As the Affordable Care Act was about to go fully into effect last month, the New York Times ran a big front-page article highlighting the fact that millions of Americans would go uncovered by the law as a result of the Supreme Court decision making it possible for states to opt out of the expansion of Medicaid. Half of the states have made this choice, creating a confounding scenario in which middle-income people can qualify for subsidies to obtain private coverage but the neediest working poor, who were supposed to be covered by Medicaid, are getting no help at all.
“How can somebody in poverty not be eligible for subsidies?” an unemployed health care worker in Virginia asked through tears. The woman, who identified herself only as Robin L. because she does not want potential employers to know she is down on her luck, thought she had run into a computer problem when she went online Tuesday and learned she would not qualify.
At 55, she has high blood pressure, and she had been waiting for the law to take effect so she could get coverage. Before she lost her job and her house and had to move in with her brother in Virginia, she lived in Maryland, a state that is expanding Medicaid. “Would I go back there?” she asked. “It might involve me living in my car. I don’t know. I might consider it.”
Last night, the prospects for Robin L. and the estimated 400,000 Virginians who would be eligible under a Medicaid expansion brightened considerably. The gubernatorial election was won by Terry McAuliffe, who made the Medicaid expansion such a central part of his campaign that for a time he was even threatening to shut down the state government unless legislators included it in their budget. The expansion, which is now being studied by an ad hoc state panel, still faces big hurdles—the General Assembly remains firmly in Republican control, and the Koch brothers are spending heavily to pressure those Republican state legislators who dare to support the expansion. Still, the odds of the expansion happening are infinitely greater with McAuliffe in the Governor’s Mansion than with the fiercely anti-Obamacare Ken Cuccinelli.
So, the election was a clear win for Obamacare, right? Nope, say the pundits. The fact that Cuccinelli finished closer than recent polling suggested, they say, is a clear sign of strong public opposition to Obamacare, which Cuccinelli made a centerpiece of his campaign in the final days.
Virginia was the first swing state to hold an election after the Affordable Care Act website's troublesome rollout, a controversy that has permeated national news coverage for weeks. Almost 30% of Virginia voters said health care was the most important issue in the race. While Democrat Terry McAuliffe narrowly beat out conservative Republican Attorney General Ken Cuccinelli, analysts credit a GOP focus on Obamacare for boosting Cuccinelli's vote total. "This is what kept this race close," CNN's John King said Wednesday on "New Day."
And Politico proclaimed: “Obamacare almost killed McAuliffe”:
Exit polls show a majority of voters—53 percent—opposed the law. Among them, 81 percent voted for Cuccinelli and 8 percent voted for Libertarian candidate Robert Sarvis. McAuliffe won overwhelmingly among the 46 percent who support the health care overhaul.
Cuccinelli actually won independents by 9 percentage points, 47 percent to 38 percent, according to exit polls conducted for a group of media organizations. They made up about one-third of the electorate. “Obamacare helped close the gap,” said Richmond-based strategist Chris Jankowski, the president of the Republican State Leadership Committee.
I’m not sure when I last saw such a stark example of election spin and punditry floating away from the substantive reality of governing and its impact on actual people. There is no mention in these accounts of the greatly enhanced prospects for the Medicaid expansion in Virginia as a result of McAuliffe’s win. No, it’s all about the exit polls and what it might mean for Obama and the Democrats. But Obama’s not on the ballot again, ever, and the Democrats aren’t on it again for another year. Who knows what voters will think of Obamacare then—the troubles with the rollout will either have resolved by then or they will not have. All we know right now is that after a very rough patch for the law, the guy who ran strongly in support of it beat a guy who was strongly opposed to it, in the most purple state in the country. And as a result, hundreds of thousands of working poor may get health insurance coverage. How removed from the reality of these people’s lives does one have to be to chalk up such a result as a loss for Obamacare?