When he ran in the special election for the Fifth Congressional District, the question was whether novice Republican candidate then, now Rep. Vance McAllister was politician enough to win. Then when he took office the question mutated into whether he was politician enough to hang with the big boys and girls. If the latest media reports on him are any indication, we’ve already got an answer of affirmative – and then some.
McAllister’s win largely occurred
because he effectively tapped
into a populist base but also was able to position himself as the more flexible
conservative in the contest that could suck in leftist voters. By tapping
into the conservative populist wing of the Republican Party, it gave him the base
necessary to get ahead of all but one candidate in the field in the general
election. In the runoff, against
the odds his assumed flexibility got him to the head of the line and swoons
from the mainstream media, all bubbling about how his presence could allow more
liberalism to be injected into public policy than otherwise with a Republican
elected to Congress from Louisiana.
Key to all this was McAllister,
by tapping into a conservative populism that distrusts anything big but most of
all government and the groups that use it to benefit themselves and by
intimating he would not show national GOP orthodoxy on all issues, presented
himself as an anti-politician. The great irony, of course, is that you must be
a consummate politician in order to do this. And, so far, McAllister has shown
the political chops to succeed in maintaining this image.
A case in point is his use of the
Medicaid expansion issue, which is a no-brainer to refuse it for a number of
reasons, but chiefly
two. One, under the most likely scenario according to the most valid
research on the topic, while because of huge, beginning with total, federal
subsidies the earliest years would be a net gain to the state, that would be
wiped out not long after 2020 because of the withdraw of those. By 2023, under
the most likely scenario the state would pay an additional $92.5 million that
year if expansion occurs, by then the additional costs growing at 15 percent a
year. Under the most pessimistic scenario, that amount would be hundreds of
millions of dollars a year higher, and the inevitable state response (since the
law appears not to allow a state to withdraw from expansion once undertaken)
would have to be raising taxes.
If McAllister knows this, he’s
not letting on. Or maybe he does, because when he argues in favor of it, rather
than admitting he countenances government taking more of what people earn, he
phrases his support in terms of his district being better off as a fifth of its
citizens don’t have health insurance and they could use it, especially because,
he claims, “our people are already paying for it.”
Which, of course, is entirely
false. The only sense in which Louisianans pay for expansion by other states is
in federal taxes and/or increased debt to support that new, extra spending. But
those are decisions made out of Louisiana’s hands, and this costs Louisianans even
more if Louisiana independently were to accept expansion. After a few months on
the job, his staffers seem not to have told him that Medicaid is paid as a
federal matching grant (with plenty of strings), so there’s no
pool of money that Louisianans pay into that they “get back” through expansion
as he implies.
Second, while, as McAllister
states, “Medicaid is one way to take care of people's health needs,” it’s not
the best way. As research
has shown, Medicaid use does not improve health outcomes, users of it
actually are worse off than the uninsured, and they actually are more likely to
use emergency rooms than the uninsured. So if McAllister really cares about
improving health of constituents in the district, much less do it more cost effectively,
getting more of them onto Medicaid isn’t the way to do it.
And maybe he knows this as well,
but ploughs ahead with expansion support. Because, if he is pandering to a
portion of the electorate that got him into office, he can use this as a
get-out-of-jail-free card for instances when he makes votes or expresses conservative
opinions that this part of the presumed base doesn’t like as proof he is with
them. He has zero responsibility over this state issue, so even if it did
happen he could claim he had nothing to do with higher taxes or worse health outcomes.
By championing expansion, he therefore reaps the symbolic benefits without paying
the political costs.
Naturally, this exposes the great
irony: particularly referencing this issue preference that’s contrary to practically
every other Republican’s view in Washington, the mainstream media lionize him
for being a pragmatic anti-politician while in fact he creates this image by
acting very shrewdly politically. Don’t be fooled: the fast-learning
McAllister, having just set foot for the first time ever in Washington fewer
than four months ago, despite his “aw shucks” rhetoric has proven by his
support of Medicaid expansion he’s become one of them already. Neat flim-flam,
don’t you think?
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