Will The South Ever Warm Up To Obamacare?

by Dish Staff

Beutler contends that fighting Obamacare has “become a war on minorities and the poor”:

[T]he GOP-controlled states that have expanded Medicaid, or are considering Medicaid expansion, are pretty white relative to GOP-controlled states where expansion is out of the question. Deep Southern states, where poverty is most concentrated and black population rates approach 30 percent, aren’t calling up the Department of Health and Human Services in Washington to negotiate a conservative Medicaid expansion compromise. To the contrary, that’s probably where resistance to the expansion runs strongest.

But Stuart M. Butler hasn’t given up hope:

[L]et’s remember that, in 2017, Section 1332 of the ACA takes effect. This provision permits states to apply for sweeping waivers from the ACA, including exemptions from the individual mandate, the employer mandate, many constraints of the essential benefits, and even the requirement to have an exchange, provided that the state can achieve the broad coverage goals of the law. Little wonder that former Ted Kennedy senior adviser John McDonough describes the provision as “state innovation on steroids” and as “a significant and unpredictable game changer” for future reform.

True, some sponsors of the 1332 saw it as a way to sneak in a single payer system down the road in Vermont and possibly other states. But the same provision could allow more conservative southern states to craft very different health systems in the future under the loose framework of the ACA.