CHARLESTON, W.Va. -- West Virginia Governor Earl Ray Tomblin, like many governors around the country, is contemplating the decision whether or not to expand Medicaid coverage to low-income working people.
* Around the same time, North Dakota's Jack Dalrymple said "We try to leave the politics out in the hallway when we make these decisions. In the end, it comes down to are you going to allow your people to have additional Medicaid money that comes at no cost to us, or aren't you? We're thinking, yes, we should."
* One of the most eloquent Republican governors to make the case was John Kasich from right next door in Ohio in early February. "We're doing this for a variety of reasons," he said. "Number one, many of these people who are below the $14,000 in income -- some of the poorest Ohioans -- they get their primary care in an emergency room. Now that is not the best way to get people primary care. Not only is it not good for them, because it doesn't allow them to get healthy, but secondly, it drives up the cost of everybody's health care. ..."
He went on to say, "If we were to reject extending Medicaid, I believe that we would create financial chaos, particularly across our rural hospitals ... It would create, in my judgment, a financial mess."
Kasich was also able to make the connection between Medicaid expansion and two other issues on policy makers minds these days: substance abuse and prisons: "The fact is, extending Medicaid is going to significantly allow our local providers -- of both mental health services and addictive services -- with some space and some opportunity to begin to rebuild that safety net, so we don't find as many of our mentally ill in our jails today because they receive no care."
* Last word goes to Michigan Gov. Rick Snyder, whose decision came shortly after Kasich's. According to him, "Expansion will create more access to primary care providers, reduce the burden on hospitals and small businesses, and save precious tax dollars. It also puts Michigan rather than Washington in the driver's seat in terms of implementation, which allows us to better address Michigan's specific needs."
It's nice to know that at least these six Republican governors have the backs of the people who do the grunt work. For all the areas where I may disagree with them, I salute their willingness to step up for the people who serve our food, wait on us in stores, care for our kids and elderly, and do the many other necessary but ill-rewarded jobs that make the good life possible for others.
I would like to believe that in the end, West Virginia's Democratic governor will do the same.
Wilson is director of the American Friends Service Committee WV Economic Justice Project and a Gazette contributing columnist.
CHARLESTON, W.Va. -- West Virginia Governor Earl Ray Tomblin, like many governors around the country, is contemplating the decision whether or not to expand Medicaid coverage to low-income working people.
The expansion is part of the Affordable Care Act and would raise the eligibility level for health coverage under Medicaid to 138 percent of the federal poverty level.
As things now stand, Medicaid eligibility here is very low, at around 35 percent of the federal poverty level. A family of three can't earn more than $7,000 per year to qualify. Low-income people who aren't parents can't get Medicaid at all unless they are disabled or over age 65.
Total costs of the expansion for the first three years will be completely paid for by the federal government. After that, the federal share will be 90 percent.
Here are some reasons to consider expanding coverage to people who work hard every day provided not by the usual suspects, but by six conservative Republican governors who have already made that decision:
* Nevada Gov. Brian Sandoval was the first to make the call back in mid-December. After looking at the math, he discovered that not expanding the program would actually cost his state $16 million. "All in all, it makes the best sense for the state to opt in. This is a way for me to protect these people."
* In early January, New Mexico Gov. Susana Martinez came to the same conclusion, saying, "We have an obligation to provide an adequate level of basic health care services for those most in need in our state. However, we also have an obligation to ensure our state's financial security. In deciding to expand Medicaid, I weighed every possible outcome and impact. Ultimately, this decision comes down to what is best for New Mexicans."
* The following week, Arizona Gov. Jan Brewer, perhaps best known for harsh anti-immigrant legislation, turned some heads when she declared that "Saying 'No' to this plan would not save these federal dollars from being spent or direct them to bringing down the deficit. ... By agreeing to expand our Medicaid program just slightly, we will protect rural and safety-net hospitals from being pushed to the brink."
* Around the same time, North Dakota's Jack Dalrymple said "We try to leave the politics out in the hallway when we make these decisions. In the end, it comes down to are you going to allow your people to have additional Medicaid money that comes at no cost to us, or aren't you? We're thinking, yes, we should."
* One of the most eloquent Republican governors to make the case was John Kasich from right next door in Ohio in early February. "We're doing this for a variety of reasons," he said. "Number one, many of these people who are below the $14,000 in income -- some of the poorest Ohioans -- they get their primary care in an emergency room. Now that is not the best way to get people primary care. Not only is it not good for them, because it doesn't allow them to get healthy, but secondly, it drives up the cost of everybody's health care. ..."
He went on to say, "If we were to reject extending Medicaid, I believe that we would create financial chaos, particularly across our rural hospitals ... It would create, in my judgment, a financial mess."
Kasich was also able to make the connection between Medicaid expansion and two other issues on policy makers minds these days: substance abuse and prisons: "The fact is, extending Medicaid is going to significantly allow our local providers -- of both mental health services and addictive services -- with some space and some opportunity to begin to rebuild that safety net, so we don't find as many of our mentally ill in our jails today because they receive no care."
* Last word goes to Michigan Gov. Rick Snyder, whose decision came shortly after Kasich's. According to him, "Expansion will create more access to primary care providers, reduce the burden on hospitals and small businesses, and save precious tax dollars. It also puts Michigan rather than Washington in the driver's seat in terms of implementation, which allows us to better address Michigan's specific needs."
It's nice to know that at least these six Republican governors have the backs of the people who do the grunt work. For all the areas where I may disagree with them, I salute their willingness to step up for the people who serve our food, wait on us in stores, care for our kids and elderly, and do the many other necessary but ill-rewarded jobs that make the good life possible for others.
I would like to believe that in the end, West Virginia's Democratic governor will do the same.
Wilson is director of the American Friends Service Committee WV Economic Justice Project and a Gazette contributing columnist.
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