Louisiana: John Bel Edwards's win *DOES* have an important lesson for Democrats nationally

The huge political story this morning is Democrat John Bel Edwards winning the Louisiana gubernatorial race by a whopping 12 points.

Much is being written about What This Means for Democrats Next Year®, blah blah blah. The reality is, as happy as I am about the outcome (sort of the Yang to the recent Yin in Kentucky), most of the specifics of the Louisiana results probably don't mean much nationally. As Matthew Yglesias notes at Vox this morning:

Louisiana was a perfect storm

A number of different factors came together to power Edwards' win. One is that Edwards, as a former Army Ranger with deep family ties to Louisiana state politics, had the right kind of biography to win in a red state. The other is that Vitter's rather unusual history with paid sex gave him the wrong kind of biography to win in any state. Add on to that the fact that the Louisiana Republican Party is divided and factionalized and the GOP has a firm grip on the state legislature, so some Republicans aren't exactly weeping to see Vitter lose.

Last but by no means least, the Louisiana economy is suffering from the global trend toward cheaper oil in a way that naturally helps challengers.

Or, as someone else put it (in cruder terms) last night:

@yeselson @neeratanden now we just need EVERY GOP candidate to wear diapers while impregnating a prostitute & illegally recording a sheriff.

— Charles Gaba (@charles_gaba) November 22, 2015

In addition, Edwards is also solidly anti-choice and pro-gun; he's not gonna be a champion of progressive causes on some big issues. So, Democrats shouldn't get too excited here, right?

Well...OK. However, there are two things which Edwards' win does mean which are vitally important to note:

The first is the one most directly relevant to this website. As noted in Mother Jones last night:

[Outgoing GOP Governor Bobby] Jindal also rejected federal funding to expand Medicaid. Edwards has pledged to sign an executive order authorizing the expansion of the program on his first day in office. That's a really big deal. Such a move would provide coverage to about 225,000 residents in one of the poorest states in the nation.

The actual number of people who will become eligible for Medicaid upon Edwards signing such an executive order is actually a bit fuzzy. The headline of the Mother Jones piece exaggerates that 225K figure to "a Quarter of a Million People" (250K), but the most reliable number I know of comes from the Kaiser Family Foundation, which estimates around 192,000 people currently caught in the "Medicaid Gap". The discrepancy may be due to the fact that, also according to KFF, there are an additional 49,000 uninsured Lousianans who are already eligible for Medicaid without expansion but who haven't signed up yet; these will hopefully fall into the "Woodworker" category, as in "pre-ACA Medicaid eligible who come out of the woodwork to sign up once expansion is enacted", as around 3.8 million others have done already nationally.

OK, so around 192,000 more uninsured people should instantly become eligible for Medicaid as soon as Edwards takes office, which is huge all by itself, right?

Right. And heres is where national Democrats should pay close attention. Take a look at the home page of Edwards campaign website:

Again, that's a huge banner which appears on the home page of his site. It's even the very first slide (the other 2 are about education and the military).

Furthermore, when you click on the (huge) banner, here's Edwards' healthcare position page:

Healthcare in Louisiana is at a crossroads. Years of neglect and indifference from Bobby Jindal’s administration have caused serious damage to our healthcare system. As such, now, more than ever, our state needs a governor committed to the well-being of Louisianans – not someone beholden to political ideologies or chasing personal ambitions. Louisiana needs a governor who will make healthcare accessible to all citizens. In short, Louisiana needs a governor who will put Louisiana first. We need John Bel Edwards.

MEDICAID EXPANSION

As a state legislator, John Bel has championed the cause of bringing $16 billion of our own taxes home to Louisiana over the next ten years to care for working families in our state. Accepting Medicaid expansion would provide a much-needed spark of life to our state’s healthcare system, which has suffered due to an ever expanding number of uninsured patients.

Expansion would provide health insurance to over 290,000 uninsured parents and adults, most of whom come from working families. By increasing the number of insured patients, expansion would decrease the amount of uncompensated care providers must deliver each year. Decreasing the amount of uncompensated care allows healthcare providers to pass savings along to all consumers through lowered costs and expanded access. Accepting the Medicaid money to which we are entitled would also inject 1.8 billion dollars into our economy and create over 15,000 jobs within two years.

The economic benefits of Medicaid expansion are impactful, but just as importantly, we must recognize that it is simply the right thing to do. To improve healthcare for everyone, we must ensure the parents, children and working-disadvantaged of our state have access to care and that providers are not struggling to provide that care.

...AS GOVERNOR, JOHN BEL EDWARDS WILL

  • Work with the state legislature to accept our healthcare dollars back into the state to expand Medicaid and provide access to health care to over 290,000 uninsured Louisiana citizens.
  • Collaborate with Louisiana’s “safety net” hospitals and other charity care providers to ensure they receive the support needed to increase efficiencies and achieve improved health outcomes for all patients.
  • Continue to work with the VA to increase access to care and improve outcomes for our servicewomen and servicemen.
  • Increase the number of inpatient beds for the mentally disabled and prioritize the quality of our state’s mental healthcare system.

Again, the exact number of Louisianans who will become eligible seems a bit vague; Edwards claims it's 290K. Other than that, however, this is pretty much perfect. No equivocation, no code language, no vague descriptions; he comes right out and clearly states that he supports expanding Medicaid, period. Now, he doesn't actually mention the words "Affordable Care Act" (or "Obamacare", although that's reasonable since it's not the actual name of the legislation), but even so, contrast this with losing Kentucky candidate Jack Conway's nearly nonexistent mention of the ACA or Medicaid at all on his website:

...when it comes to Medicaid expansion, he supports it...although I've gotta admit, when you look for "Medicaid" on his campaign site, all that comes up is his record on protecting Medicaid recipients from fraud/abuse as Attorney General...and there's no mention of Kynect at all.

Now, it would be oversimplification to just say "Conway lost because he didn't push Medicaid expansion; Edwards won because he did". Kentucky and Louisiana are different states; Conway and Edwards were different candidates; Matt Bevin (the Kentucky GOP winner) and David Vitter (the Louisiana GOP loser) were different candidates, and so on. It's entirely possible that Conway (who lost by 9 points in KY) would still have lost even if he had pushed the Medicaid/kynect issue, and it's possible that Edwards (who won by 12 points in LA) might still have won if he hadn't pushed it, given how damaged Vitter's reputation has become back home.

HOWEVER, the larger point is that whether or not Medicaid expansion would have/did help the Democrats, it sure as hell didn't hurt them.

THIS is the lesson that Democrats need to get through their heads nationally: The Affordable Care Act may or may not be helpful to run on next year, but it isn't anything to run away from either...and since it is a large portion of the U.S. economy and has significantly transformed the U.S. healthcare industry over the past few years, trying to run from it is pointless. National Dems should embrace the positives while also discussing ways of enhancing them & resolving the negatives, because trying to ignore the law will make them look, frankly, pretty stupid.

Or, put more simply:

I hope yesterday's election teaches Democrats that they can and should run on Obamacare.

— Emma Sandoe (@emma_sandoe) November 22, 2015