Yesterday, Pennsylvania became the 11th state to reject the Affordable Care Act’s expansion of Medicaid. (Except for Maine, they’re all red.) One some level, Tom Corbett’s decision isn’t too surprising–he’s an avowed Obamacare critic, and has never been shy about cutting social safety net programs. That said, yesterday’s 2013 budget address was a peculiar time for him to make the announcement.
That’s because the state would have paid nothing to usher in the expansion next year, or in the two years after that, with the federal government picking up the bill. The maximum yearly share it would ever have paid was 10 percent—beginning in 2020. What’s more, according to the Pennsylvania Health Law Project, the expansion would have saved upwards of $400 million a year, largely because Medicaid would be covering heath care costs the state used to. Not to put too fine a point on it, but the statement Corbett gave explaining his decision—“At this time, without serious reforms, it would be financially unsustainable”—doesn’t really make sense. Perhaps even more puzzling, though, is Corbett’s political reasoning.
Corbett is in terrible position heading into the 2014 election. According to a recent Quinnipiac poll, only 31 percent of voters think he should be elected (including 49 percent of GOP voters), while 43 percent of voters disapprove of his performance. Concluded the poll: “There is no strong base of support for Gov. Corbett among any income or age group or in any region of the state.”
Part of that has to do with all the budget slashing he’s done in his first two years in office, including steep cuts to public schools and higher ed, welfare, food stamps, health insurance for the working poor, and environmental protection. But perhaps more damaging has been the “tin-eared” way he’s gone about doing it, as Terry Madonna and Michael Young put it earlier this week. “He has often failed to explain very well why he did things or to promote his agenda,” the pundits wrote. “Equally problematic has been his tendency to take on contentious issues without building consensus for them.”
As a result, he ends up looking not like the centrist he needs voters to think he is, or even like a calculating political schemer, but like an irrational right-wing ideologue. Take his December decision to reject another facet of Obamacare—the state-run exchanges that will make it easier for customers to shop comparatively for health insurance. Ostensibly, this was a protest against an overreaching federal government. All Corbett did, though, was allow the feds to set up the exchanges instead, meaning more, not less, federal government presence.
Or take his plan to privatize the state lottery, a popular, well-run system that reliably provides funding for senior citizens’ programs. Since the firm he awarded the contract to is promising about the same amount of revenue the lottery was projected to bring in anyways, Corbett’s decision doesn’t seem to do much except score a sweet deal for a private company (the only bidder) and eliminate unionized state jobs.
The Medicaid decision features a similarly bizarre political calculus. According to a July study by the Urban Institute, 520,000 Pennsylvanians would have been newly eligible for health insurance under the expansion, which grants Medicaid to anyone under 65 living below 133 percent of the federal poverty level (meaning: annual income of $14,404 for a single person, or $30,657 for a family of four). The decision to deny most of them Medicaid (about 100,000 will be eligible for other Obamacare health insurance subsidies) is not only going to be unpopular among those getting their health insurance taken away (most of whom aren’t voting for Corbett anyways), but among supporters of Obama’s policies in general. Remember, the Affordable Care Act remains popular in Pennsylvania.
In a state that hasn’t voted Republican in a presidential election since 1988, one would have expected Corbett to have fired up his etch-a-sketch by now. After all, the Tea Party momentum he rode to election in 2010 has all but dissipated, in Pennsylvania and elsewhere. Even Ohio Governor John Kasich and Arizona Governor Jan Brewer, two of the heroes of the 2010 right-wing resurgence, are going ahead with the Medicaid expansion. (Corbett’s 2013 budget proposal, which is far less austere than his previous two, may be too little too late.) The only explanation for Corbett’s recent behavior appears to be his adherence to an ideological bent Pennsylvanians no longer share with him. “My crystal ball said Corbett couldn’t possibly be dumb enough to reject Medicaid expansion,” said one political analyst who wished to remain anonymous. “So much for my crystal ball.”
Whatever you think of his policies, he’s got chutzpah. Back when he was contemplating suing the NCAA over the Penn State sanctions, Corbett said political advisers warned him, “Walk away. Don’t do this.” Yesterday’s decision only confirms how little he’s listening to those advisers.