Republicans’ rational for refusing to expand Medicaid under the Affordable Care Act just keeps getting thinner. Originally, they thought they could hamstring the new law and force its repeal or restructuring. If a few million people missed out on health care, so be it. It was the principle of the thing. Besides, most of the GOP base has health insurance or Medicare. 

Now, it’s looking like they’ve made a very bad financial decision. The News & Observer reports that a new study shows that paying for the uninsured people denied Medicaid will cost the state more than $10 billion over the next eight years. And if we don’t accept it, our tax dollars will subsidize Medicaid expansion in other states. In addition, rejecting the expansion costs the state jobs and tax revenue, both of which we need badly.  

The GOP’s stubborn refusal is borne of ideological zeal. They’re looking for the invisible hand of the market to provide a solution that gets struggling people the care they need. They never put any effort into finding that solution when they had the power to do something, so complaining now seems a bit disingenuous.

But attitudes may be changing. President Pro Tem Phil Berger was the only Republican leader willing to comment on the story and defend rejecting the expansion. Both Pat McCrory nor Thom Tillis stayed mum.

McCrory and Tillis need to appeal to a statewide audience while gerrymandered districts assure that Berger is secure in his position as leader of the Senate. While helping poor people may not be much of a political winner, costing jobs and money is a loser. Apparently, neither Tillis nor McCrory has a good answer for their positions. 

We’ll see if rejecting Medicaid has become a political liability yet. If it has, expect to a wave of negative ads bashing Tillis. If it hasn’t, expect to see McCrory come out with a plan to expand it before it does. Ironically, the law Republicans expected to run against, may become a problem for them, not Democrats.


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