How Political Positioning Will Hurt the Center Plank of the GOP Governors' Agenda
Now that the presidential election is in the rear view mirror, two things have become abundantly clear about the Affordable Care Act. First, Obamacare wasn't the death knell the president's opponents thought it would be. Second, love it or hate it, even Speaker Boehner says ACA is "the law of the land."
The battle ahead is over implementation at the state level -- and those states that fight against the headwinds of history here will dramatically hurt the ability to create jobs within their own borders.
Way back when running for president,, Texas Gov. Rick Perry campaigned as the job-creating candidate. He told the Manchester Union Leader, "I'm about getting Americans to work."
That is why it is so odd that, by steadfastly refusing to expand Medicaid under The Affordable Care Act, Gov. Perry is turning his back on hundreds of thousands of new Texas jobs.
A study done by the Perryman Group found that by allowing expansion of the state Medicaid program, as called for under Obamacare, the private sector would create over 300,000 jobs by the third year of the law. That is in Texas alone.
Ninety-eight thousand of these jobs would be in the health care industry. This is not government creating jobs. This is the private sector growing to accommodate the more than million and a half Texans who would join the rolls of the insured. These are good paying jobs, that don't require years of training -- and can't be outsourced.
So why is Gov. Perry so insistent to keep these good paying jobs out of his state? The real clue comes later in that same interview with the Manchester Union Leader: "So the idea of somehow or another, 'Oh, Texas has a large uninsured population' -- that doesn't mean anything to me."
But Perry's not alone.
TIME reported that the Florida Center for Fiscal and Economic Policy estimates that expanding Medicaid would create 65,000 private-sector jobs in Florida over six years. That hasn't stopped Florida Gov. Rick Scott from digging in against expansion of Medicaid.
Gov. Scott has hung his first term on the bold plan to create 700,000 new jobs in seven years. If he would just allow Medicaid expansion, he would be well on his way to his goal. As for the one million Floridians who would otherwise no longer be uninsured -- well, you're up Coconut Creek without a fan boat.
But why pick on Texas and Florida? The same pattern is repeating itself in 18 states where governors are saying they will refuse to allow Medicaid expansion as allowed under the Affordable Care Act. Hey, here's a crazy coincidence: They're all Republicans.
As for my state of Mississippi, our governor, Phil Bryant, said the state could not afford the matching funds required to trigger the federal match for Medicaid expansion. We won't do it even though in 2014, the federal government would pay over $50 for every one-dollar Mississippi chips in. You couldn't get 50-to-1 if Itawamba Community College took on the Alabama Crimson Tide and spotted them two touchdowns.
Of course, Mississippi participates in federal matching programs for everything from preserving the post-Civil War home of Jefferson Davis to beaver control. In fact, the Mississippi Business Journal reported that, "somewhere between $2 and $3 flow to Mississippi from the federal government for every dollar sent north from the state."
But Gov. Bryant feels the State of Mississippi is unable -- or unwilling -- to carve $8.5 million from the state's almost $10 billion budget to get $427 million in federal matching Medicaid funds. That alone would create over 4,000 Mississippi jobs in the first year of the program.
It is clearly a political stand against what Gov. Perry calls "the Obamacare power grab."
But what does this political stand mean long-term -- aside from these 18 states having a tragically less healthy population than the neighboring states that do choose to add more people to Medicaid?
The thousands of direct Medicaid jobs these states miss out on will be a nothing compared to the legions of jobs they will miss out on in the future.
Here's why: Most any governor will tell you their most important job is economic development -- bring more jobs to the state.
When companies are trying to find a state to locate a new business or factory, they look at a number of factors -- including tax structure, employment base, infrastructure, education system, etc. One of the most important is a strong and sound health care system in the communities where employees will work and live.
They want to know the people working at their factories and businesses will get quality health care. It gets very competitive between neighbors, as several states within the same region fight tooth-and-nail for the same dwindling list of projects.
The states that do expand Medicaid will have a significantly better funded health care system. They will be drawing a larger share from the same basket of Obamacare funds. In short, those states that fully implement the Affordable Care Act will have a significant advantage at attracting new businesses over those that do not.
And this disadvantage for the 18 states that do not -- 18 states whose governors presumably came into office promising to create employment in their states -- will dramatically impact their ability to attract new jobs for decades.