When President Barack Obama signed the Patient Protection and Affordable Care Act, also known as Obamacare, into law in March 2010, a House Republican voted in favor of the law and got no GOP votes in the Senate, amid strong Democratic opposition. majority. From that day on, the Republican mantra “Repeal. “
Over the next six years, Republicans tried to repeal all or part of Obamacare more than 50 times. When the GOP finally managed to muster the votes needed for a full repeal in January 2016, Obama, unsurprisingly, vetoed the bill.
After Sen. John McCain (R-AZ) rejected a “minimal repeal” of Obamacare in July 2017, the effort is still dead.
One of the significant features of Obamacare is the expansion of Medicaid. Typically, Medicaid had limited eligibility for certain low-income children, pregnant women, parents of dependent children, the elderly, and others with disabilities. The expansion allowed states to offer Medicaid for other people based solely on their income. States had to sign up in order to download the equivalent federal budget for their expansion.
As expected, the “blue” states pulled out all the stops, while many “red” states declined. Congress passed the Families First Coronavirus Response Act in 2020, which calls for expanded Medicaid policy in all states. However, Congress decoupled the rolling enrollment provision from the COVID-19 public fitness emergency, ending rolling enrollment on March 31, 2023. As a result, 10 states have “canceled” the expansion: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin. These states refuse to continue rising costs, efficiency, and ideological opposition to a more publicly funded physical care system.
However, practical and political realities have begun to create fissures within the opposition. Former President Donald Trump’s influence and populist strategy in politics created a shift within the party, with the Republican Party now appealing to a larger working-class electorate. . In 2012, Obama beat Republican rival Mitt Romney with an electorate earning less than $50,000 by 22 points, or 60 percent to 38 percent. In 2020, that gap narrowed between Trump and President Joe Biden to 11 points, or 55% to 44%. Obama won over those without a school degree in 2012, but Trump affirmed that demographic outcome in 2016 and 2020.
Antipathy toward Obamacare has faded. In July 2014, Obamacare scored just 37 percent favorably, compared to 53 percent disapproval. In February of this year, the situation was completely reversed: 59% of the public gave a favourable opinion, while 39% disapproved.
The other challenge is that the majority of the working-class electorate in “red” states live in rural areas, where hospital closures pose a significant challenge. Eight of Mississippi’s rural hospitals have closed since 2009, and five others have entered bankruptcy proceedings since then. , according to the Mississippi Hospital Association.
It came as a surprise when the Mississippi House of Representatives passed the Healthy Mississippi Works bill on Feb. 28, which would expand Medicaid policy for 210,000 state residents. The vote in the House was 98 to 20, with no vocal opposition. .
The proponent of the expansion was Republican House Speaker Jason White. He told reporters, “As I’ve traveled around this state, visiting business leaders, network leaders, and ultimately constituents, the most consistent message I hear is the call to confront the situation. “gaps in accessibility and availability of physical care in Mississippi. I’ve found that Mississippians’ preference for staying in the workforce and out of our emergency rooms transcends any political party and affects each and every region of our state. Our determination to access fitness care is a critical piece of the economic puzzle, as a physically fit workforce underpins a fit economy.
The bill will now go to the state Senate, where it will most likely pass. The only impediment is Gov. Tate Reeves (R-MS), who is a staunch opponent of Medicaid expansion. However, if the Senate passes the bill with a no-veto majority as it did in the House, Reeves’ opinion will matter.
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In Alabama, Republican House Speaker Nathaniel Ledbetter said the state wants to “start the conversation” about expanding Medicaid coverage. Georgia has implemented a narrow Medicaid expansion, but critics say thousands of other people remain uninsured. In Kansas, the governor. Laura Kelly (D-KS) tried to convince the Republican-controlled legislature to expand Medicaid by proposing to include a painting requirement. Still, lawmakers hesitated, and Republican House Speaker Dan Hawkins said in an interview that “Medicaid deserves to be reserved only for those who want it, the children, the elderly, the disabled. “
It remains to be seen whether the reluctance continues. If the expansion is successful in Mississippi, it could be seen as a green light for other states to follow suit, especially as the 2024 election approaches.