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.)

Good news and a big deal

In case you missed it, there was a pretty major victory for working people and for social justice today. The Virginia state senate voted to expand Medicaid under the Affordable Care Act. The house previously passed a similar measure and the governor is all in.

Of course this could have happened four years ago and helped a lot more people at less cost to the state, but a different team was running their legislature at the 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 addictions. 400,000 to be exact. Congratulations to everyone there who fought the good fight.

The other reason this is important is that the more states that take advantage of the expansion, the harder it will be to undo it. So far, 33 states and the District of Columbia have expanded Medicaid and some other states are in play.

And to think that only a few months ago it looked like all that would have been wiped out by the Trump crew and the oligarchs in congress...That was a long, tough fight. It's not over yet, of course. It's likely that the Trump administration will keep pushing states to apply for waivers restricting coverage. But they'll have a tough time pulling the plug on the whole thing.

(West Virginia, thank God, expanded it at the first opportunity, thanks to then Governor Earl Ray Tomblin. A different team was running things then too. Around 165,000 people are covered by it today.)

It's working

A showdown is taking place in Virginia, where Democratic Governor Terry McAulliffe is pushing to expand Medicaid coverage under the Affordable Care Act to an estimated 400,000 residents of that state. Republicans in the state House are going all out to block any expansion. I guess the rationale is "Let them eat spite."

Meanwhile, in West Virginia, over 117,500 have gained Medicaid coverage since Jan. 1 of this year--not counting those who signed up via the exchange or found out they were eligible for traditional programs.

 And the results are already apparent. As the WV Center on Budget and Policy notes in its blog, the state's largest hospital system, CAMC, reported a 75 percent drop in self-pay patients the first month that the ACA and Medicaid expansion took effect. It has fallen even more since then.

In other words, it's working. I am grateful for the fact that whatever else you can say about WV's Gov. Earl Ray Tomblin (and some days there is plenty) he did have the decency to bring health care to many who were doing without. I only wish the leaders in the mean-spirited states have a change of heart.

Another civilized state?

One result of yesterday's election is that 400,000 low income residents of Virginia may become eligible for health coverage. The race was a close one between a strong supporter of Medicaid expansion and an ardent foe of anything associated with the Affordable Care Act. It's still a long way from happening there but the odds have definitely improved. I hope Virginia joins the civilized states.

Meanwhile, over 61,000 West Virginians have signed up for Medicaid since Oct. 1, which effectually reduced the number of the state's uninsured by 1/4 in a little over a month.

WHAT DID THEY EXPECT? State tax revenues are dropping and higher education is just one victim. Quite a few people are calling for raising revenue. Let the record show that these wounds are self inflicted. WV slashed corporate taxes a few years back and eliminated the regressive food tax without thinking about other sources of revenue.

TWO TO PONDER. Here are a couple interesting items from Alternet. The first tries to plumb the thinking of the Ayn Rand-type one percenters and the second ponders whether the ruling class needs anybody else these days.

PREDICTING THE UNPREDICTABLE. Can chaos theory do it?

GOAT ROPE ADVISORY LEVEL: ELEVATED