It was somewhat of a surprise Monday when Ohio Governor John Kasich gave the go-ahead for Ohio to expand their Medicaid market in lines with the Affordable Care Act. This makes Kasich the 5th Republican governor and 19th governor over all to sign up for the Medicaid expansion. He did so because it would be good for the people of Ohio.

What a great idea. A Governor, a Republican Governor no less, doing something because it would be good for his state. I hope this concept catches on among other governors. Currently the trend especially among Republican governors is to do things that are only good for a small subsection of the public – that 1% that seems to get most of their attention.

Surprisingly also is not just that some Republicans have already decided to go with Medicaid expansion, but also the ones who have not outright rejected Medicaid expansion in their states. Some of the the most revisionary of Republican governors have yet to fully come out against expansion. Walker in Wisconsin and his neighbors Snyder in Michigan and Daniels in Indiana have yet to come fully out against expansion. Neither has one of the most reactionary, Rick Scott in Florida.

Which makes it odd that Iowa’s Branstad was so quick to dismiss expansion. His reputation is that of a moderate. However, that reutation was hewed in previous terms. This time around he has acted as one of the far right leaning governors. As such he puts Iowa in league with the deep southern states. This is sad for Iowa, which used to be known for its prairie styled common sense.

One of the things that Kasich and Brewer of Arizona like him know is that turning down Medicaid expansion has a great chance of being a money loser for individual states in the long run. Since the ACA picks up mostcost in the early years expanding care to those who can’t afford it will create jobs in the states. If the state refuses that money, it is a loss of revenue and jobs. But the kicker is that many of those who would be covered and thus their bills paid by Medicaid will either skip care as they do now or will end up going to the emergency room for care they can’t pay for as they do now. And, just as they do now, both of these have a quite negative effect on the state. We have lost productivity and people in pain because they can’t afford care. Then when things get so bad they end up in the emegency room. Someone has to pay for that and it often ends up being the state. The state doesn’t like it, nor do the hospitals.

Kasich and Brewer both put the practical ahead of the political:
Kasich echoed the sentiments of the other GOP governors who have also agreed to expand Medicaid in their states. Gov. Jan Brewer (R-AZ), another vocal opponent of President Obama’s health care reform law, conceded last month that expanding the eligibility level for Arizona’s Medicaid program will “secure a federal revenue stream to cover the costs of the uninsured who already show up in our doctors’ offices and emergency rooms” and “protect rural and safety-net hospitals from being pushed to the brink.”

So it looks like once more our governor has taken the short term decision that may be a wash over the long term fix which would be the best choice for all the people of Iowa.

Like many, I am a huge supporter of universal health care. With universal health care we wouldn’t have this hodge-podge of care here, no care there, if you are hurt at work who pays the bill – on and on. With universal health care, when someone was ill or injured, the person could go get care. That’s it. No waiting in pain, no trying to figure out if we could pay, no concern whether you are in a Medicaid or a non-Medicaid state. Nope, you get hurt you get care. They do that in Canada and EVERY OTHER industrialized country in the world. And when care is given, a person doesn’t have to worry about losing all their savings to pay for it.

So once more, our governor leads Iowa backward. Once we get headed the wrong direction, it will be hard to turn the boat around.

If you are interested how the Medicaid expansion stands, here is a current scorecard: