The Washington Post’s dishonest attack on opponents of the Medicaid expansion

The Washington Post’s editorial board accuses the Commonwealth of Virginia (specifically its Republican legislators) of once again engaging in “massive resistance.” The editors write:

Sixty years after Virginia waged a campaign of “massive resistance” against integrating its public schools, the state is once again insisting on a policy that targets its least advantaged citizens.

Even as one Republican-led state after another moves to tap available federal funds for extending health coverage to needy citizens under Medicaid, Virginia stands pat. GOP governors in Indiana, Tennessee, Ohio, Pennsylvania, Arizona, Iowa, Arkansas and elsewhere have embraced the expansion, and it’s under consideration in conservative states such as Montana, Alaska, Idaho and Utah.

Yet Republicans in Richmond, standing on the “principle” that Virginians bear no responsibility for their least fortunate neighbors, will not budge.

This passage amounts to demagoguery. Resisting the Medicaid expansion is not analogous to refusing to integrate public schools. The Constitution mandated school integration. Federal law doesn’t mandate the Medicaid expansion. That decision is left up to the states.

In no sense, then, are Virginia Republicans resisting or circumventing the law by not agreeing to the Medicaid expansion. The Post’s analogy can’t withstand scrutiny.

Neither can its claim that by not agreeing to the Medicaid expansion, the Virginia GOP is ignoring the welfare of “their least fortunate neighbors.” As the Post well knows, the least fortunate Virginia residents are already covered by Medicaid (that’s why it’s called an “expansion”). Moreover, those in the income strata that would otherwise be covered by a Medicaid expansion are eligible for Obamacare subsidies if they elect to purchase health insurance.

Thus, in the three sentences the Post’s editors — normally an intellectually honest group — produce two howlers. Why?

The answer is obvious to me. The Post’s editorial is a heavy-handed attempt to invest the Medicaid expansion with a moral significance it lacks under an honest analysis.

Obamacare is an income redistribution program and, as such, is far more closely analogous to food stamps than to school integration. Certain relatively well-off groups end up subsidizing the health care of the less-well-off. Furthermore, those being subsidized under Obamacare aren’t indisputably poor. The indisputably poor are already covered by Medicaid.

Many liberals view income redistribution as a moral imperative, but most Americans don’t. For most Americans, income redistribution may be desirable, or at least acceptable, up to a point — but it’s not morally required.

Given American ambivalence about income redistribution, and the absence of a perceived moral requirement to engage in this practice, it’s not surprising that some states have accepted the Medicaid expansion while others — generally those where a more conservative outlook prevails — have rejected it.

To some, the hold-out states appear callous. However, they aren’t circumventing anything required by by law, discriminating on the basis of race, or leaving their poorest residents uninsured.

Nonetheless, the obvious move for liberals like the Post’s editors is to invoke the most highly charged, moralist rhetoric in an effort to shame the hold-out states into dropping their “resistance.” Hence, the bogus comparison to massive resistance of school desegregation and the ludicrous claim that Virginia’s “neediest people” are being access to decent health care (as the Post’s editorial concludes).

Attempts to demonize one’s opponents as akin to racial segregationists are usually a sign of desperation. The Post’s over-the-top editorial is no exception.


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