Obamacare

Where Each State Stands on Medicaid Expansion

Where Each State Stands on Medicaid Expansion

The Supreme Court’s ruling on the Affordable Care Act (ACA) allowed states to opt out of the law’s Medicaid expansion, leaving each state’s decision to participate in the hands of the nation’s governors and state leaders.

A roundup of what each state’s leadership has said about their Medicaid plans

February 27, 2013 Text last updated on Feb. 26, 2013, at 3:45 p.m. ETmedicaid_map

For an interactive map where you can hover your cursor over a state to see the policy of the state, please click here.
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The Supreme Court’s ruling on the Affordable Care Act (ACA) allowed states to opt out of the law’s Medicaid expansion, leaving each state’s decision to participate in the hands of the nation’s governors and state leaders.

Based on lawmakers’ statements, press releases, and media coverage, the Daily Briefing and American Health Line editorial teams have rounded up where each state currently stands on the expansion.

NOT PARTICIPATING (14 states)

  • Alabama*: Gov. Robert Bentley (R) on Nov. 13 announced that Alabama will not participate in the Medicaid expansion “because we simply cannot afford it” (Gadsden Times, 11/13; Lyman, Montgomery Advertiser, 11/13).
  • Georgia*: Gov. Nathan Deal (R) in an Atlanta Journal-Constitution/Politico/11 Alive interview on Aug. 28 said, “No, I do not have any intentions of expanding Medicaid,” adding, “I think that is something our state cannot afford.” When asked about the insurance exchanges, Deal said “we do have a time frame for making the decision on that I think, especially on the exchanges,” adding that “we have just a few days after the election in order to make a final determination on that” (Wingfield, “Kyle Wingfield,” Atlanta Journal-Constitution, 8/28).
  • Idaho*: Gov. C.L. Otter (R) in his 2013 State of the State address delivered on Jan. 7 said that while “there is broad agreement that the existing Medicaid program is broken,” the state “face[s] no immediate federal deadline” to address the situation. He added, “We have time to do this right … [s]o I’m seeking no expansion of” the program. Otter said he’s instructed the state Health and Welfare director to “flesh out a plan” that focuses on potential costs, savings and economic impact, which he plans to introduce in 2014 (Ritter Saunders, Boise State Public Radio, 1/7; Young, Huffington Post, 1/7; Petcash, KTVB, 1/7).
  • Iowa*: Gov. Terry Branstad (R) on Feb. 23 said that he has informed HHS Secretary Kathleen Sebelius that he will not expand Medicaid in Iowa because of concerns that the expansion “will either collapse or the burden will be pushed onto the states in a very significant way.” Instead, Branstad pressed Sebelius for a federal waiver to continue IowaCare, a health care program that provides limited benefits to 70,000 low-income state residents (AP/Modern Healthcare, 2/24).
  • Louisiana*: Gov. Bobby Jindal (R) in an NBC “Meet the Press” interview on July 1 said, “Every governor’s got two critical decisions to make. One is do we set up these exchanges? And, secondly, do we expand Medicaid? And, no, in Louisiana, we’re not doing either one of those things.” However, state Sen. Karen Carter Peterson (D) and other Democratic leaders after the Nov. 6 election urged Jindal to reconsider his opposition or the state will not be forced to accept a “one-size-fits-all” plan, CBC News “Money Watch” reports (Barrow, New Orleans Times-Picayune, 7/2; “Money Watch,” CBS News, 11/9).
