Our Views: For the poor, more Medicaid

On paper, there probably wasn’t a dime’s worth of difference between the platforms of two candidates for U.S. Congress in last month’s runoff in the 5th District.

To some extent, issues didn’t matter that much. The endorsements of major politicos who finished out of the money in the primary, the more genuine manner of young businessman Vance McAllister, endorsements by some of the “Duck Dynasty” family — all were probably more central to McAllister’s come-from-behind win.

But his victory over state Sen. Neil Riser, of Columbia, did involve one distinction between the two conservative Republicans: expanding Medicaid.

Both candidates called for repeal of the Affordable Care Act, aka Obamacare. McAllister was pilloried by Riser for saying that immediate repeal is unlikely until Republicans control the Senate and White House again. This connection with political reality was met by a storm of advertising of the sort Louisiana voters are familiar with from Riser consultant Timmy Teepell, the ad man and close friend of Gov. Bobby Jindal.

That this was a bogus attack is obvious, but McAllister did differ from many GOP officials in saying that the state should accept expanded Medicaid funding for health care for the poor. Jindal has blocked the expansion in Louisiana and encouraged other governors to do the same.

We disagree, and note that many GOP leaders are not on the same page, including conservative Republican governors in several big states.

It makes sense that McAllister should back the expanded Medicaid coverage. The sprawling and mostly rural 5th District includes most of the desperately poor parishes of the Mississippi River delta. His constituents even if working would probably never be able to afford meaningful health policies.

Medicaid is, as Jindal often says, not perfect. But it is an option that would be paid for 100 percent for three years by the U.S. government under the Affordable Care Act, and 90 percent after that. It is the best coverage that many families in low-wage jobs could get, at small cost to the state and with great benefits for the recipients.

Jindal has argued that expanding Medicaid would be costly over the long term. Given the parlous situation in the state budget, Jindal’s caution is warranted.

Yet, the reality is that health care coverage, if and when the Obamacare websites begin to function better, won’t be affordable for many Louisiana families holding low-wage jobs. Further, the state has begun a major shift to managed-care administration of Medicaid, and that may help reduce costs and improve outcomes over time.

The Medicaid coverage is a part of the Affordable Care Act, which is law and as McAllister noted likely to remain that way for at least the next few years. Denying health care to very poor families, when it is available to the state on such favorable terms, is not good policy.

And if the returns from the 5th District reflect any policy judgment by voters, denying Medicaid coverage is not good politics either.