The politics of refusing Medicaid expansion

Ron Brownstein posits that by his stubborn and increasingly isolated resistance to Medicaid expansion, including via the Arkansas option, Rick Perry is putting Republicans in electoral danger in Texas. Brownstein runs through the economic arguments and touches on the legislative action so far, then gets to the big finish:

It’s constitutional – deal with it

Rejecting the federal money might not pose an immediate political threat to Texas Republicans, whose coalition revolves around white voters responsive to small-government arguments. But renouncing the money represents an enormous gamble for Republicans with the growing Hispanic community, which is expected to approach one-third of the state’s eligible voters in 2016. Hispanics would benefit most from expansion because they constitute 60 percent of the state’s uninsured. A jaw-dropping 3.6 million Texas Hispanics lack insurance.

Texas Democrats are too weak to much affect the Medicaid debate. But if state Republicans reject federal money that could insure 1 million or more Hispanics, they could provide Democrats with an unprecedented opportunity to energize those voters—the key to the party’s long-term revival. With rejection, says Democratic state Rep. Rafael Anchia of Dallas, Republicans “would dig themselves into an even deeper hole with the Hispanic community.”

In 1994, California Republican Gov. Pete Wilson mobilized his base by promoting Proposition 187, a ballot initiative to deny services to illegal immigrants. He won reelection that year—and then lost the war as Hispanics stampeded from the GOP and helped turn the state lastingly Democratic. Texas Republicans wouldn’t be threatened as quickly, but they may someday judge their impending decision on expanding Medicaid as a similar turning point.

Color me less than overwhelmed. I agree that Perry’s intransigence is a dilemma for the Republicans in the Legislature and at local levels that want to get something done, and I certainly agree that Democrats should hammer him for it. I’m sure Battleground Texas would love to start off the 2014 election season with a Democratic base that’s already fired up and ready to vote on this. But that sort of motivation can work for both sides, and if it becomes a matter of tribal identity then all the rational arguments go out the window. A more interesting question is whether Perry’s strident opposition would affect Greg Abbott’s candidacy if Perry steps aside. Abbott is of course as violently opposed to all things related to the Affordable Care Act as Perry is, but he’s just not as visible. As we saw in 2010 and 2006, there’s a not-insignificant number of Republicans willing to vote against Perry in a November election. I presume most of them would switch back for Abbott, and it’s not clear to me if this issue would affect Abbott in any significant way. Maybe Tom Pauken can stir things up by being Mister Pragmatic and making a play for the Ed Emmett types – it’s a longshot strategy to say the least, but he’s not going to out-wingnut either Perry or Abbott, so what the hell. It would undoubtedly help him if Republicans would figure out just what it is they want out of a Medicaid deal, but there is time for that.

Anyway. I just don’t know how this plays out. Among other things, the Dems need to find a credible candidate for Governor who can make the case that Perry and Abbott’s obstruction is hurting the state. Without that, this is all so much trivia. Ed Kilgore and Burka have more.

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3 Responses to The politics of refusing Medicaid expansion

  1. Yvonne Larsen says:

    Where does the “federal money that would insure ” come from? And it seems rather racist of you to infer a growing Hispanic community is incapable of providing for themselves and their families. People do pay cash for their medical treatment.

  2. Pingback: Yes, Rick Perry still hates Medicaid – Off the Kuff

  3. Pingback: From the “Turning out more Democratic voters will mean more Democratic votes” department – Off the Kuff

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