream of rolling back health care. I don't know if that's true, since the US Supreme Court could still do a lot of damage.

Still, I think we can agree that the optics, in the parlance of our time, of taking health care away from people or keeping them from getting it to start with just don't look that good. In an election year.

We'll see. But this is another reminder that all news isn't bad.

Signed. Sealed. Delivered.

It's official. President Obama signed the health care reform bill into law yesterday.

He told those in attendance that

We have just now enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their health care.

Critics of the bill may point out that this isn't exactly the case, but there's no denying that this is a landmark piece of legislation that will extend health coverage to millions who have been doing without it. The New York Times calls it

the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.

It remains to be seen whether the immediate benefits (political and otherwise) will outweigh the blowback. This item from Politico argues that the former will come before the latter, but I'm not sure I agree. It always seemed to me that a major drawback of the legislation was that the major expansion of health coverage via Medicaid and subsidies won't hit until several years down the line, meaning that the risks might hit earlier than the benefits.

Still, it probably will be hard for those who want to repeal it to win much of a crowd by saying "Bring back the donut hole" for Medicare Part D, or "let's cut those young people off their parent's insurance" or "Bring back denials of coverage for pre-existing conditions!"

The game has changed, although it's hard to guess just how or how much.

AN EARLY INDICATOR might be a USA Today poll that found 49 percent of those surveyed thought it was a good thing compared with 40 percent who thought it was a bad thing.

CHARM SCHOOL DROPOUTS. Here's more on the less than appealing actions of some tea partiers this weekend.

THIS IS RICH. JPMorganChase is blaming unemployment on unemployment insurance. Until that stunning revelation, I thought shady banking and credit practices had something to do with it.

GOAT ROPE ADVISORY LEVEL: ELEVATED