Last month, Arizona Sen. John McCain told Fox News' Greta van Susteren that the Affordable Care Act, aka Obamacare, is the "ultimate experiment in social engineering." Never mind that nearly every other developed country in the world manages to provide health care to its citizens without falling under the yoke of socialism. Never mind that the version of Obamacare being rolled out is actually based on a 1989 plan from the ultra-conservative Heritage Foundation, which called on Americans to carry health insurance the same way drivers carry liability insurance. And never mind that "Obamacare" had a different name when then-Governor and later 2012 GOP presidential candidate Mitt Romney enacted a version of it in Massachusetts in 2008, where it was nicknamed Romneycare. Like Obamacare, Romneycare needed a good amount of tweaking after its implementation.
Some object to the Affordable Care Act on principle. For others, it's more political, which brings us to Gov. Bobby Jindal. The governor has made his opposition to Obamacare plain — in speeches, on talk show appearances and in an increasing number of op-ed pieces, most of which he writes for the Beltway establishment he claims to distrust. Among Jindal's arguments: Obamacare would cost too much for the citizens of Louisiana. But the true cost of health care is about to come due after Jan. 1.
Twenty percent of Louisianans have no insurance at all — the fourth-highest percentage in the country. Under Obamacare, the feds are offering billions of dollars to help cover each state's poorest residents — an extension of the Medicaid program, which has been part of the bedrock of the American health system for nearly 50 years. More than 200,000 of the poorest Louisianans could get coverage under this extension, but Jindal is hell-bent on turning it down.
Jindal says it would hand over too much control to the federal government and eventually cost Louisiana too much money. In truth, Medicaid expansion in Louisiana would be entirely paid for with federal funds for the first three years before a gradual, 10-year phase-in would result in a 90-10 split. Just to be clear, that's 90 percent of the cost being picked up by the feds.
We've seen this act from Jindal before. In 2009, the governor decried Obama's Recovery Act, before turning around and quietly accepting $3.2 billion in federal Recovery Act funds. When he toured the state later that year handing out gigantic sweepstakes-like checks to the leaders of Louisiana parishes, Jindal put his own name on the checks as the payor — conveniently omitting the fact that some of the money came from the Recovery Act he had derided. Thus, Jindal is not entirely allergic to federal funds when it suits his own political ends.
Sadly, the map of states rejecting Medicaid expansion dovetails with the map of the states with the most health problems — Louisiana among them — and several are in the Deep South. Alabama Gov. Robert Bentley, a dermatologist, said recently, "I can't think of anything worse right now than to have expanded Medicaid and have all these people on an entitlement program right now and for this entire thing to go under." Mississippi Gov. Phil Bryant proposes a $4.4 million transfer of state funds to offset the loss of federal funding, calling it a way to "weather the Obamacare storm." There are two problems with that argument: Bryant would be robbing Peter to pay Paul (the money would come from somewhere else in Mississippi's already-strapped state budget), and it's far less than the nearly $1 billion his state is turning down.
Jindal's solution is no better. In an October interview with Fox News' Chris Wallace, Jindal said bluntly, "We don't need the government running our health care." Just minutes later, when asked for his solution to the Louisiana health care crisis, Jindal told Wallace, "We're the only state that has a state-operated network of charity hospitals. ... We had 10 state-operated hospitals when I became governor."
What's a state-operated hospital if not a form of government-run health care? And given that Jindal got his start in state government in 1996 as the director of Health & Hospitals, what does it say that Louisiana remains at or near the bottom of nearly every available wellness matrix?
There is indeed some "social engineering" in health care, but in Jindal's Louisiana, it's Darwinian in nature. Only the strong (and wealthy) survive. Come Jan. 1, when Jindal passes up billions in Medicaid money — which some other Republican governors have managed to accept — we'll see Jindalist social engineering in action. It won't be pretty.