Despite the political volatility of the Medicaid issue in the poorest state in the union, that argument remains wishful Democratic Party thinking. Medicaid expansion isn’t a strong enough issue to offset other fundamental public policy divides over taxation and social issues that the current majority of Mississippians have simply refused to ignore.
For the foreseeable future, Republicans still have the numbers on their side in Mississippi politics and voter behavior — i.e., turnout and engagement — strengthens an already winning hand for the GOP.
But on Capitol Hill and in national politics, Republicans are increasingly running out of fences to straddle on issues that could decide Republican primary contest and the outcome of presidential elections.
The Affordable Care Act or “Obamacare” remains a key issue. There’s not much stretch in Democratic 2nd District U.S. Rep. Bennie Thompson’s support of the public health care law and for expansion of Medicaid in Mississippi. It’s an issue that has the support of the majority of his constituents and his party.
But for Mississippi’s Republican members of the state’s congressional delegation, Medicaid remains a tough issue. The Tea Party and the most conservative wing of the GOP continue to demand a “repeal and replace” strategy on Obamacare at best and a “defund” Obamacare strategy at worst.
They are willing to see the federal government shut down over the issue of funding the Affordable Care Act. Couple that will a similar desire to make the federal debt ceiling vote a litmus test of conservative bona fides and Republican Mississippi U.S. Sens. Thad Cochran and Roger Wicker and U.S. Reps Gregg Harper, Steven Palazzo , and Alan Nunnelee.
In states like Mississippi where Medicaid expansion is a two-fold issue — one that impacts individual lives and one that impacts the fiscal health of the availability of health care and the survival of rural hospitals — Republican lawmakers face choices that are difficult.
Republican votes on Obamacare and debt ceiling expansion that would have been called compromises, bipartisanship, or reaching across the aisle in earlier eras are now called disloyal failures of principle and evidence of a lack of ideological purity.
Nationally, a Republican strategy of shutting down the government rather than funding Obamacare and government defaults rather than raising the debt ceiling is one of extreme risk in terms of the 2014 midterm elections and the 2016 presidential elections.
With the economy slowly recovering, swing voters are unlikely to embrace the political theatrics of a government shutdown or a default over the federal debt ceiling.
For Republicans, the threat of getting “primaried” looms. A recent Tea Party gathering at the state Capitol encouraging Congress to “exempt Americans from Obamacare” followed that general theme.
But otherwise conservative types who administer or serve on Mississippi hospital boards continue to push the Mississippi delegation to consider the economic impact of failing to expand Medicaid through the Affordable Care Act.
That’s the rub, however. The hard truth is that congressional Republicans here can more readily survive votes that ultimately hurt the availability of health care in the state than they can survive votes that increase the size and scope of the federal government and that increase spending.
(Daily Corinthian and syndicated columnist Sid Salter can be contacted at 601-507-8004 or firstname.lastname@example.org.)