The Affordable Care Act could be declared unconstitutional and thrown out root and branch, as Mitch McConnell likes to say, by a federal court any day now. That includes Medicaid expansion, which has covered millions of low-income working people across the nation in states not too knee-jerk conservative stupid to take it.
Some of those knee-jerk conservative stupid lawmakers in Republican states, though, are quietly rethinking their idiocy. One of those states is Oklahoma, where a grassroots group is working to do what Maine, Idaho, Nebraska, and Utah did in previous elections: pass a voter initiative to bring the expansion there. But more than that, a bipartisan group of lawmakers is also considering ways to do it. Remarkably, the Republican former speaker of the House in that state, who helped lead the fight against Obamacare, now endorses it. "The reality is this," he said, "Collectively we are a rural state. Health care in rural Oklahoma is in crisis. If there's a way to bring some of our tax dollars back home to benefit the people who live in our state, I don't know why we wouldn't do that."
That's what rural Republican lawmakers in North Carolina have been saying, too. "We don't have the luxury of doing things based on some national political party's stance on some issue," Dale Wiggins, chairman of the Graham County commissioners, wrote to Republican state Senate leader Phil Berger. "Here in Graham County Senator," he wrote, "we are accustomed to being ignored by not only the governor but by our legislature as well. […] We supported Medicaid expansion because our citizens need it. Did you know Senator that our poverty level is near 30%?" he continued. "Did you know that we have several hundred working adults with no means to have health care?"
The legislature continues in a fight with Democratic Gov. Roy Cooper over his veto of their budget because it did not include Medicaid expansion, an impasse that has been going for weeks. But it has made the legislature look for a compromise, because not doing it has consequences.
That's something federal Republican lawmakers should be thinking about as well, with Trump hellbent on stripping coverage away from millions of their constituents, and a federal court poised to do it. At this point, even they know the idea that they'll come up with a replacement plan is a joke. The harder they embrace Trump, the more they'll be blamed by voters when everything comes crashing down. State-level Republicans are figuring it out; maybe the realization will trickle up.
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