On Friday and Saturday last week, two widely separated major state newspapers – the Tennessean and the Tampa Bay Times – published strikingly similar editorials calling for Medicaid expansion in their respective states. How unusual? The Tennessean’s editorial covered the majority of the newspaper’s front page with a bold headline at least three inches high. The Tampa Bay Times published the photos of recalcitrant legislators under a headline asking readers to “tell the legislature’s immoral minority to expand Medicaid in Florida.”

The fact that editorials were published urging acceptance of the Medicaid funding under the Affordable Care Act wasn’t unusual. Over the past year as this debate has gone on in non-expansion states editorial support for accepting the federal money has been broad from smaller outlets to larger papers.

The turning point illustrated by these two editorials is this. In states like Tennessee and Florida the debate around Medicaid is maturing. After prolonged discussion the issues have become very clear and misinformation – the perennial bête noir of any complex health policy debate – is at a minimum. In both states, public opinion across the ideological spectrum favors accepting the Medicaid money. Business and provider groups are actively supportive. And substantial bipartisan coalitions of Democrats and Republicans in each legislature are in favor of action. In the face of this momentum state leaders opposed to accepting the money have had the ideological nature of their opposition come into sharper and sharper focus. Especially in these states, where Republican state leaders have developed alternative plans for accepting the Medicaid expansion money that put a conservative stamp on these expansion proposals, it is very hard for opponents to come up with reasoned arguments not to accept the funding.

Sure, listen to political debate enough and you will hear everything from “But there are also unknown unknowns – the ones we don’t know we don’t know” to “It depends on what the meaning of the word ‘is’ is.” So there will continue to be arguments made in these states against accepting the federal money. However, the issues are now so clear in both these states that the almost purely ideological nature of the opposition combines with the costs of not acting to make principled opposition much more difficult. Therefore these two respected media outlets are feeling comfortable publishing editorials urging not just a position but continuing and active advocacy by themselves and their readers. You just don’t see editorials like these very much and their publication says a great deal about the Medicaid debate in these states today.

Excerpt from the Tennessean:  “Senator Todd Gardenhire might as well have called all Tennesseans “a**holes” last week when he leveled the vulgar term at a man in the hallway of the state Capitol. The man had questioned Gardenhire about how the lawmaker could justify taking taxpayer-funded state health insurance yet vote against Insure Tennessee, which would provide health insurance for hundreds of thousands of Tennesseans. That disdain seems indicative about how most Tennessee legislators feel about residents in our state.…

Daily we will publish stories, op-eds from Middle Tennessee community leaders, letters from ordinary citizens and other commentaries. We will publish the amount of money Tennessee is losing by not having Insure Tennessee, the amount of jobs that won’t be created without it, and the names and contact information of legislative leaders and the Commerce and Labor Committee senators who voted against the resolution (including Gardenhire) or abstained.” [Read more]

Excerpt from the Tampa Bay Times: Most Floridians want it. So do thousands of businesses and the medical community. So do Republicans and Democrats in the Florida Senate. Yet 80 Florida House Republicans are denying 800,000 Floridians access to health care by refusing to accept Medicaid expansion money from Washington. It is immoral, and it is financially irresponsible. Of those 80 House Republicans, 13 represent Tampa Bay districts. Call them. Email them. Ask them why they are blocking health insurance for your families, friends and co-workers. [Read more]