Last week, the Republicans in the Kansas legislature reached an agreement with the Democratic governor to expand Medicaid. Today, the North Carolina legislature goes back into session. Maybe we could see a similar agreement here. 

If the agreement goes through, Kansas will become the 38th state to adopt Medicaid expansion. North Carolina will remain in a minority of states that refuses to help its citizens gain access to healthcare. The majority of those states are part of the old Confederacy.

In states that have expanded Medicaid, coverage has increased significantly. According the Kaiser Family Foundation, “Studies also show that Medicaid expansion has resulted in coverage gains in a number of vulnerable populations, increased coverage for children as parents have gained coverage, and disproportionately positive coverage impacts in rural areas in expansion states.” In other words, the most Republican parts of the states benefit the most. 

It’s ironic that rural legislators in North Carolina overwhelmingly oppose expanding Medicaid, a move that would help their constituents, while supporting the corporate tax cuts and cuts to the top income rate that disproportionally benefits residents of more urban areas represented by Democrats. Higher incomes and big corporations are overwhelmingly centered around metropolitan areas like Wake, Mecklenburg, Buncombe and New Hanover Counties. GOP policies have taken the greatest toll on the people they represent. 

Republicans can cut corporate and income taxes all they want but that’s not going to attract industries to the areas that would most benefit from Medicaid expansion. GOP legislators would be wise to set aside their ideology and instead look at what’s best for the people they serve. Medicaid expansion would not just provide additional coverage for people without it, it might also provide easier access for people who already have it. Medicaid expansion could help save rural hospitals and increase the number of doctors in areas that are now poorly served. If the demand increases, providers might follow. 

As the legislature comes back into session, they should work toward a compromise on Medicaid expansion. If states like Kansas and Louisiana can do it, so can we. Republicans in rural districts should start looking out for their constituents instead of bowing to ideological idiocy that benefits wealthier, more urban counties represented by Democrats. 

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