A Real Debate on Medicaid

Health

One reason Medicaid and the Affordable Care Act are some politicians’ favorite punching bags is because nobody responds to their attacks. But a recent Salt Lake Tribune op-ed by Lincoln Nehring at Voices for Utah Children shows it doesn’t have to be that way.

Lincoln’s op-ed (mistakenly attributed by Tribune webmasters to Ken Bullock of the Utah League of Cities and Towns!) responds to a commentary by Utah’s Governor, Gary Herbert, in the Washington Times. Governor Herbert’s op-ed hits familiar themes, attacking the Affordable Care Act (ACA) as “a misguided budget-buster that … undermines state solvency and subverts individual liberty,” and painting Medicaid’s proponents as Washington insiders who’ve “forgotten that Medicaid is supposed to be a bridge, not a hammock.”

Such attacks are rhetorical chestnuts for some politicians, because the traditional response is defensive (‘we shouldn’t balance budgets on the backs of the poor’) or at most corrective (‘the ACA’s not as expensive as you say’). Lincoln’s response is better, because it:

  1. Sets the record straight — Beyond simply correcting the governor’s budget math, the op-ed puts the responsibility for Medicaid-eligible kids and families remaining uninsured where it belongs: with policymakers like Gov. Herbert.
  2. Acknowledges Costs, but Stresses Value — Smart readers likely suspicious of free-lunch offers. The op-ed respects readers’ intelligence, by acknowledging that Medicaid and the ACA have costs, but emphasizing that Utah gets something valuable in return for that investment.
  3. Positions the ACA and Medicaid as solutions to real problems — By reminding readers that Medicaid and the ACA are about health care, not just state budgets, the op-ed shows that they’re solutions, not problems.
  4. Undermines the attacker’s vision — Recalling that the best defense is a good offense, Lincoln’s op-ed shows the governor’s vision for what it is – a spin-only plan that can win the favor of Washington insiders but does nothing to solve the real problems of real people.
  5. Positions the attacker as a Washington insider — It turns the governor’s argument on its head, questioning whether he’s more focused on Utah kids or Washington interest groups.

Responding assertively to attacks isn’t easy, and it’s important to be respectful. But it’s also important to be honest, and that means holding politicians accountable when they misrepresent the facts. Lincoln’s op-ed is a great example for all of us who work on children’s issues, because it uses smart tactics to bring real balance to an important debate and shows other politicians that attacks on investments in kids won’t go unanswered.