Governor Dennis Daugaard's position on the Affordable Care Act's Medicaid expansion may be shifting a bit. In the pretty clear you-lazy-bums language of his budget address in December, he said expanding Medicaid is bad, bad, bad. But now he's saying he doesn't want to expand it "for now" because of uncertainty over federal funding.
Maybe Daugaard got an early memo from fellow Republican Governor Jan Brewer of Arizona: ObamaCare is here to stay, and expanding Medicaid is good for the states. In her State of the State address yesterday, the notably conservative Republican said she will sign Arizona up for the Medicaid expansion, saying it makes no sense to reject this opportunity:
Under the Affordable Care Act, if Arizona boosts eligibility to 138 percent Washington would initially pick up virtually all of the extra cost, eventually scaling back to about 90 percent. Brewer told Republican colleagues who control the state House and Senate it makes no sense to pass up those dollars.
"We will protect rural and safety-net hospitals from being pushed to the brink by growing their cost in caring for the uninsured,'' the governor said. Brewer said joining the federal program will create enormous economic benefit, inject $2 billion into the Arizona economy, save and create thousands of jobs and provide health care to hundreds of thousands of low-income individuals.
The governor said going along will save money. She said the costs of providing care to the uninsured are not simply absorbed by hospitals but passed along.
"Health care premiums are raised year after year to account for expenses incurred by our hospitals,'' she said. "This amounts to a hidden tax estimated at nearly $2,000 per family per year [Howard Fischer, "Brewer Address: Ariz. Should Expand Medicaid, CPS Efforts," East Valley Tribune (Tempe, AZ), 2013.01.14].
But what about that niggling uncertainty that the SDGOP wants to study oh-so-cautiously before submitting to Obama's tyranny? Nuts, says Governor Brewer:
Conversely, Brewer said it won't raise taxes in Arizona.
She said the state's share will be paid for by a "bed tax'' on hospitals. And Brewer said if Washington cuts funding, the state law would including a "circuit breaker'' to automatically roll back enrollment [Fischer, 2013.01.14].
Governor Brewer just destroyed the last reasons Governor Daugaard could offer for balking at the cost-saving, life-saving Medicaid expansion. If a conservative firebrand like Governor Brewer can say Governor Daugaard's position "makes no sense" and embrace the Affordable Care Act, then Governor Daugaard can, too.
President Obama has won. ObamaCare has won. Let's bury that argument (Brewer's action signals the GOP realizes campaigning against ObamaCare is no longer a winning argument) and adopt good policy for South Dakota.