Medicaid Expansion: Enough to Make You Sick (Richmond Times-Dispatch)

Richmond Times-DispatchStephen J. Farnsworth: Virginia public opinion supports the idea of Medicaid expansion by a more than 2-to-1 margin, according to a statewide survey. ... But in a state full of gerrymandered legislative districts, delegates and senators who want another term in Richmond must focus on satisfying the more intense, ideologically extreme voters who show up for nomination contests. As a result, most Republican lawmakers are concerned primarily with what GOP voters think.

Here’s where Republican lawmakers find strong support for their opposition: Only 38 percent of the state residents who said they were Republican and expressed an opinion on Medicaid expansion favored it. ... Opposition to Medicaid expansion would be even more intense among the subgroup of Republican voters who vote in those all-important but tiny turnout primaries. (Opposition among GOP identifiers likewise would be more intense if the trigger word “Obamacare” were included in the survey question.)

Virginia Republicans have every incentive to take party activists seriously. Last June, Rep. Eric Cantor, then the House majority leader, was defeated in a primary for not being conservative enough. In 2013, two senior Republican members of the House of Delegates were defeated in primaries for backing a Republican governor’s transportation plan. And nearly all of the moderate Republicans who crafted bipartisan compromises with then-Gov. Mark R. Warner a dozen years ago have lost primaries or have retired and been replaced by more extreme lawmakers.

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