In his commercials before the Republican primary, in addition to playing with his guns, his chainsaw, and his big pickup, Kemp proclaimed himself to be a “proud Trump Conservative.” Putting aside the fact that there is nothing conservative about Trump and the wonderment at anyone wishing to associate himself with a President best known for not telling the truth, I did find one characteristic that Kemp and Trump share: they like straw men.

In Trump’s presidential campaign, he routinely set up straw men (Latino rapists, and Muslim terrorists among others) and promised his screaming supporters that he could save them from the straw men.

Now Kemp is doing the same thing, dredging up (and misrepresenting) a decades-old sex offender law and trying to convince the mothers of Georgia that their children will be sold into sex slavery if they don’t vote for Kemp. (He’s right that Abrams didn’t vote for a law setting minimum sentences for human traffickers; she said that Judges should set sentences, not politicians, and this bill restricted the discretion of the judges. A group called Georgia Women for Change has noted that they have worked with Abrams for over decade to fight human trafficking and that Kemp’s critique of Abrams was “despicable.")

However, when you dig through the spin, the one issue that will probably affect the Citizens of Georgia most is whether Georgia goes with Medicaid Expansion. Abrams is for it. Kemp is against it.

His website echoes the charge that Stacey Abrams is “extreme,” and says that her proposal is a step toward a single-payer healthcare system, will cost the billions, triple state income taxes, worsen the doctor shortage, reduce access to quality care, ultimately bankrupt our state, and put the government, not the individual in charge of health needs. In his own platform, he says he worries about rural hospitals and proposes a $100 million in tax credit to fund them.

There are too many straw men in this single sentence to deal with in a single blog. But there are a few salient points that we can glean from the experiences of the 33 states who have adopted Medicaid Expansion. It’s hard to believe that 33 states, including some with both Republican governors and Republican legislators, are really extremists.

Kentucky’s experience is illustrative. When Kentucky adopted expanded Medicaid in 2014, the uninsured rate dropped from 14% to 5%. The state auditor said that this led “to more patients being able to pay for care and a reversal of fortunes for rural hospitals” that had been struggling.  “You can’t overstate how important the Affordable Care Act has been to rural hospitals,” he said.

Kentucky and other states have found that, even as the Federal part of the expansion ultimately falls to 90%, the multiplier effect of money being put into the state economy would return between $1.35 and $1.80 in economic activity for each federal dollar. That money is taxed by the state in terms of sales and income taxes, and the break-even point is estimated to be about 7.5%.

Kentucky and Arkansas predicted that the state-tax revenue associated with expansion would $360 million and $50 million respectively over five years.

And this, of course, doesn’t consider that Georgia citizens, because we haven’t accepted expanded Medicaid, are paying taxes that support health care insurance in other states. To some degree, other states are now exporting the care of their low-income population to Georgia.

Healthcare in a state that ranks in the bottom 20% by pretty much any measure deserves a serious conversation. It deserves a thoughtful and fact-based discussion. It certainly doesn’t deserve being the subject of a cynical parade of straw men.

There is no evidence that I can find that adopting Medicaid Expansion would do any of the horrible things that Kemp claims.

It’s difficult to take much of what he says about healthcare seriously. This is the man who devoted seven words to the subject for much of his campaign. Then he and the Lieutenant Gubernatorial candidate drafted a release touting the tax credit idea, and now he has a number of other proposals. I’m waiting to see where he goes next.

But while we wait, keep this in mind: of the states ranked in the top tier in terms of affordability, availability and results, 90% have adopted Medicaid Expansion. Of those in the bottom tier, two-thirds have not adopted it. It’s also interesting that, of those in top tier, 30% have both a Republican legislature and a Republican governor. Of those in the bottom tier, more than twice that number have a Republican legislature and a Republican governor.

Sounds like it’s healthier to live in a state that has either a Democratic legislature, a Democratic governor, or both.

References (click to follow link):
US News, US News, Huffington Post, Healthcare, 2016 State of Healthcare Quality, Center for Medicare and Medicaid Services, Healthcare Quality: How Does Your State Compare?, National Healthcare Quality and Disparity Report