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Cartoon illustrating Medicaid gap using highway and road signs.

Has the country finally reached sanity when it comes to Obamacare? Are the crazy politics and the irrational decision-making by red state lawmakers finally petering out? It's possible. Check out Wyoming.
Nearly 70 percent of its voters went for Mitt Romney in 2012. Out of 90 legislative seats, 78 are held by Republicans. A Republican governor. It also epitomizes the independent streak found in the West, defined by a deep distrust of the federal government.

But even there, state officials are starting to open up to the idea of expanding Medicaid under Obamacare. The legislature requested earlier this year that Gov. Matt Mead (R) meet with the Obama administration to discuss the state's options. Mead's office told TPM that the governor met with staff from the U.S. Department of Health and Human Services for the first time in July. Mead said recently that he would present expansion options to the legislature early next year.

So in recent months, that makes Indiana, Pennsylvania, Tennessee and now Wyoming, all either beginning to relent or reversing course entirely on taking the expansion. A major factor in that is the success of the Arkansas privatized model of expansion, and the administration's willingness to consider and grant waivers for plans that governors can sell to Republican legislatures.

There's also plenty of economic arguments, and heavy lobbying from hospitals—a traditionally influential force with local and state lawmakers. The expansion is great for hospitals, since it means they have to provide a lot less uncompensated care, and don't have to have their big billing departments constantly hounding the uninsured for payment. In fact,

Mead cited the hospital association's statistic on lost federal dollars when explaining the latest developments. The group, which is leading the lobbying coalition that is pushing for expansion in Wyoming, has been sending information to state legislators and current legislative candidates in the mail and meeting with select lawmakers.
There's additionally a politically salient fairness argument: people paying federal taxes in red states are seeing their money provide health care to people in other states. Those are all arguments that can sway Republican lawmakers, that and the fact that opposition to Obamacare is losing more and more of its political potency as time passes. Which isn't to say diehard lawmakers in Tennessee or Wyoming, or any of the other states are going to change their minds soon. But they're wearing down.

Originally posted to Joan McCarter on Tue Sep 02, 2014 at 01:51 PM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (32+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Tue Sep 02, 2014 at 01:51:01 PM PDT

  •  Hospitals seem to be the driving factor (5+ / 0-)

    Where they stand and how politically active they are

    Wyoming Hospital Association

    I want 1 less Tiny Coffin, Why Don't You? Support The President's Gun Violence Plan.

    by JML9999 on Tue Sep 02, 2014 at 02:07:50 PM PDT

    •  In hindsight, the brilliant move (0+ / 0-)

      in the ACA was cutting back on the pre-ACA payments to hospitals for uncompensated care. It's causing harsh consequences (hospital closures in some rural communities), but it concentrates the mind of hospital admins and puts them on the side of advocating for Medicaid expansion.

      It would have been nice if the GOPers had paid attention to this before they ploughed ahead to get the SCOTUS to let them turn down the Medicaid money.

  •  Mead wanted to wait until after the primary (6+ / 0-)

    Once he was home free from the terroristic threats of the Tea Party, he was ready to deal.

    If you refuse to vote for the Democrat in a Presidential general election, then I hold you personally responsible for any right-wing Supreme Court decision.

    by USA629 on Tue Sep 02, 2014 at 02:09:52 PM PDT

  •  Red States are used to be takers (4+ / 0-)

    when it comes to federal dollars. It sucks being on the other end of that.

    Election Day is Nov 4th, 2014 It's time for the Undo button on the 2010 Election.

    by bear83 on Tue Sep 02, 2014 at 03:21:56 PM PDT

  •  Medicaid expansion on WY (8+ / 0-)

    Yes, USA629 is correct - Mead waited until his tea party challengers were handily defeated and because of all of the pressure from the practical and intelligent people in the state of Wyoming (yes, there are a few), he is seeing the writing on the wall. I am enjoying the Republican party eating itself in Wyoming.

    •  I Don't Buy This For A New Your Second (0+ / 0-)

      not at all. Mead and his fellow conservative/Republican/Tea Party politicians would have been just as happy to go ahead and let 17,000 people suffer and/or die.

      The only thing that has changed their minds is the hospitals and medical providers who are going to lose millions of dollars and still have to treat people who can't pay.

      Collect Different Days

      by Homers24 on Wed Sep 03, 2014 at 07:00:32 PM PDT

      [ Parent ]

  •  Wyoming has quite a few self employed and not (2+ / 0-)
    Recommended by:
    Calamity Jean, procrastn8

    young people, the exact demographic that benefits from the ACA.

    Just because they are very conservative does not mean they are dumb.

    “Conservation… is a positive exercise of skill and insight, not merely a negative exercise of abstinence and caution…” Aldo Leopold

    by ban nock on Tue Sep 02, 2014 at 07:48:06 PM PDT

    •  Although that's usually a safe assumption. (3+ / 0-)
      Recommended by:
      RTIII, sja, Jason Scott Hunter

      Although that's usually a safe assumption.

    •  No... (1+ / 0-)
      Recommended by:
      "Just because they are very conservative does not mean they are dumb."
      No, it doesn't, but it DOES mean that as a group they are unaccustomed to re-evaluating decisions they already made, that a great many have an ideologically driven blind spot, and that they are seldom able to admit they've ever made a mistake.

      So it's surprising, remarkable, and worthy of some optimism when they do re-evaluate a decision, do set aside ideological bind spot, and, indirectly at least, admit they were wrong.

      Change the charter of corporations to serve the public interest BEFORE fiduciary concerns. 100% of Republicans and HALF the Dems are AGAINST We The People. We need TRUE Progressives, NOT Republican-Lite Dems - like Hillary, Pelosi, Feinstein...

      by RTIII on Wed Sep 03, 2014 at 07:03:14 PM PDT

      [ Parent ]

      •  Admit it, doubt it (1+ / 0-)
        Recommended by:

        They'll take the $, but never admit the black guy had a good idea. They will insist that Obama care is terrible and their Wyoming care or whatever is great.

