One reason John Kasich was unacceptable to many conservatives as this year’s GOP standard bearer involves his acquiescence in Obamacare’s expansion of Medicaid. Many believe that, as Governor of Ohio, he has squandered the hard won 2012 Supreme Court victory concerning a provision of the “reform” law that granted the President and his apparatchiks the power to coerce the states into compliance. Despite the 7-2 SCOTUS ruling that such coercion is unconstitutional, Kasich and a few other GOP governors have voluntarily colluded with the Obama administration on Medicaid expansion. Among these Republican sell-outs was the Governor of Indiana — Mike Pence.
Now that Donald Trump has picked Pence to be his running mate, the latter’s apostasy is unlikely to provide much comfort to conservatives who question the sincerity of the Donald’s commitment to killing Obamacare. Pence did, of course, provide a perfunctory declaration during his Saturday acceptance speech that he and Trump are committed to repealing the increasingly unpopular law “lock, stock, and barrel.” And this is consistent with his past rhetoric regarding the President’s “signature domestic achievement.” Sadly, when it came time to make a choice between living up to such lip service and accepting a big fat bribe from our Beltway masters, Governor Pence chose the cash.
Before the advent of Obamacare, Medicaid was a joint state-federal program that provided ineffective health coverage for the poor. It was financed by state funds that were matched by infusions of taxpayer pelf from Washington. The authors of the risibly titled “Affordable Care Act,” knowing that many low-income individuals would never be able to afford the premiums charged for coverage purchased through the newly-minted “marketplaces,” decided to expand eligibility for Medicaid and created a carrot-and-stick incentive program designed to make it nearly impossible for states to demur. As noted above, the stick was struck down by SCOTUS, leaving only the taxpayer-funded carrot.
These bribes work as follows: Federal tax dollars covered 100 percent of expansion costs for the first three years and, after 2016, Washington’s share will incrementally decline to 90 percent by 2020. What happens after 2020? It’s anyone’s guess. Obamacare apologists would like governors and state legislatures to act on the proposition that our Beltway masters will keep faith with their funding promises, but that would be an unwise bet. That money could evaporate just as easily as did the “risk corridor” funds promised to insurance companies willing to sell coverage through Obamacare exchanges. And, if it does, state politicians will have to choose between kicking a lot of people off Medicaid and going bankrupt.
Only 19 states with GOP governors or Republican-controlled legislatures have resisted the temptation to take the money. The state of Indiana isn’t among them. In 2015, Pence launched a program called the Healthy Indiana Plan (HIP), which Governor Pence tarted up with just enough free market lipstick to call it an “alternative” to Medicaid expansion. But, no matter how much pancake makeup Pence trowels onto HIP, he can’t hide its Obamacare origins. And, just to make sure that everyone knows about Pence’s perfidy, White House spokesman Josh Earnest has gleefully praised him: “I know that Governor Pence did do some important work with the administration to expand Medicaid in his state.”
This endorsement isn’t likely to endear him to many conservative voters, which brings us back to the effect Pence’s Obamacare apostasy will have on Donald Trump’s chances of being elected President. Trump’s choice of Pence as his running mate suggests that the Donald was attempting to shore up the ticket with a solid conservative who will increase the GOP’s chances of keeping fiscal and social conservatives on the reservation. And Pence does come with what seem to be solid conservative credentials. Not even the most fastidious fiscal conservative can complain about his record in Congress, where he fought the good fight against some of the more expensive components of President G.W. Bush’s agenda.
Thus, if Pence’s only policy pirouette had been the expansion of Medicaid according to the stipulations of Obamacare, his credibility as a conservative would probably not have been harmed irreparably. However, when he became the governor of Indiana he began to exhibit symptoms of incipient political correctitude. In addition to caving on Medicaid, Pence executed an excruciating flip-flop on Indiana’s Religious Freedom Restoration Act that still has many evangelical voters upset. He initially signed a very strong bill, but caved under pressure from the left. As Erick Erickson puts it, “When the national criticism from the gay mafia and press stormed into Indiana, Pence folded like a cheap suit.”
So, the Republican Party is about to nominate a presidential candidate whose history of public statements about socialized medicine has caused a lot of conservatives to doubt the sincerity of his commitment to getting rid of Obamacare. And this candidate has chosen a running mate who has vehemently denounced that very “reform” law, yet colluded with the Obama administration on one of its most pernicious provisions. What most liberals don’t understand about Obamacare is that it is not merely the law itself that creates angst among the general electorate. It is also highly symbolic. It represents the obnoxious admixture of opportunism, elitism, and ignorance of the quotidian facts of life beyond the Beltway.
By choosing Indiana Governor Mike Pence as his running mate, Donald Trump has demonstrated that he doesn’t really get it either. Otherwise, he would not have chosen an obvious opportunist rather than a genuine conservative. This doesn’t mean that Mike Pence will make or break him in November. It is, instead, yet another indication that Donald Trump will not do — or simply does not understand — his homework. In the end, he just doesn’t know what he needs to know to “make America great again.” He doesn’t know why America was great. Even worse, he doesn’t really understand who made it great.