  • Maine*: Gov. Paul LePage (R) on Nov. 16 said that Maine will not participate in the Medicaid expansion. He called the expansion and the state-based insurance exchanges a “degradation of our nation’s premier health care system” (Mistler, Kennebec Journal, 11/16).
  • Mississippi*: Gov. Phil Bryant (R) on Nov. 7 said Mississippi will not participate in the Medicaid expansion, reiterating previous statements that he had made about the ACA provision (Pender/Hall, Jackson Clarion-Ledger, 11/7).
  • North Carolina: Gov. Pat McCrory (R) on Feb. 12 announced that his state will not expand Medicaid or establish its own health insurance marketplace under the Affordable Care Act. McCrory said state officials conducted a comprehensive analysis to determine the advantages and disadvantages of expanding Medicaid and the right type of exchange option in the state, and concluded that it is “abundantly clear that North Carolina is not ready to expand the Medicaid system and that we should utilize a federal exchange.” He said the review included discussions with other governors, White House officials, health care providers, and leaders in the state Legislature (AP/Myrtle Beach Sun News, 2/12; Binker/Burns, “@NCCapitol,” WRAL, 2/12; Cornatzer, Raleigh News & Observer, 2/12).
  • Oklahoma: Gov. Mary Fallin (R) on Nov. 19 said Oklahoma will not participate in the Medicaid expansion. “Oklahoma will not be participating in the Obama Administration’s proposed expansion of Medicaid,” she said in a statement. She noted that the program would cost the state as much as $475 million over the next eight years (Greene, Tulsa World, 11/19).
  • Pennsylvania*: Gov. Tom Corbett (R) on Feb. 5 sent a letter to HHS saying he “cannot recommend a dramatic Medicaid expansion” in Pennsylvania because “it would be financially unsustainable for Pennsylvania taxpayers.” He noted that the expansion would necessitate “a large tax increase on Pennsylvania families” (Tolland, Pittsburgh Post-Gazette, 2/5).
  • South Carolina*: Gov. Nikki Haley (R) on July 1 announced via Facebook that South Carolina “will NOT expand Medicaid, or participate in any health exchanges.” The state Legislature is expected to make a decision on the Medicaid expansion during the 2013 session (Gov. Haley Facebook page, 7/1; Holleman, Columbia State, 11/9).
  • South Dakota: Gov. Dennis Daugaard (R) in his annual budget address on Dec. 4 said he does not plan to participate in the Medicaid expansion. “I really think it would be premature to expand this year,” he said, adding that he hoped for more flexibility for the state program (Montgomery, Sioux Falls Argus Leader, 12/4).
  • Texas*: Gov. Rick Perry (R) in a statement on July 9 said, “If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under ObamaCare.” Perry also sent a letter to HHS Secretary Kathleen Sebelius on July 9 asserting this position. The Dallas Morning News reported that on Nov. 8, Perry reiterated his opposition to the expansion, saying, “Nothing changes from our perspective” (Office of Gov. Perry release, 7/9; Gov. Perry letter, 7/9; Garrett, Dallas Morning News, 11/11).
  • Wisconsin*: Gov. Scott Walker (R) on Feb. 13 announced his rejection of the Medicaid expansion. He proposed an alternative plan that would expand coverage to low-income state residents through private health care exchanges (Spicuzza, Wisconsin State Journal, 2/13).

