12 November 2018 — 0944 mst
Comparison of 2004 and 2018 tobacco tax initiatives
In 2004, voters approved an increase in Montana’s tobacco tax by a two to one margin. Last week, they rejected Initiative 185, which raised tobacco taxes and removed the sunset provision in the law approving expanded Medicaid.
The graph below compares how Montana’s counties voted in both elections.
I-185’s defeat means approximately 100,000 Montanans will lose their health insurance unless the 2019 legislature — where Republicans will hold commanding majorities — ignores the will of the voters and reauthorizes expanded Medicaid.
Before the election, several legislators made requests for bills dealing with health care and Medicaid. At this point, drafts of those bill are not available — and may not become available, as I suspect many were predicated on the voters’ approving I-185.
If the legislature does extend expanded Medicaid, it will come at a heavy price for recipients of Medicaid, expanded and regular. There likely will be onerous work requirements, heavy copays, and all sorts of mean-spirited provisions intended to discourage and stigmatize those who qualify for Medicaid.
And if expanded Medicare is extended, it won’t be extended to help people directly. It will be extended to help hospitals and insurance companies and other players in the medical industrial complex that fails to cover everyone but succeeds in costing more per capita than in any other civilized nation.
That’s the best deal Montana will get as long as its legislature remains controlled by Republicans. As long as Montana’s Democratic party resigns itself to being a permanent legislative minority that extolls the virtues of “Responsible Republicans” and prefers Democratic activists who are meek, mild, and “reasonable,” and who worship compromise as an intrinsic instead of instrumental good, nothing will change and the poor will have many fine opportunities to accept personal responsibility, many fine opportunities to pull themselves up by their bootstraps, and many reminders not to commit the moral failing of becoming ill.