Medicaid Expansion Is Nearly Free, But Republicans Won’t Take It Anyway

Paul Krugman writes today about the fate of the rural poor in two neighboring states. Kentucky accepted Medicaid expansion while Tennessee didn’t:

According to a Georgetown University study that covered a seven-year period spanning the introduction of the A.C.A., the percentage of low-income rural adults without health insurance fell 27 points in Kentucky, only six points in Tennessee.

I clicked and took a look at the Georgetown study. Here’s what the rural uninsured rate looks like for all expansion states compared to all nonexpansion states:

In 2009, the states are pretty mixed up. By 2016, however, there’s virtually no overlap at all: it’s all red at the top and all blue at the bottom. On average, the expansion states reduced the uninsurance rate of their rural population by 19 percentage points. The non-expansion states reduced it by only 6 points.

And it’s all for nothing. Literally. Expansion cost the states nothing at the start and only a tiny amount past 2020. It was virtually free, and the funding came from taxes these states were paying regardless. There was no reason to refuse Medicaid expansion except for sheer spite toward Barack Obama or else simple hatred of providing services for the poor—or both.

I can barely conceive of the kind of mind that thinks this way. The cruelty and contempt for their fellow citizens is just jaw dropping. And then they go out and tell all these rural folks that only Republicans have their best interests at heart and Democrats just want to rob them blind. How do they sleep at night?

THE BIG QUESTION...

as we head into 2020 is whether politics and media will be a billionaires’ game, or a playing field where the rest of us have a shot. That's what Mother Jones CEO Monika Bauerlein tackles in her annual December column—"Billionaires Are Not the Answer"—about the state of journalism and our plans for the year ahead.

We can't afford to let independent reporting depend on the goodwill of the superrich: Please help Mother Jones build an alternative to oligarchy that is funded by and answerable to its readers. Please join us with a tax-deductible, year-end donation so we can keep going after the big stories without fear, favor, or false equivalency.

THE BIG QUESTION...

as we head into 2020 is whether politics and media will be a billionaires’ game, or a playing field where the rest of us have a shot.

Please read our annual column about the state of journalism and Mother Jones' plans for the year ahead, and help us build an alternative to oligarchy by supporting our people-powered journalism with a year-end gift today.

We Recommend

Latest

Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate

We have a new comment system! We are now using Coral, from Vox Media, for comments on all new articles. We'd love your feedback.