LEANING TOWARD NOT PARTICIPATING (2 states)

  • Nebraska*: Gov. Dave Heineman (R) in a statement on his website on June 28 said, “As I have said repeatedly, if this unfunded Medicaid expansion is implemented, state aid to education and funding for the University of Nebraska will be cut or taxes will be increased. If some state senators want to increase taxes or cut education funding, I will oppose them.” Heineman on July 11 sent a letter to state lawmakers saying the state could not afford the expansion, but he stopped short of saying that the state will not participate in the expansion, according to Reuters (Office of Gov. Heineman release, 6/28; Wisniewski, Reuters, 7/11).
  • Wyoming*: Gov. Matt Mead (R) on Nov. 30 recommended that Wyoming not participate in the Medicaid expansion, but added that his position could change in the future and urged “everyone to keep an open mind on this.” The state legislature will make the final decision on whether to expand the program, the AP/Jackson Hole Daily reports (Brown, Wyoming Tribune Eagle, 12/1; Graham, AP/Jackson Hole Daily, 12/1).

LEANING TOWARD PARTICIPATING (4 states)

  • Kentucky: Gov. Steve Beshear (D) when asked about the expansion in July said, “If there is a way that we can afford that will get more coverage for more Kentuckians, I’m for it.” However, state lawmakers are putting pressure on Beshear to reject the expansion (Office of Gov. Beshear release, 6/28; AP/Evansville Courier & Press, 6/28; AP/Evansville Courier & Press, 7/17; Autry, WYU, 7/5; Cross, Louisville Courier-Journal, 6/29).
  • New York: Gov. Andrew Cuomo (D) in a statement on his website on June 28 said he was “pleased the Supreme Court upheld the [ACA]” and looks forward “to continuing to work together with the Obama administration to ensure accessible, quality care for all New Yorkers.” On July 26, Danielle Holahan—project director for New York’s health insurance exchange planning—said the state “largely meet[s] the federal required Medicaid levels already.” Although Cuomo’s office has not officially announced a decision, the Associated Press reported on Nov. 13 that New York will expand Medicaid (Office Gov. Cuomo release, 6/28; Grant, North Country Public Radio, 7/27; Delli Santi/Mulvihill, AP/San Francisco Chronicle, 11/13).
  • Oregon: Gov. John Kitzhaber (D) said on June 28 that he is confident that the Oregon Legislature will approve a state Medicaid decision. In an interview with the Oregonian just hours after the Supreme Court issued its ruling on the ACA, Kitzhaber said, “We’ll make a decision on whether or not to expand the Medicaid program really based on, I think, the resources we have available in the general fund for that purpose going forward” (Budnick, Oregonian, 6/28).
  • Virginia: The House of Delegates and Senate on Feb. 23 amended the state budget to include the ability to expand the state’s Medicaid program. According to the Richmond Times-Dispatch, the move gives “a green light” to talks between state and federal officials over flexibility in the Medicaid program. Although Medicaid expansion supporters have hailed the legislative action as a victory, Gov. Bob McDonnell (R) on Feb. 23 said, “As long as I’m governor, there’s not going to be any Medicaid expansion unless there is sustainable, long-lasting, cost-saving reforms” (Martz, Richmond Times-Dispatch, 2/24).

PARTICIPATING (24 states and the District of Columbia)

