This One Chart Shows Everything That’s Wrong With Liberal Politics
All right, not just a chart, but the chart and accompanying post. And not everything, but something important.
The other Jonathan Cohn had a post from shortly before the election at the New Republic that highlights a chart from the Georgia Budget and Policy Institute regarding the state’s decision not to expand Medicaid as part of the ACA.
It’s easy to recognize the human toll of refusing to expand Medicaid. It’s not so easy to recognize the economic toll. Maybe this chart will help:
But the state officials who have blocked expansion aren’t simply depriving some people of health insurance. They are depriving the entire state of federal funds. Under the Affordable Care Act, the federal government picks up 100 percent of the expansion cost for the first three years, then scales back its support to 90 percent. At that point, states will have to find the money to cover that remaining 10 percent. It’s real money. But it’s tiny compared to what they get in return. The federal money is a huge influx of cash, which goes first to providers and suppliers of health care. That money, in turn, generates additional economic activity.
Where to begin? First, it may be easy to recognize the human toll, but there’s been precious little effort by the Democratic Party or the liberal media to put that front and center. Sure, there’s been plenty of attacking Republicans for it, but that’s not the same. And the reality is that if you are trying to mobilizing people, letting them hear the stories of real people who are affected by a policy is far more effective than cost arguments.
Second, do you really think that Georgia legislators don’t know this? Cohn seems to take conservative arguments a bit too seriously, as if their whining about costs were sincere.
Conservatives like to point out that the federal dollars don’t materialize out of thin air—they come from the federal treasury. That’s true. But there’s a net transfer of money here, from the very rich (who pay higher taxes under the health care law) to the poor and middle class (who get either Medicaid or tax credits for buying private insurance). That’s perfectly consistent with a program that fosters growth, particularly at a time of low demand, since it’s taking money from rich people (who might otherwise save it) and puts it right back into the economy.
Let’s leave aside the fact that federal dollars do materialize out of thin air. Transferring money from the rich to the poor is precisely what conservatives don’t want to do. Normally this complaint is about “redistribution” but the reality is that conservatives (especially elite conservatives) are opposed to any distributions that don’t transfer money upward. They support policies that make the poor more insecure, more miserable, and they oppose those that prevent the rich from having more wealth and power. They will pay the costs when it comes to these goals. As I’ve said before, ‘big government’ is any action that enforces the law against the rich or provides protections to the poor while ‘small government’ is any and all protections and benefits for the rich or punishments for the poor. This is the conservative project, not spending less federal dollars as a matter of principle.
Every once and a while there’s a renewed effort among liberals to insist that the GOP is the party of death because they oppose universal health care (or more to the point, somewhat more universal). People die without health care, people don’t get health care without health insurance, so those who oppose expansion of health insurance are ensuring people die. But if we admit that people die without health care than what do we say about not fighting to change that? The Democratic Party has still not engaged in a serious effort to fight for Medicaid expansion. The original bill was designed to coerce states into accepting it, and when the Supreme Court took that mechanism away, Democrats mostly threw up their hands. (I mean officials and candidates. Even then there are exceptions. There are people out there fighting for this, and they are to be commended and supported). The party put most of its resources and attention on the Senate, never really made a case for why people should vote for them, never tried to move passive supporters of Medicare expansion or various other policies into active supporters, and the GOP ended up racking up large victories in state houses around the country in addition to taking the Senate.
The thing is that Medicaid expansion is popular. It’s popular in red states. It gives Democrats a wedge to use in less hospitable places. But to translate that position into political support takes work. And charts won’t do that. Facts won’t do that. ‘Cost’ arguments won’t do it. Only contestation will.
[Update] For what it’s worth, I was objecting to liberal claims that the Medicaid expansion would happen without a fight back in June 2012. One could argue that it will happen eventually so there is no need to worry about it, but that still leaves many people without access to health care that might have it if we fought for it.
Also, to be clear: I’m not against charts. I like charts. I like facts. My point is that they won’t do our political work for us.
[Update 2] Like I said, I’m not against all charts.