Quack Quack

If it walks like a duck and quacks like a duck but the Governor says it’s a chicken…it’s Medicaid expansion!

On Tuesday, the Pence Administration announced that the federal government had approved the Governor’s “It’s not Medicaid It’s Healthy Indiana” plan to provide health insurance to additional numbers of Hoosiers. As Talking Points Memo noted,

Indiana Gov. Mike Pence (R) agreed to expand Medicaid under Obamacare Tuesday, but you’d be forgiven for not catching that if you actually listened to what he had to say.

TPM noted that Indiana’s expansion was announced with much the same terminology as expansions in other states headed by Republican governors.

The emphasis is always on the “alternative” and “unique” elements of their expansion plans. To be fair, that’s true. Starting with Arkansas, which proposed using Medicaid dollars to pay for private coverage, states with conservatives in positions of power have pushed the Obama administration to accept a wider and wider range of alternative plans that are more palatable to Republicans.

They’ve branded those plans with names like Healthy Indiana or Healthy Utah. But that doesn’t change the fact that these are proposals authorized under and paid for by Obamacare…..

The article included carefully wordsmithed statements from several other Republican states that have expanded Medicaid while denying that they were doing so.

But Pence might have been the boldest yet. His office effectively portrayed his state’s plan as a blow to Medicaid and government-funded health care.

“With this approval, Indiana will end traditional Medicaid for all non-disabled Hoosiers between 19 and 64,” Pence’s office said, “and will continue to offer the first-ever consumer-driven health care plan for a low-income population.”

But despite all of those linguistic gymnastics, astute observers on the conservative side still recognized Pence’s plan, like others before it, for what it was.

Linguistics aside, Pence might have gotten some decent publicity for his Medicaid expansion, which (whatever he wants to call it) is welcome news, and will make coverage available to many more Hoosiers– but the Administration’s ham-handed, tone-deaf effort to create a state-run news service (called “Pravda on the Plains” by the Daily Beast) sucked all the air from the news cycle, and eclipsed the announcement.

He got national attention, all right, but it wasn’t for Healthy Indiana.

Hint: Governor, if you are going to provide us with our news coverage, you need to learn how not to “step on the lede.”

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Politics 101

Governor Mike Pence has unveiled a proposal to expand Medicaid using Healthy Indiana, prompting blogger Steve Benen to suggest that Indiana’s Governor might be “evolving.”

Although I’m sure Pence would reject terminology that even slightly referenced evolution, his plan to expand Medicaid through Healthy Indiana is a good thing. That it is also a brave thing is a sad commentary on the current GOP, which is where most criticism of the proposal has come from.

It seems to be slowly dawning on Pence that there is a considerable difference between pontificating in DC and actually running a state. In Washington, the man who has been described as “a Tea Partier before there was a Tea Party” could–and did– sermonize ad nauseum without paying a political price. He could–and did–ignore the nitty-gritty of actual lawmaking (he served 11+ years without passing any legislation). A chief executive doesn’t have that luxury; he’s expected to actually do something.

And a chief executive with ambitions/delusions of higher office will be evaluated on the “somethings” that he did.

The problem is, when you are a Republican Governor, you have to satisfy a base that demands ideological purity and ever-more-red meat, at the same time that you have to deal with real budgets, real challenges and the real consequences of bad decisions.

Pence–and several other GOP officeholders–think they’ve figured a way to thread that needle.

We saw it earlier with Common Core. When the GOP suddenly turned on a dime and decided that Common Core was evil (right after the scary black dude in the White House embraced it), Republicans who’d previously been very supportive of Common Core faced a dilemma. They solved the problem by passing  “Indiana” standards that looked a lot like Common Core, but were called something else.

Now we have Medicaid expansion by a different name.

Mind you, these strategies are A-OK with me. There really is no “Hoosier” version of math (unless you count the time our legislature passed a measure changing the value of pi…); and 350,000 Indiana citizens desperately need access to affordable health care. If the current Administration has to engage in a bit of misrepresentation to get it done, I won’t complain.

It’s just a shame that these gyrations are necessary in order to avoid being eaten alive by the angry, uninformed people who now control the party.

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