  • Arizona*: Gov. Jan Brewer (R) in her 2013 State of the State speech, delivered on Jan. 14, announced that Arizona will participate in the Medicaid expansion, which would extend health care services to an estimated 300,000 more state residents. Brewer noted that the expansion plan will “include a circuit-breaker that automatically” would reduce enrollment if federal reimbursement rates decrease. Brewer was expected to offer further details of the plan in her budget proposal, which is subject to approval by the Republican-controlled Legislature (Christie, AP/Sacramento Bee, 1/14; Sanders/Wingett Sanchez, Arizona Republic, 1/14; Fischer, Sierra Vista Herald, 1/14; Safier, Tucson Citizen, 1/14).
  • Arkansas: Gov. Mike Beebe (D) on Sept. 11 said he planned to participate in the Medicaid expansion, the Associated Press reports. According to the AP, Beebe agreed to participate in the expansion after officials assured him the state could opt out later if it faces a financial crunch. Beebe said, “I’m for it. I think it’s good for our people because it’s helping folks that don’t have insurance now that are working their tails off. They’re not sitting on a couch somewhere asking for something” (Brantley, Arkansas Times, 9/11).
  • California: Gov. Jerry Brown (D) in a statement on June 28 said the Supreme Court’s ruling “removes the last roadblock to fulfilling President Obama’s historic plan to bring health care to millions of uninsured citizens.” California got a head start on expanding its Medicaid program in November 2010 with its “Bridge to Reform” program, which aimed to bring at least two million uninsured Californians into Medicaid (Office of Gov. Brown release, 6/28; DeBord, “KPCC News,” KPCC, 6/28).
  • Colorado*: Gov. John Hickenlooper (D) on Jan. 3 announced that his state will participate in the expansion. In a news release, his office said the move would extend Medicaid coverage to about 160,000 low-income residents and save Colorado an estimated $280 million over 10 years without affecting the state’s general fund (Stokols, KDVR, 1/3; Wyatt, AP/Denver Post, 1/3).
  • Connecticut: Gov. Dannel Malloy (D) was among the first governors to sign up for the Medicaid expansion after the ACA was enacted in March 2010. Soon after the Supreme Court ruling on June 28, Malloy said “it’s great … [and a] very important decision for the people of Connecticut. 500,000 people would have lost coverage if Republicans had their way” (Davis, WTNH, 6/28).
  • Delaware: Gov. Jack Markell (D) in a statement on June 28 said, “The Supreme Court’s ruling enables Delaware to continue to implement provisions of the Patient Protection and Affordable Care Act to provide access to health care benefits for Delawareans.” He added, “On the Medicaid front, Delaware already voluntarily expanded the state’s Medicaid coverage program in 1996 to cover many Delawareans not previously covered” (Office of Gov. Markell release, 6/28).
  • District of Columbia: D.C. Mayor Vincent Gray (D) in a statement on June 28 said, “The District is not at risk of losing any Medicaid funding as a result of this ruling, because District officials have already begun implementation of the ACA’s Medicaid-expansion provisions and will continue to implement the expansion” (Executive Office of the Mayor release, 6/28).
  • Florida*: Gov. Rick Scott (R) on Feb. 20 announced that the state will participate in the ACA’s Medicaid expansion, citing HHS’s conditional support for a waiver to shift most of the state’s Medicaid beneficiaries into a managed-care program. However, Scott said that Florida would only participate in the expansion for three years before reevaluating the decision. Supporters of the ACA heralded Florida’s shift as a major reversal; Scott mounted his successful campaign for governor in 2010, in part, by being one of the nation’s foremost critics of President Obama’s planned health reforms (Kennedy/Fineout, Associated Press, 2/20; Office of Gov. Scott release, 2/20).
  • Hawaii: Gov. Neil Abercrombie (D) in a statement on June 28 welcomed the Supreme Court’s ruling and said the ACA “is our ally” in the effort to “support a health care system that ensures high quality, safety and sustainable costs.” Pat McManaman, director of the state Department of Human Services, said Hawaii’s Medicaid eligibility requirements in July would fall in line with the law’ guidelines, meaning an additional 24,000 people will be eligible for the program by 2014 (Office of Gov. Abercrombie release, 6/28; Garcia, AP/CBS News, 6/29).
  • Illinois: Gov. Pat Quinn (D) on June 28 praised the court’s decision and said he “will continue to work with President Obama to help working families get the healthcare coverage they need,” including expanding Medicaid (Office of the Governor release, 6/28; Thomason, Rock River Times, 7/3; Ehley, Fiscal Times, 8/20).
  • Maryland: Gov. Martin O’Malley (D) in a statement on June 28 said the Supreme Court’s decision “gives considerable momentum to our health care reform efforts here in Maryland,” adding that the state will move forward to implement the overhaul (Office of the Governor release, 6/28).
  • Massachusetts: Gov. Deval Patrick (D) in late June said Massachusetts is “an early expansion state as you know and we’re expecting further resources from the federal government to sustain the experiment here in Massachusetts.” Patrick called the ruling “good news for us” (Walker, YNN, 6/28).
