Last week, in front of a press gathering, Sen. David Vitter who is running for governor in 2015 mentioned he could be in favor of Medicaid expansion. Gov. Bobby Jindal has opposed unshakably this under the Patient Protection and Affordable Care Act for good reason.
So does Vitter, as he has for a long time, but you wouldn’t have known it from the breathless coverage that went out in the state media, across wire services, and on national Internet political sites. Lost in all of the manufactured hubbub was Vitter invoked the same framework as has Jindal when it comes to the issue, which he would confirm in a subsequent media appearance shortly after, that there would have to be fundamental reform of the Medicaid program before committing any extra state money to the federal-state effort. Jindal specifically calls for loosening grant restrictions that allow for a premium support system that does not feature the same constrictions as seen, for example, in Arkansas’ attempt to expand Medicaid of last year.
A broad outline of that fundamental reform appears in the recently signed SB 682, which creates a panel to come up in the near future with a plan to expand government-provided health care insurance to all of the indigent (as defined by income) along those lines. While taken from Jindal’s ideas for national health care reform, it is drawn to state specifics but is unlikely to be able to be implemented as a whole unilaterally as also it likely would have to rely upon federal government changes to bring about that fundamental reform.
But while readers may have gotten an eyeful over the media’s interpretation of Vitter’s remarks, they saw nothing about Jindal signing this bill last week as well as almost nothing about Vitter’s clarification of those remarks. True, during the three weeks after the close of a legislative session when a governor decides whether to sign dozens of bills a week the media almost always focus only on the ones where the governor’s office prepares individual news releases for them and none was issued for SB 682, it’s still indicative of how the media treat the Medicaid expansion issue.
Medicaid expansion takes an existing government health insurance plan and extends it to all the adult indigent. Jindal’s plan (he’s not alone, as others have suggested variations of it) is to take government money and use it to fund nongovernment providers of health insurance to put the indigent on their rolls. Both provide health insurance to the indigent for minimal or no cost.
However, the media don’t like the plan because unlike expansion it does not empower government enough. The ideology of most of those who identify themselves as part of the media is that more and bigger domestic government is better, not only because of their own root ideological feelings about issues such as government’s ability to engage in redistribution of wealth and in molding society to values they feel important for it to reflect, but also because this makes them feel more important through identifying with and flexing power through the institution allegedly vital to safeguarding the country against evils in government; the bigger the media’s natural adversary, they more their importance is elevated. By reducing government involvement in provision of health care insurance, it makes government less capable of adhering to their agenda, and makes themselves of decreased relevance as self-ordained crusaders against corruption and abuse of power.
Understand then that the primary ideological goal of the media (and, more generally, of the political left) on this issue is to expand Medicaid, with a byproduct being the indigent receiving health care insurance. As Jindal’s plan’s primary goal is to provide the indigent with health care insurance, this explains why state media coverage of SB 682 has been so tepid: not only does it not comport to the media’s goal, but it also distracts because it does not expand Medicaid as we know it but, in their mind, can be mistaken for that (a point recognized and elucidated upon by a special interest that is a fellow traveler with media on the issue.)
This also explains the media spin placed upon Vitter’s remarks, led by the chief ostrich the New Orleans Times-Picayune, which never has printed a single word in its news hole about SB 682 yet obsessively stumps for Medicaid expansion on its editorial pages and responded to Vitter’s comments with cautious commending for his presumed openness on the issue, without ever realizing or acknowledging that he’s saying nothing different than Jindal. Yet to write something like this means of course it can’t: pretending that Vitter might be for expansion is a tactic to try to legitimize the idea while trying to do the opposite to Jindal opposition of it – even though it also commends efforts of governors who suggest pretty much the same thing Jindal does.
It easy to do that when you pretend that what Jindal has suggested does not exist and paint his opposition to Medicaid expansion as the same as being against expanding health care to the poor. Obviously, these rest on the false notion that Medicaid as currently constituted is the only way to provide health care insurance to the indigent and conflates government-provided health insurance with provision of health care. But to bring in all of these nuances does destroy their argument.
So this explains why when Vitter said nothing different than what Jindal has said that the media report the opposite and do not seek clarification. It also illuminates why none bothered to cover a salient moment in how health care in Louisiana may become revolutionized. Simply, any deviation or distraction from the narrative that Medicaid expansion is good cannot be tolerated – regardless of whether this acts to inform the public or to serve its interests.
It's real early, but, already, the apologies for David Vitter have begun.
All us Republicans that have been embarrassed by Bobby Jindal must think long and hard before voting for Vitter.
If you think so, just read this blog again.
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