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A Brief Ray Of Sanity

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It wasn’t easy to sway his party away from the increasingly strongly held Republican principle that poor people shouldn’t have health care, but Snyder did it:

It took two votes and eight hours of mostly closed-door politicking and vote wrangling, but the state Senate approved a plan late Tuesday to expand Medicaid health care coverage to 470,000 low-income Michiganders.

The historic 20-18 vote makes Michigan the 25th state in the nation to go ahead with the Medicaid expansion as part of the federal Affordable Care Act, according to the Kaiser Family Foundation. Five more states are debating the issue and 21 have decided not to go ahead with the expansion.

The plan almost fell apart when Sen. Patrick Colbeck, R-Canton, decided not to vote the first time the bill came up, leaving it with a 19-18 tally, one vote shy of passage.

In the longer term, you can see a basis for optimism, in that a lot of powerful interests will be lobbying to take the money, and even some conservative Republicans will want to take it. In the short term, Republican opposition to health care is sufficiently intense that a lot of state legislators will resist even when Republican governors want to take the expansion.

I also note that the refusal of many Republican statehouses to take the money makes clear that the opposition to the ACA had nothing to do with “federalism.” They don’t want to leave the provision of health care to the states; most Republicans don’t want either level of government to make health care accessible to the non-affluent. If they’re not willing to expand Medicaid if they have to pay a fraction of the costs they’re sure not going to do it if they have to pay everything.

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