  • Michigan*: Gov. Rick Snyder (R), in a statement released on Feb. 6, announced that his fiscal year 2014 budget proposal includes a plan to expand the state’s Medicaid program under the Affordable Care Act. The plan would extend Medicaid benefits to about 320,000 eligible residents. Snyder said the plan contains safeguards that will ensure the financial stability of the program and protect against changes in the government’s financial commitment to the expansion (Office of Gov. Snyder release, 2/6).
  • Minnesota: Gov. Mark Dayton (D) said in a statement on June 28 said, “Today’s ruling will be met with relief by the Minnesotans whose lives have already been improved by this law.” Dayton in 2011 used federal money to expand Medicaid early to 84,000 adults with annual incomes below $8,400 (Lohn, AP/San Francisco Chronicle, 6/28).
  • Missouri: Gov. Jay Nixon (D) on Nov. 29 announced that Missouri will participate in the Medicaid expansion. Nixon said he will include the expansion in the state budget proposal he submits to lawmakers. “We’re not going to let politics get in the way of doing the best thing for our state,” he said (Crisp, “Political Fix,” St. Louis Post-Dispatch, 11/29).
  • Montana: Gov.-elect Steve Bullock (D) — who takes office on Jan. 7 — on Jan. 4 announced several changes to outgoing Gov. Brian Schweitzer’s (D) two-year budget recommendations, but retained the proposal to expand Medicaid. During a news conference, Bullock said the Medicaid expansion is part of his “Access Health Montana” plan to increase health care coverage for more Montana families. (Johnson, Billings Gazette, 1/5; Johnson, Montana Standard, 1/5).
  • Nevada*: Gov. Brian Sandoval (R) on Dec. 11 announced that the state will participate in the Medicaid expansion. “Though I have never liked the Affordable Care Act because of the individual mandate it places on citizens, the increased burden on businesses and concerns about access to health care, the law has been upheld by the Supreme Court,” Sandoval said in a statement, adding, “As such, I am forced to accept it as today’s reality and I have decided to expand Nevada’s Medicaid coverage” (Damon, Las Vegas Sun, 12/11).
  • New Jersey: Gov. Chris Christie (R) in his Feb. 26 budget address announced that New Jersey will participate in the Medicaid expansion. The ACA provision is expected to extended Medicaid coverage to about 300,000 uninsured New Jersey residents (Delli Santi, AP/San Francisco Chronicle, 2/26).
  • New Hampshire: Gov. Maggie Hassan (D) in her Feb. 14 budget address said that New Hampshire will opt into the ACA’s Medicaid expansion because “it’s a good deal…[that will] allow us to save money in existing state programs, while increasing state revenues.” A state report estimates that the expansion will cost New Hampshire about $85 million through 2020, but will bring in $2.5 billion in federal funds and help reduce the number of uninsured residents from roughly 170,000 to 71,000 (Ramer, AP/Seacoastonline.com, 2/14)
  • New Mexico: Gov. Susana Martinez (R) on Jan. 9 announced that her state will participate in the Medicaid expansion, which potentially could extend health coverage to nearly 170,000 additional low-income uninsured residents. Martinez noted that contingency measures will be established if federal funding for the expansion diminishes, which would mean scaling back the expansion by dropping newly covered beneficiaries from the Medicaid rolls (Massey/Montoya Bryan, AP/Santa Fe New Mexican, 1/9; Schirtzinger, Santa Fe Reporter, 1/9; Reichbach, New Mexico Telegram, 1/9).
  • North Dakota*: Gov. Jack Dalrymple (R) in January said the politics associated with the ACA should not prevent North Dakota from participating in the Medicaid expansion. He is supporting a bill that would allow the state health department to access federal funds allocated through the ACA. Dalrymple also said he will include the expansion in his budget proposal and that members of his staff will testify in favor of the expansion before state lawmakers (Jerke, Grand Forks Herald, 1/12).
  • Ohio*: Gov. John Kasich (R) on Feb. 4 announced that the state will be participating in the Medicaid expansion, the Cleveland Plain Dealer reports. He made the announcement in his two-year budget announcement, but warned that Ohio would “reverse this decision” if the federal government does not provide the funds it has pledged to the expansion (Tribble, Cleveland Plain Dealer, 2/4).
  • Rhode Island: Gov. Lincoln Chaffee (I) in a statement on his website on June 28 said, “I have fully committed to ensuring Rhode Island is a national leader in implementing health reform whatever the Supreme Court decision, and this just reinforces that commitment.” According to Steven Costantino, the state’s secretary of health and human services, “The expansion is easy to do and makes sense.” Moreover, on July 12, USA Today reported that Chaffee planned to participate in the expansion (Chaffee statement, 6/28; Wolf, USA Today, 7/12; Radnofsky et al., Wall Street Journal, 7/2).
  • Vermont: Gov. Peter Shumlin (D) on June 28 said Vermont’s Medicaid program already meets the requirements under the health reform law’s Medicaid expansion (Steimle, WCAX, 7/1).
  • Washington*: In an email responding to a query by American Health Line, Karina Shagren—a deputy communications director in Gov. Chris Gregoire’s (D) administration—in early July said “the governor supports the Medicaid expansion—and Washington will move forward.” U.S. Rep. Jay Inslee (D)—who supports the expansion—was elected governor on Nov. 6 (Shagren email, 7/5; Washington Secretary of State website, 11/12).

