Editorial: If Republicans can support Medicaid expansion, they really should support the rest of Obamacare
photo by: Journal-World Photo Illustration
A proposed deal between Democratic Gov. Laura Kelly and Republican Senate Majority Leader Jim Denning to expand Medicaid will be good for Kansas, perhaps adding coverage for 150,000 people.
It will be an even better deal for the country, if the idea behind the proposal takes hold: Democrats and Republicans can work together for a common good. Both sides have accepted some provisions that don’t thrill them. But that’s the way politics used to work.
Of course, this deal hasn’t worked quite yet. Legislative approval is still needed. That’s the most urgent question to get answered. Perhaps the most interesting question to be answered, though, is whether there is more compromise to be had across the country.
Health care would be a great place for it to continue. The pending Medicaid expansion in Kansas comes amid other Republican states becoming supportive of the idea. Now, will Republicans become more supportive of the truly needed change in health care — an individual mandate for health insurance?
It is not likely that Republicans will cross that bridge because the name upon it is Obamacare. But they should because the idea underlying the individual insurance mandate is very much rooted in conservative philosophy.
There are conservatives who no doubt disagree. The individual mandate smacks of liberalism, they say, because they believe it is government mandating that individuals must buy a particular product. But, in reality, Obamacare does not do that. It says people will be taxed if they don’t own a health insurance policy. (Technically, the individual mandate law still exists, but the Trump administration has gutted it by reducing the tax to zero for those who do not have insurance.)The distinction is important because there has long been a precedent for government to determine your tax based on what you own. People who own property pay property taxes. People who don’t own property don’t pay property taxes. While not loved, it is a system both liberals and conservatives have learned to live with. They would learn to do the same with Obamacare.
The reason Republicans ought to try is because without the individual mandate, a very liberal idea is allowed to flourish. That’s the idea that government gives people the permission to gamble with other people’s money. It happens all the time when somebody makes the decision to forgo health insurance.
Yes, when you forgo health insurance you are risking a lot of your own money if you get sick. But you also are risking the money of your friends, neighbors and lots of people you don’t know.
The reason: bankruptcy laws in America. If you get sick without health insurance, you may well declare bankruptcy. The laws allow bankruptcy to wipe away most medical bills. Good for you, but not good for the health care system, which incurred costs to provide treatment to you. Just like any business that needs to survive, the health care system will do its best to pass those costs you didn’t pay onto the rest of its customers.
It is common sense that bankruptcy places upward pressure on health care costs. Those of us who pay our bills pay more for services and insurance premiums as a result. Why should that be the case? Why should someone’s decision to gamble on not having health insurance cost any of the rest of us one red cent more?
Conservatives didn’t use to think that it should. That’s why the conservative Heritage Foundation once supported the idea of an individual mandate. At some point, liberals came around to the idea as well. With support from both ends of the spectrum, a person might think it is an idea that has a real chance.
Then we were reminded of a reality in today’s political world: There’s no insurance to protect us from partisanship. The two sides have to hate each other or the cable news networks would be too boring.
Maybe the cable got cut for a day in Topeka. Whatever the case, Kelly and Denning deserve congratulations on setting aside partisan differences and working together on a plan to make Kansas both a healthier and fairer place.