Diary

How do you like Matt Bevin now?

A lot of conservatives were very upset when Senator Mitch McConnell (R-KY) defeated businessman Matt Bevin in the Republican senatorial primary in 2014. Senator McConnell, in line to become Senate Majority Leader if the Republicans captured the chamber, wasn’t a true conservative, while Mr Bevin most certainly was. But, when The Washington Post praises now Governor Bevin, you know that something is wrong:

Mr. Bevin’s good sense

January 3

When Republican Matt Bevin won the Kentucky governor’s race last year, 400,000 low-income people seemed doomed to lose their health coverage. An ardent Obamacare opponent, Mr. Bevin swore during his campaign to roll back the state’s Medicaid expansion. The expansion had extended coverage to nearly half a million Kentuckians, halving the state’s uninsured rate, under a provision of President Obama’s signature health-care law. This reversal would have added Kentucky to the list of 20 states irrationally refusing federal Medicaid money to cover needy people, and it would have put pressure on Republican leaders in other states to withdraw coverage, too.

Thankfully, common sense prevailed. The governor announced Wednesday that he would seek to reform Kentucky’s Medicaid program rather than amputate it. To some conservatives, this will no doubt seem like more evidence that social benefits, once extended, can never be taken away. That impression would make more sense if the case against expanding Medicaid were stronger. Instead, Mr. Bevin’s announcement reflects two crucial points. First, state leaders interested in governing rather than simply campaigning have no reasonable basis on which to reject federal Medicaid funding. Second, because the federal government is willing to allow states to experiment with Medicaid’s design within their borders, conservative politicians have the opportunity to reform as well as expand the federal coverage program. Mr. Bevin is embracing this option, and so should Republicans in the states that continue to lag behind, such as Virginia.

There’s more at the link, and MSNBC is chortling as well:

As the Affordable Care Act has taken root, its implementation has moved in only one direction: forward. The health care law has seen more consumers, more Medicaid expansion, and more coverage. Aside from occasional, pointless repeal votes in Congress, there’s been no meaningful effort to go backwards on “Obamacare.”

Which is why Kentucky created such an interesting test. The Bluegrass State has been a national leader in ACA implementation, slashing its uninsured rate, and excelling in overhauling its health system. The results have been amazing for state residents. Republican Gov. Matt Bevin, however, vowed to make Kentucky the first state to reverse course, starting with the elimination of Medicaid expansion.

The assumption has long been that it’s far more difficult to take Americans’ health care benefits away than to block those benefits from existing in the first place. Would Bevin prove these assumptions wrong? Would he keep his campaign promise and scrap coverage for thousands of Kentucky families?

It now appears the answer to both of these questions is no. The Lexington Herald Leader reported late last week:

Gov. Matt Bevin says he intends to draft a plan to overhaul the state’s expanded Medicaid program by the middle of next year, one that could be implemented by the start of 2017. […]

He said Wednesday that his plan will be fashioned after the one in Indiana, which uses waivers from the federal government that allow states to create their own system for providing coverage to the poor.

“Indiana’s is the model that frankly is most likely that we will look to replicate,” the governor added last week.

The trouble for Bevin’s right-wing allies, of course, is that Indiana is already a Medicaid-expansion state. The new Kentucky governor, in other words, is planning to make the transition from Medicaid expansion to a slightly less generous version of Medicaid expansion.

This isn’t at all what the Tea Party Republican promised as a candidate early last year, but there’s apparently an important difference between vowing to take away health care benefits and actually following through on the threat.

Mr Bevin has been Governor of the Bluegrass State for slightly less than a month now, and he has just broken his primary campaign promise. Hey, conservatives, how do you like him now?

Governor Bevin’s plan isn’t complete yet, but what we do know is that he plans on reducing the Commonwealth’s exposure to increased Medicaid costs, but still retain the Medicaid expansion. Had state Attorney General Jack Conway, the Democrat’s nominee, won the election, his actions on former Governor Steve Beshear’s Medicaid expansion might have differed at the margins from what Mr Bevin is planning, but in the overall picture, they would ave been indistinguishable: the Medicaid expansion would remain in place.

So, when conservatives say that Senator McConnell has abandoned them, and Kentuckians should have replaced him with Mr Bevin, it seems to me that Kentuckians took the right decision in 2014: Mr Bevin would have been indistinguishable from Mr McConnell in the Senate, and he’d have been a very junior member of the majority, rather than the Majority Leader.

I have already said that all of the Republicans are RINOs when it comes to Obaminablecare:

Let me be very blunt here: the Republicans have surrendered, completely, on the principle (that the federal government should be responsible for guaranteeing health care), and are simply arguing about how to achieve the goal. Is the Obysmalcare legislation poorly crafted? Certainly it is! Does the Obaminablecare foul up our health care system? Absotively, posilutely it does! But all that the Republicans are arguing is how to improve the delivery of socialized health care, and not whether health care should be socialized in the first place.

And I’ll be blunt again: our choice is between two fundamental positions:

  1. The government, at some level, is ultimately responsible for insuring that every American has access to health care; or
  2. The government is not responsible for seeing to it that everyone has access to health care, which necessarily includes the consequence that some people who need health care and cannot afford it will not get it.

Now, I am an [insert slang term for the rectum here], and I am perfectly willing to return to a system in which those people who cannot pay for their health care do not receive it, even if that means they will die in the street due to the lack. That is the natural result of not guaranteeing health care for everyone, and I am willing to both admit it and support that.

But the Republican candidates don’t seem to be willing to take that position — at least, not publicly — and thus they have been left with agreeing with the premise of the Affordable Care Act, but simply differing on how to achieve the objective. Doesn’t that make all of them RINOs?

When Matt Bevin, Matt Bevin of all people! caves in and surrenders on the principle that the government should be responsible for guaranteeing health care, we might as well face it: it’s here to stay, and it doesn’t matter what the Republican presidential candidates say, what any Republican says, guaranteed health care is here to stay, the guarantee will never be ended, and all that Republicans can do now is argue about the best way to fulfill the guarantee.