UNDECIDED/NO COMMENT (6 states)

  • Alaska*: Gov. Sean Parnell (R) on Aug. 8 said he is guarded on the expansion “because our history with the federal government right now is they cut what they promise to fund.” Parnell said he wants to thoroughly understand the costs to the state before making a decision (Bohrer, AP/San Francisco Chronicle, 8/8).
  • Indiana*: Gov. Mitch Daniels (R) in a statement on June 29 said, “Any decision to expand Medicaid in 2014 is entirely the province of the next General Assembly and governor.” U.S. Rep. Mike Pence (R) was elected governor on Nov. 6. In a position statement earlier this year, Pence noted that the Medicaid expansion would double “down on an already broken and unaffordable Medicaid system.” Addressing the Affordable Care Act as a whole, he wrote, “I believe the State of Indiana should take no part in this deeply flawed healthcare bureaucracy” (Office of Gov. Daniels release, 6/29; Pence letter).
  • Kansas*: Gov. Sam Brownback (R), who has been a vocal opponent of the Affordable Care Act, has not stated whether to opt in or out of the Medicaid expansion, the Associated Press reported on Nov. 9 (AP/NECN, 11/9).
  • Tennessee: Gov. Bill Haslam (R) has not decided whether Tennessee will participate in the Medicaid expansion. However, two lawmakers—Sen. Brian Kelsey (R) and Rep. Jeremy Durham (R)—already have committed to introducing legislation that would block expansion, and the state’s new Republican supermajority in the General Assembly means such a bill could pass (Bohs, “Bohs Column,” The Jackson Sun, 11/9).
  • Utah*: In an email responding to a query by American Health Line, Nate McDonald—public information officer for Gov. Gary Herbert (R), who won re-election in the state’s gubernatorial race in November 2012—said “[n]o official decision” has been made on the Medicaid expansion (McDonald email, 11/9).
  • West Virginia: Gov. Earl Ray Tomblin (D) in a statement on his website on June 28 said, “We know what the law is but as I’ve said before, I will continue to do what is best for West Virginia … We’re going to review the Supreme Court’s ruling, and work with our federal delegation on how we move forward.” In the state’s gubernatorial race in November 2012, Tomblin was re-elected (Office of Gov. Tomblin release, 6/28; AP/Marietta Times, 11/7).

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This article is composed by The Advisory Board for their Daily Briefing.  It can be seen at http://www.advisory.com/Daily-Briefing/2012/11/09/MedicaidMap#lightbox/0/
The Advisory Board Company

NC House to take different path on Medicaid bill

Bill blocks federal health care law

ObamacareRALEIGH — The state Senate gave final approval to a health care bill laden with politics Tuesday, even as Gov. Pat McCrory renewed his objections saying the measure could cost state taxpayers millions of dollars.

With the 32-17 vote, the legislation now goes to the House, where Republican leaders plan to take a slower approach than the Senate, which pushed it through just days after being introduced.

The bill is designed to block the implementation of major parts of the federal health care law in North Carolina, preventing low-income residents from receiving health coverage under Medicaid and prohibiting a state-sponsored online marketplace for insurance policies.

The GOP-dominated Senate used the debate to attack President Barack Obama’s health care law and demonstrated their independence from the governor. McCrory asked the Senate to delay the bill, but lawmakers ignored the request.

House lawmakers plan to take a different tact, taking extra time to address the governor’s concerns, said Speaker Thom Tillis (R-ALEC).

But the Cornelius Republican made it clear that the House, like the Senate, stands opposed to the federal health care law.

“I remain consistent in my opposition to both an expansion of Medicaid and the establishment of a state-based health exchange in North Carolina,” Tillis said in a statement.

McCrory is worried the bill may cost the state money because it would jeopardize a $40 million federal grant that pays for the current Medicaid tracking system. The state received the money after former Gov. Bev Perdue took the first steps toward a joint federal-state health care exchange.

“We are optimistic that we can hopefully work out an agreement with the House to deal with some of our concerns about the cost to the North Carolina taxpayers,” McCrory said Tuesday. “We hope we can work those out before it gets through the legislature because we continue to have those concerns.”

The expansion of Medicaid would provide health care coverage to as many as 648,000 low-income residents, a large portion of which don’t have health insurance. The program currently only covers low-income women, the disabled, the elderly and children. The federal government will fully fund the newly eligible for the first three years and then pay no less than 90 percent going forward.

More than 700,000 North Carolinians are expected to shop for insurance policies through the online health care exchange. If the state doesn’t participate, the federal government will craft a marketplace for the state.

Elsewhere across the country, at least five Republican governors plan to take the money while at least nine GOP chief executives are refusing the expand Medicaid.

Ohio Gov. John R. Kasich (R-ALEC), a fierce opponent of the Affordable Care Act and a strident conservative, is the latest to opt for expansion. In releasing his budget this week, Kasich argued expanding Medicaid would save money because fewer uninsured people would seek care at emergency rooms and drive up health costs – the same argument critics are making against the North Carolina bill.

Sen. Pete Brunstetter, a Winston-Salem Republican, said if Washington changes the terms of the deal, lawmakers will reconsider. But right now, “we don’t trust the federal government” to pay for its share of the expansion. He said the Senate will alleviate McCrory’s concerns through separate legislation.

“We do think we are backing into both the state-based exchange and Medicaid expansion” through current actions, he said. “We don’t want to take the money under false pretenses.”

 

N.C. switches stance on drivers licenses for illegal immigrants

Crap!  We’ve know it was coming, but the shitstorm of rad-right legislation that is only to be expected by a state led by a Duke Energy exec–paytoplaypat, Art Pope, an ALEC-dominated State Legislature – a supermajority in Raleigh.

Recently I reposted an article from Mother Jones talking about the Democracy Initiative where they reported that this new, amply funded liberal action group (” The groups in attendance pledged a total of millions of dollars and dozens of organizers to form a united front on these issues…) would be making North Carolina one of its top targets, where “the fight is more about countering the influence of a single powerful donor, the conservative millionaire Art Pope, whose largesse helped install a Republican governor and turn the state legislature entirely red.”

  • North Carolina was the first state to file against Obamacare.
  • North Carolina will not have a state insurance exchange, a recommended action in ALEC’s Plan to Repeal Obamacare. More →

What I learned from the ALEC 2012 Spring Task Force Summit

editor’s note:  This is a fascinating article, a first person account by a conservative ALEC member from New Hampshire.  As a conservative, he was involved in the meetings, as opposed to the way ALEC has treated Marc Pocan–keep him away from everything.

This is a very significant article for the information and insights into conservative thought and the worldview that it shows.  There are also some previously unseen ALEC Model Legislation found in the links of Mancuse’s article, which will be published separately of this narrative. I thought of excerpting this “diary”, but found it too interesting to cut.

Having grown up in New England and having a number of good friends living in New Hampshire,  I need to yell: 
                                LOOK OUT NEW HAMPSHIRE!!!
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What I learned from the ALEC 2012 Spring Task Force Summit: My trip to the ALEC Conference in Charlotte, N.C., Part II

CHARLOTTE, N.C.—As a freshman attendant at the American Legislative Exchange Council Spring 2012 summit, I was assigned to the Commerce, Insurance and Economic Development Task Force, which More →

Presidential race may leave lasting imprint on Supreme Court

Future appointments by Obama or Romney could be pivotal on issues of gay rights, gun laws, abortion and money in politics.

The Supreme Court is not on the ballot in November, but its future direction on issues such as abortion, gay rights, gun rights, voting laws and the role of money in politics depends on who is elected president for the next four years.

Clint Bolick, a lawyer for the Goldwater Institute in Phoenix, is not rooting for an Obama victory, but he agrees the election could have a lasting effect on a closely split court. “The average justice remains in office nearly 25 years — more than six presidential terms. Supreme Court nominations are one of most enduring legacies a president has,” he said.

Obama’s two appointees — Justices Sonia Sotomayor, 58, and Elena Kagan, 52 — have generally liberal voting records. Sotomayor was in the minority in the 5-4 decision in the Citizens United case, which freed corporations and unions to independently spend unlimited sums on campaign ads, and Kagan opposed the move when she served as solicitor general.

Given one more liberal vote, the court would likely switch directions on campaign money and uphold laws that limit election spending and require the full disclosure of donors. With an extra conservative vote, however, the justices on the right are likely to go further and free big donors — including corporations — to give money directly to candidates and parties.

The law on abortion could also switch with a change of one justice. With an extra vote on the right, the six Republican appointees would likely uphold strict regulation of abortion, and possibly a criminal ban. With an extra vote on the left, however, the liberal bloc could strike down state or federal regulations that limit abortions or restrict abortion doctors.

To read this incisive report by David Savage in the L.A. Times please click here.

And if you are thinking of not voting or making a symbolic futile vote, just think of what another activist conservative Federalist Supreme Court Justice can do to influence the next 25 years,

What Hath Roberts Wrought?

But Roberts is a conservative, and a very smart, forward-looking one at that.  What Roberts accomplished on one issue was to enshrine two conservative ideologies — without the Democrats even noticing while they were cheering.  He did this by using the Court’s ability to turn metaphors into law. He accomplished this with two votes.

…First he was the swing vote that imposed the idea that Health Care Is A Product and set the stage for a possible general principle: The Interstate Commerce Clause governs the buying and selling of products and the government cannot force anyone to people to buy a product (real or metaphorical).

Second, Roberts was the swing vote on the ruling that saved the Affordable Health Care Act by creating a precedent for another metaphorical legal principle: A fee or payment imposed by the government is a tax. 

