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Medicaid expansionConservative political support for one of the central components of Obamacare continues to grow. The latest conversion: North Carolina House Speaker Thom Tillis.

This is from a story by reporter Craig Jarvis in Raleigh’s News & Observer about Tillis’  televised appearance on Time Warner Cable’s “Capital Tonight” show last evening:

Medicaid: Asked if he thought it would be likely that the state legislature would expand Medicaid coverage after refusing to do so previously, Tillis said it might make sense once the state has better control of the financing of the program, which is notorious for its cost overruns.

He said he didn’t have an ideological objection to expanding the coverage. But he said when the state auditor told the previous governor that money was being wasted on it, the appropriate response would not have been to make it bigger and more costly.

“I would encourage the state legislature and governor to consider it if they’re completely convinced they now have the situation under control,” Tillis said.

In other words, the Speaker is echoing the McCrory administration’s imperfect but mostly encouraging line on the issue. Let’s fervently hope that Tillis’ successor as House Speaker and Senate President Pro Tem Berger adopt this same common-sense stance so that the matter can be disposed of as early in 2015 as possible.

Commentary

The ideologues on the far right may continue to scream for “repeal” of Obamacare, but the evidence continues to pile up that this is simply not something that’s going to happen. That was the analysis delivered by Judy Waxman of the National Women’s Law Center at this morning’s NC Policy Watch Crucial Conversation breakfast in Raleigh. Waxman noted that amendments to the ACA are certainly likely — indeed, she thinks they are essential — but based on decades of experience in Washington and her numerous political and policy contacts around the country, she believes repeal is simply not in the cards.

Waxman’s analysis is consistent with this AP story that ran on several North Carolina news sites this morning. This is from the version that ran in Raleigh’s News & Observer under the headline “GOP governors don’t see ‘Obamacare’ going away”:

Nine Republican governors have expanded Medicaid for low-income people in their states, despite their own misgivings and adamant opposition from conservative legislators. Three more governors are negotiating with the Democratic administration in Washington.

Rather than demanding repeal, the governors generally have sought federal concessions to make their decisions more politically acceptable at home. That approach is in sharp contrast to the anti-Obamacare fervor of their party in Congress.

Ohio Gov. John Kasich says he doesn’t think there will be a repeal in Washington, even if Republicans win a Senate majority and consolidate their hold on the House in next month’s election.

“That’s not gonna happen,” the Republican governor told The Associated Press during a recent re-election campaign swing.

This take on the situation is consistent with the views expressed recently and repeatedly by the McCrory administration of late that Medicaid expansion in North Carolina under the ACA should and will occur in the near future.

Commentary

If there’s one story that’s been notably and inexplicably under-reported in the mainstream news media this week it’s been this one. As  our former colleague Adam Searing, to his credit, reported Monday:

In two interviews over the last few days, North Carolina’s Secretary of the Department of Health and Human Services Dr. Aldona Wos and NC’s Medicaid Director Dr. Robin Cummings address the question of Medicaid expansion in NC:  How soon, the presentation of options for policymakers and whether the state should create its own unique plan are discussed.  Both officials comment on the fact that the federal government is working with states to create state-tailored plans and seem clear that North Carolina’s Governor will be presented with options for expansion that can be taken to NC’s General Assembly.  No timeline is discussed, but NC’s legislature reconvenes in January 2015.

Click here to watch Health and Human Services Secretary Aldona Wos and Medicaid Director Robin Cummings finally confirm plans to do what advocates, providers and economists have been demanding for nearly two years: expand Medicaid.

Commentary
Obama window

Pres. Obama and a staffer hail Rose Garden maintenance team to join them at today’s press event. Photo: www.whitehouse.gov

President proposes heath care expansion financed by rich liberals, people of color and immigrants
Conservative leaders skeptical that tax plan is sufficiently targeted

WASHINGTON - In an effort to break the logjam that has kept millions of Americans in numerous states from fully participating in all aspects of the Affordable Care Act, President Obama announced today that he would offer yet another olive branch to conservative critics of his signature health plan.

Under a new initiative the President referred to as the “Keeping Our Citizens Healthy by Selling-out Wholesale If Necessary” plan or “KOCHS WIN” for short, Medicaid expansion and other costs associated with the Affordable Care Act would be underwritten as of January, 2015 via a series of new taxes to be levied directly on three of Mr. Obama’s most loyal groups of supporters: liberal billionaires, people of color and immigrants. The President announced the new plan today at a White House ceremony in which he was joined by Warren Buffett, Bill Gates, George Soros and a several members of the Rose Garden maintenance team.

According to Mr. Obama, the KOCHS WIN plan was just his latest good-faith effort to do whatever it takes to find common ground with critics who have fought the Affordable Care Act and virtually every other initiative of his administration since it took office in 2009, even when the initiatives in question were originally the critics’ ideas.

“My administration has compromised so much on so many things at this point – Iraq, Guantanamo, taxes, trade, reproductive rights, immigration, gun control, just to name a few – that this one was really a no-brainer,“ said the President. Hearkening back to a theme that has arisen repeatedly over the last five and a half years, Mr. Obama declared that “there are very few principles of progressivism and good governance that we aren’t prepared to sacrifice in order to get a deal and maybe save some lives.”

New tax schemes

Under the plan, which Mr. Buffett claimed to have first suggested to the President during toasts at a White House state dinner for African leaders last month, each of the growing number of billionaires who have contributed to the President’s Organizing for Action advocacy group and its affiliated nonprofits, plus those who are registered as Democrats or who have significant holdings in the film industry, will pay a special one-time surtax of 3% of their net wealth.

“Heck, I told the President that Bill, George and I ought to probably just pay for the whole darned thing ourselves,” said Mr. Buffett. “But he said ‘no, if we’re going to have a shot at getting this through we can’t let ourselves be accused of engaging in class warfare.’ That’s when someone – I think it was Harry Reid – suggested a small tax on some other groups conservatives love to hate. ”

Those other groups, under the initial version of the KOCHS WIN plan, would be immigrants and lower-income minorities – both of which would be targeted for new federal excise taxes. Read More

Commentary

Health-Reform-SBFinding irony and contradictions in the arguments espoused by Obamacare haters is not a difficult thing to do. Heck, one of the nation’s most powerful opponents of the new law is trying to force its repeal even as he embraces its remarkably positive impact in his home state!

That said, a new issue brief from the Center for Economic and Policy Research points to an especially interesting and problematic finding for opponents who continue to lambaste the law as an “assault on freedom”: the law is actually enhancing freedom. It’s doing this for millions of average Americans in a vitally important way by expanding their choices when it comes to how, when and where they work. Here’s the introduction:

“Most of the discussion of the Affordable Care Act (ACA) has focused on the extent to which it has extended health insurance coverage to the formerly uninsured. This is certainly an important aspect of the law. However by allowing people to buy insurance through the exchanges and extending Medicaid coverage to millions of people,
the ACA also largely ends workers’ dependence on their employer for insurance. This gives tens of millions of people the option to change their job, to work part-time, or take time off to be with young children or family members in need of care, or to retire early. Read More