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On Medicaid expansion, John Kasich is unchained in North Carolina

Former Ohio Gov. John Kasich (Photo by Andrew Renneisen, Getty Images)

“Now, when you die and get to the meeting with St. Peter, he’s probably not going to ask you much about what you did about keeping government small. But he is going to ask you what you did for the poor. You better have a good answer.”

– Former Ohio Gov. John Kasich in 2013, on his controversial decision to accept  Medicaid expansion. Kasich was one of the first Republican governors to adopt one of Obamacare’s signature components.

John Kasich insisted several times this week that he’s a free man.

Free from politics? Free from partisanship? Free from Trump? Certainly not free of ambition – the former Ohio governor all but acknowledged last week that he hasn’t ruled out another run for president [2].

Yet whatever’s unchained Kasich, be it canny political strategy or a moneymaking book deal [3] or Jiminy Cricket on his shoulder [4], we’re the better for it in North Carolina, at least for today.

Kasich’s savvy skewering of North Carolina Republicans during Tuesday’s N.C. Rural Center event [5] was one part stump speech — rife with jabs at his supposedly vanquished political rivals in Ohio — and one part scolding, lambasting the GOP’s untenable and unconscionable Medicaid blockade in Raleigh.

Kasich, of course, was among the first Republican governors to embrace Obamacare’s Medicaid expansion in 2013, a mostly federally-funded expansion. [6] In North Carolina, it would have guaranteed health care to hundreds of thousands of low-income people who would not otherwise have coverage. Nationwide, an estimated three million would benefit today if states like North Carolina left the sidelines.

At the podium Tuesday, he cautioned convincing North Carolina lawmakers would take more than lobbying. It would require a grassroots stampede, something akin to Rev. William Barber’s “Moral Monday” protests [7].

“I would put 10,000 people out here on the steps of the Capitol,” Kasich declared to applause Tuesday. “I would tell (the General Assembly) ‘you don’t want people to be treated poorly. This is a matter of justice.’”

And of the entrenched opposition on the right, where a bloc built by Senate President Pro Tem Phil Berger lords over the health care debate [8], Kasich advises a bullish approach for the conscientious conservative torn by Medicaid.

“There would be nothing better than to be caught in a primary because you decided to show dignity to another person,” Kasich quipped.

In 2013, Kasich made his appeal to the Almighty [9], speculating that, at the gates of Heaven, St. Peter would prize human empathy above fiscal conservatism, although his argument resonates in the secular world too. Not so much in modern Republican theology, where God is a tax cut and government is the fork-tongued Lucifer himself.

Kasich is no liberal hero. But during 2016’s caustic presidential election, Kasich distinguished himself because the former Ohio congressman wasn’t particularly angry about immigrants or Obamacare.

What happens when rather ordinary moderation becomes rather extraordinary? What happens when your most boast-worthy attribute is that, well, you’re not a political abomination, that you’re not the Frankenstein’s monster of avarice, insecurity, and rocket-powered ignorance that the country elected in 2016?

Still, if you can nail down Kasich’s offensive, tap-dance on LGBTQ rights [10], more power to you, and his position on abortion rights places him several football fields to the right of most Americans.

But on health care, the former Ohio congressman would seem to understand that, for all of the issue’s convoluted trappings, caring for the poor is simple, blunt and cruel. Either you believe that all Americans should have access to health care, or you do not.

Kasich boasted Tuesday of making his Medicaid pitch to a Koch convention too. “The whole place booed me,” he said. “I loved every second of it.”

These things are often a debate about priorities. The North Carolina Republicans who dam up Medicaid funding have made their choice one budget cycle after another, and it’s the wrong one.

Republicans warn of runaway Medicaid spending that, in North Carolina, has been anything but. And national Republicans fear the consequences for the national debt, but would lustfully send the debt into orbit [11] if it justifies lucrative tax cuts for the wealthy.

To call the GOP’s Medicaid stance heartless isn’t enough. It’s headless too.

Medicaid expansion reduces the number of uninsured and boosts the economy [12]. And what about the dire forecasts of looming Obamacare doom – their ominous claims that the federal government would scrap Obamacare for parts and balk on its share of the costs? They’re wasted newspaper clippings now, good for the bottom of the bird cage and little else.

The federal government paid for 100 percent of the expansion through 2016, but the feds’ share will level off at 90 percent next year. Expansion will surely cost the state, but the federal influx of billions cannot be ignored, even by the most hard-headed partisan.

Yet Berger – our state’s most powerful legislator – has never been so doggedly determined as he is on Medicaid, resisting calls from the left and the right to acquiesce. If it weren’t so wrong-headed, we’d call it brave. Berger is Frodo, trudging through darkness and danger in The Lord of the Rings, but rather than ridding the world of a looming evil, Frodo wants to deny health care to poor people.

To pass the state budget this year, Berger and company will have to negotiate. Democratic Gov. Roy Cooper and the minority leadership in the state legislature have made Medicaid expansion a centerpiece of their agenda in 2019. Republicans, bereft of the veto-proof majority they enjoyed for many years, will be forced, one way or the other, to talk Medicaid before this year’s budget is ratified.

North Carolina needs more than talk. It needs leaders who comprehend that their budget runs on more than ink; it’s flesh and blood too.

On Tuesday, Kasich recounted a fleeting conversation he had this week with a Republican Senate staffer at a Raleigh restaurant. The staffer told Kasich he was a fan. Kasich retorted with a message for his erstwhile bosses.

“Do you understand there are a lot of people who don’t have health care?” Kasich asked. “It could be your brother. This is a human justice, morality decision.”

Kasich distinguished himself in the GOP’s 2016 presidential trough by being the candidate who wasn’t yelling, but, like it or not, North Carolina could use his shouting today.