In short, in his votes on one single issue, Roberts single-handedly extended the power of the Court to turn metaphor into law in two conservative directions.

Don’t miss this fascinating explanation by George Lakoff about what was missed in the euphoria of the ACA last week,  please click here to read it in its entirety.

The Supreme Court’s Decision on Affordable Health Care – In Plain English

Even before the Supreme Court issued its ruling on NFIB v. Sebelius, the challenge to the Affordable Care Act, Fox News and CNN both announced that “Dewey Beats Truman”.  And the rhetoric from the right wing has only become more wrong, more obfuscating, more incredibly uninformed.  Of course part of this is just the GOP applying the Ailes doctrine of “repeat it enough times and people will believe it”.  They can’t win the bout on points, so they are resorting to low blows.

But this, like so many things about the entire right wing strategy as devised by their think tanks depends on one critical factor–an uninformed public.  “The best disinfectant is sunlight” is how Justice Brandeis put it.

With all the misinformation and purposeful disinformation out there, and I’m not a lawyer, how do I get to understand what the Supreme Court ruling means?  Well, first of all it needs to have an impartial writer.  Secondly, the impartial writer needs to be able to take complex constitutional issues and transform them into plain old English.

So I turned to a site that I heard about that only does one thing–report on Supreme Court actions.   It went methodically through the ruling so that even I could understand the subtleties of all of the issues involved.

So if you will click here, when you are confronted by the B.S. of those who don’t know, or those who don’t want you to know, you can take them to school.

 

 

National Federation of Independent Business–great another member of the Cabal

The NFIB is currently the lead plaintiff in the U.S. Supreme Court case NFIB v. Sebelius challenging President Barack Obama’s signature health care reform legislation in its entirety. The suit is being brought forward by the NFIB’s legal arm, the Small Business Legal Center. The NFIB legal arm’s advisory board includes Wendy Lee Gramm, who founded the Mercatus Center‘s Regulatory Studies Program at George Mason University and C. Boyden Gray, a former White House Counselor during the Bush Administration who helped found the Federalist Society. [19] Both the Mercatus Center and the Federalist Society are funded by the Koch Family Foundations.

The NFIB is a private-sector member of ALEC and has had representatives on the ALEC Civil Justice Task Force, Health and Human Services Task Force and Tax and Fiscal Policy Task Force.

To read up on more about NFIB, please click here

There is also an excellent article from Brendan Fischer at PR Watch – Who is Bankrolling the Fight Against Obamacare, which you can read by clicking here that talks about NFIB.

And just check out the list of tags to this article.  These guys are involved with a lot of right wing Cabal organizations

Top 10 Obamacare Benefits at Stake for Women

Supreme Court Decision Could Set Women’s Health Back

The Supreme Court is currently reviewing the constitutionality of the Affordable Care Act, more commonly known as “Obamacare.” This landmark piece of legislation signed into law by President Barack Obama drastically reforms the way health insurance works in our country. Below we outline 10 reasons why, as stated in the Center for American Progress report “Women and Obamacare,” women in America have so much riding on the Supreme Court’s decision.

To read about these 10 benefits, please click here.

Koch-Funded GOP Economist Uses New Math To Find That Health Reform Increases The Deficit

By Igor Volsky

George W. Bush’s Social Security privatization guru Charles Blahous — who now works for the Koch-funded Mercatus Center — is out with a new report alleging that the Affordable Care Act adds $340 billion to the deficit. The new math relies on the old “double counting” meme — an argument advanced by Republicans in Congress in the final days of the health care reform debate alleging that the Congressional Budget Office (CBO) appropriated the same revenue for extending the solvency of the Medicare trust fund as it did for paying out benefits.

To read more of Mr. Blahous’ claims, please click here:
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I feel obliged to point out that Blahous’s argument reflects more of partisan politics than the impartial facts. George Mason University’s Mercatus Center, where Blahous is a senior fellow, was launched in 1997 by Charles Koch, one of the Big Oil barons who is dedicating at least $40 million of his own money—and has helped collect $100 million in pledges—to defeat President Obama. Not only did the Koch family foundations contribute nearly $30 million to “set up” and sustain the Mercatus Center, Charles Koch is currently a member of its Board of Directors. The founder of the Mercatus Center, Richard Fink, actually headed the Koch Industries’ lobbying operation in Washington, D.C., and is currently the president of the Charles G. Koch Charitable Foundation.