      •  What it means (1+ / 0-)
        Recommended by:

        is neither that Wyoming conservatives are stupid, nor that there is hope that they can reflect and change their thinking.

        What it means is that the opposition to the ACA was entirely political from the start, and now that Obama is a lame duck and now that Obamacare no longer resonates as a campaign issue, they have moved on. And yes, red states tend to suck on the federal teat more than blue states, so there's the usual red state "hate the Feds love their money" thing going on.

        But it never was about policy, or creating the best health care system, or personal responsibility or whatever else they seemed so upset about. It was a deep personal animosity toward Pres Obama, and a sort of nullification frame of mind to anything the administration does.

        “If the misery of the poor be caused not by the laws of nature, but by our institutions, great is our sin.” Charles Darwin

        by ivorybill on Thu Sep 04, 2014 at 05:56:24 AM PDT

        [ Parent ]

  •  Guess I'll believe it when it happens. (1+ / 0-)
    Recommended by:

    Even when the red state governors want to go along, the state legislatures try to kill it.

  •  Please Help! (0+ / 0-)

    Please help us and tell Rep. Bradley Byrne (of Alabama) to support expanding Medicaid Please call Phone: (251) 690-2811 Phone: (251) 972-8545 phone: (202) 225-4931 fax: (202) 225-0562 (let him have it)   

    Please help us and tell Governor (of Alabama) Bentley to expand Medicaid.  Here’s his contact number 334-242-7100 or fax 334-353-0004. (let him have it)       

  •  Those hold-out states much like the tantrum kid (1+ / 0-)
    Recommended by:

    who threatens to hold breath until getting their way.  We all know how that ends.

    We are all made of star stuff, so please be kind to dust bunnies.

    by jwinIL14 on Wed Sep 03, 2014 at 04:46:42 PM PDT

  •  The hard to ignore argument... (3+ / 0-)
    Recommended by:
    jwinIL14, judyms9, RTIII

    I've made this many times to family and friends that oppose the medicaid expansion here in NC. All Republican Gov are doing is 1) funding subsidized healthcare in more liberal states via medicare tax increase (only those making more than 250K) with nothing in return; 2) missing out on billions of dollars of federal money that will enhance local economies and create new jobs. All because of a personal hate of the President. I like to tell them... if it makes you feel better, feel free to call it RomneyCare.

  •   No state will save money by rejecting the (0+ / 0-)

    expansion, indeed every state will lose at least 100 million, or more likely billions, by not accepting the expansion before 2022. Wyoming would lose the least among the 50 states, but thats because it is the smallest state population-wise and thus has the smallest number of people covered by the expansion. Even so Wyoming is projected to lose over 100 million by 2022, in rejected fed funding and additional money the state would have to pay. 100 million is nothing to sneeze at.

  •  Wyoming doesn't want to hurt the feelings of (1+ / 0-)
    Recommended by:

    native son Dick Cheney, an Obama hater who has been literally kept alive at taxpayer expense.  Except for his few years at Haliburton, he and his family have been well cared for by US taxpayers.  I thought of Cheney when Sen. Coburn suggested we could go back to people paying for their health care by giving their doctors chickens and goats.  Cheney's heart transplant would have cleaned out Tyson's largest chicken brooding facility and required his surgeons to build their own chicken ranches.
    Here in MI some of the holdout health care insurers are joining the exchange for the next enrollment.  They just can't stand watching all that socialist spending going to their competitors.

    Building a better America with activism, cooperation, ingenuity and snacks.

    by judyms9 on Wed Sep 03, 2014 at 05:07:50 PM PDT

  •  Wyoming not the South (1+ / 0-)
    Recommended by:

    People in Wyoming may be conservative but they are not obsessed with preventing any benefits from going to blacks. The South could be very different from the other states which rejected the expansion.

  •  It was always on the table (0+ / 0-)

    Just because Wyoming is the most republican, doesn't mean it is the craziest. Moderate republicans make up a majority in the legislature, bringing plenty of funding to education, defeating attempts to curtail abortion rights, and coming very close to legalizing civil unions. The expansion was always on the table in the legislature.  Last year they decided to "study it" rather than act. So I'm not surprised by this news at all.

    •  I Have Seen No Majority Of Moderates In Wyoming (0+ / 0-)

      Not by a long shot. And that might have been true once but now the State Legislature is dominated by Tea Party fanatics and those lining their own pockets with legislation that directly benefits them and/or their corporate sponsors.

      And a perfect example of that is funding education, as they are constitutionally obligated to do, while at the same time attacking Wyoming teachers and trying to eliminate the Superintendent of Education.

      Mead also rejected an entire science curriculum because it taught about global warming.

      Collect Different Days

      by Homers24 on Wed Sep 03, 2014 at 06:53:41 PM PDT

      [ Parent ]

  •  You Bet I Had To Laugh At This (1+ / 0-)
    Recommended by:

    And this is particularly hilarious because of all the loud mouthed talk Wyo Gov Matt Mead rained down on the ACA and his refusal expand Medicaid.

    But money talks and BS walks in Wyoming and even though most of the politicians including Mead, could care less if the 17,000 who could have qualified for Medicaid actually did just die, it was a different tune once the hospitals and medical providers started crying about their losses.

    So yes one way or the other it looks like Mead and his fellow conservative/Republican/Tea Party politicians are going to be forced to do the right thing.

    Collect Different Days

    by Homers24 on Wed Sep 03, 2014 at 06:45:38 PM PDT

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