Medicaid Expansion Is Nearly Free, But Republicans Won’t Take It Anyway

Paul Krugman writes today about the fate of the rural poor in two neighboring states. Kentucky accepted Medicaid expansion while Tennessee didn’t:

According to a Georgetown University study that covered a seven-year period spanning the introduction of the A.C.A., the percentage of low-income rural adults without health insurance fell 27 points in Kentucky, only six points in Tennessee.

I clicked and took a look at the Georgetown study. Here’s what the rural uninsured rate looks like for all expansion states compared to all nonexpansion states:

In 2009, the states are pretty mixed up. By 2016, however, there’s virtually no overlap at all: it’s all red at the top and all blue at the bottom. On average, the expansion states reduced the uninsurance rate of their rural population by 19 percentage points. The non-expansion states reduced it by only 6 points.

And it’s all for nothing. Literally. Expansion cost the states nothing at the start and only a tiny amount past 2020. It was virtually free, and the funding came from taxes these states were paying regardless. There was no reason to refuse Medicaid expansion except for sheer spite toward Barack Obama or else simple hatred of providing services for the poor—or both.

I can barely conceive of the kind of mind that thinks this way. The cruelty and contempt for their fellow citizens is just jaw dropping. And then they go out and tell all these rural folks that only Republicans have their best interests at heart and Democrats just want to rob them blind. How do they sleep at night?

A BETTER WAY TO DO THIS?

We have an ambitious $350,000 online fundraising goal this month and we can't afford to come up short. But when a reader recently asked how being a nonprofit makes Mother Jones different from other news organizations, we realized we needed to lay this out better: Because "in absolutely every way" is essentially the answer.

So we tried to explain why your year-end donations are so essential, and we'd like your help refining our pitch about what make Mother Jones valuable and worth reading to you.

We'd also like your support of our journalism with a year-end donation if you can right now—all online gifts will be doubled until we hit our $350,000 goal thanks to an incredibly generous donor's matching gift pledge.

payment methods

A BETTER WAY TO DO THIS?

We have an ambitious $350,000 online fundraising goal this month and we can't afford to come up short. But when a reader recently asked how being a nonprofit makes Mother Jones different from other news organizations, we realized we needed to lay this out better: Because "in absolutely every way" is essentially the answer.

So we tried to explain why your year-end donations are so essential, and we'd like your help refining our pitch about what make Mother Jones valuable and worth reading to you.

We'd also like your support of our journalism with a year-end donation if you can right now—all online gifts will be doubled until we hit our $350,000 goal thanks to an incredibly generous donor's matching gift pledge.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate