The human cost of an Obamacare repeal

The Supreme Court's decision allowing states to block the Medicaid expansion included under 2010's "Obamacare" law - and the promises of some GOP governors to follow through and block the program's expansion to their states' low-income workers - come at a real cost: Millions more people will continue to lack access to health care.

Republicans have continually promised to "repeal and replace" the Patient Protection and Affordable Care Act, without ever saying how they plan to replace it beyond platitudes recommended by Frank Luntz such as "patient-centered health care."

Incidental Economist blogger Aaron Carroll passes along the chart at the left - which illustrates the human cost of repeal - along with a suggested framing for President Obama to counter the GOP's insistence on returning to the old status quo, proposed by Washington Post columnist Matt Miller:

Here’s what you should do, Mr. President. In the debates this fall, pull out a small laminated card you’ve had made as a prop for this purpose. Then remind Mitt Romney that the ranks of the uninsured today are equal to the combined populations of Oklahoma, Connecticut, Iowa, Mississippi, Kansas, Kentucky, Arkansas, Utah, Oregon, Nevada, New Mexico, West Virginia, Nebraska, Idaho, Maine, New Hampshire, Hawaii, Rhode Island, Montana, Delaware, North Dakota, South Dakota, Alaska, Vermont and Wyoming.

Read that list slowly, Mr. President. Then ask your opponent: Would America turn its back on the citizens of these 25 states if everyone there lacked basic health coverage? That’s what we’ve been doing for decades. You knew it was right to act when you were governor of Massachusetts, Mitt. How can you pretend we don’t need to solve this for the nation? And how can you object with a straight face when your own pioneering plan was my model?

Carroll, who strives to be a dispassionate academic even as he supports expanded access, says he's "more than willing to consider any plan put forward by anyone that manages to increase coverage to the extent that the ACA does. But if no such plans are coming forward, then it’s hard to see how we can do well by simply going back to the way things were before."

There's a reason for that: the heavy fog of partisanship that descended over the country at the start of Obama's term, typified by Sen. Jim DeMint's promise to make health care into Obama's "Waterloo" - even though the proposal Obama and congressional Democrats negotiated is, at its root, a bipartisan compromise, as I explained in Sunday's Inquirer.  As Miller puts it:

I feel like a broken record but some truths bear repeating. Only in America could a Democratic president pass Mitt Romney’s health plan and fund it partly through John McCain’s best idea from the last campaign (taxing some employer provided plans) and be branded a “socialist.”

In every other advanced nation, the idea that government has a central role in assuring basic health security was settled decades ago — a consensus conservatives abroad embrace. Always remember: conservative icon Margaret Thatcher would have been chased from office if she had proposed anything as radically conservative as Obamacare — which relies on private docs to deliver the medicine, after all, and still leaves 20 million people uncovered.