The budget standoff continues this week. Republicans in the legislature are still waiting for an opportunity to override Governor Roy Cooper’s veto. Democrats, though, are standing firm.

The budget really reflects the values of the two parties. Democrats believe the wealthiest country in the world can afford to provide health care to all of its people. Republicans believe people should pay for the care they can afford. 

So far, 37 have states have expanded Medicaid and the number of uninsured Americans has plummeted. The Kaiser Family Foundation says expansion states have seen “budget savings, revenue gains, and overall economic growth.” In addition, they’ve seen “improved access to care, utilization of services, the affordability of care, and financial security among the low-income population.” There’s a reason Republican legislatures and governors in other states got on board the Medicaid expansion train. It’s good for the people they’re representing.

Republicans’ main objection to expanding Medicaid is the cost. They worry that the state will have to pick up the cost when the federal government reduces the share that it’s paying. They might have to ask the wealthiest North Carolinians to give back some of the windfall they’ve received from GOP tax breaks over the past decade. 

The fight is really a microcosm of the battle that Democrats and Republicans have been waging since the Reagan Revolution of the 1980s. With the exception of the Affordable Care Act, the GOP has won most of that debate and its been terrible for our country. The wealthy have gotten far richer while lower income families have suffered. Not only do the rich live better lives, they live longer ones.  

Life expectancy for lower income people is decreasing while it’s still increasing for the wealthy. The trend is driven partially by suicide and drug overdoses. It’s also related to access to health care that Republicans in North Carolina deny the working poor. Better access to care and mental health would save lives and help reduce the gap between life expectancy of the rich and poor. 

The Medicaid expansion debate is part of the ongoing argument of whether we want to continue shifting wealth and opportunity to those who have it or work to level the playing field. Instead of measuring the health of our nation by economic factors like GDP and the stock market, we should measure it by the well-being of the people who live here. As Hubert Humphrey once said, “The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life, the sick, the needy and the handicapped.” That’s what Medicaid expansion is all about. 


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