Just desserts

“I don't feel sorry for them if they get sick and then go bankrupt because their Medicaid got cut. It is what they voted for. Let them have it."

Comment from a Portland, Oregon bleeding-heart liberal

Trump told us what he would do: Lower taxes for the wealthiest. Reduce the Medicaid population.

We asked for it, and we are going to get it. Like it or not.

My Republican congressman is a go-along guy within the Republican House caucus. Cliff Bentz is unexceptional. He is a normal, reliable Republican voter, in the Reagan, Bush, Dole, McCain, Cheney, Romney, and now Trump tradition. Going with that flow got him elected to Congress in a district that votes Republican.

He publicly endorsed Donald Trump for president back when Nikki Haley was still in the running. He said he did it to preserve his credibility and influence in the GOP. He said his GOP colleagues appreciated seeing he was on the team. Republicans win Oregon's 2nd Congressional District about 60-40 against Democrats. His only real electoral risk is in a Republican primary, if Bentz were to disappoint Trump in some way and Trump were to endorse a Republican opponent.

The district is mostly rural. The main industries are agriculture and forest products. It is the poorest district in Oregon. Oregon is blue, with Democratic governors and a Democratic majority in the legislature because of votes in the more prosperous and urban Portland metropolitan area. Blue Oregon fully embraced the Medicaid expansion under the Affordable Care Act, i.e. Obamacare.

Medicaid by Congressional District

Bentz's district is unusual in the large number of residents who make use of the popular Oregon Health Plan, the mechanism that Oregon uses to implement the Medicaid under the ACA.

--224,601 people in this district voted for Cliff Bentz.

--227,986 peope in this district are on Medicaid

Many of those people are going to lose their health coverage. I expect that Oregon, being Oregon, will attempt to use state money to fill the worst of the gaps created by the federal cuts. I expect it to be thankless work for the Democratic legislature. Many Eastern Oregon counties publicly supported succession from Oregon so they can join Idaho. They want the money, sure, but not the government that provides it.

The comment from my bleeding-heart Portland correspondent is instructive. Frustration with MAGA politics may trump compassion. Damned if she wants to reduce other Oregon services to protect Eastern Oregon conservatives from their own folly. If their rural hospitals close because they go broke with un-reimbursed emergency care to people who had -- but lost -- Medicaid, then let them close. Let people drive 150 miles to a hospital. Ask Idaho for the money. Or since Elon Musk, Mark Zuckerberg and Peter Theil are getting even richer thanks to their vote, ask billionaires for the charity care they need.

Cliff Bentz will pay no political price for going along with the GOP consensus, even if it means tens of thousands of his constituents discover that they lost health coverage. Republicans vote for Republicans. Bentz's political peril would come from speaking out to protect Medicaid from cuts and becoming a conspicuous GOP defector. So he won't.

The only question is whether blue Oregon will step up. The greatest concentration of people on Medicaid are in the 2nd Congressional District, but people on Medicaid are everywhere in Oregon, so every Oregon legislator has an interest in doing something. If the legislature bails out Medicaid, it would be another iteration of the net transfer of funds from the "donor" areas of Oregon -- Greater Portland -- to the ungrateful "recipient" areas, i.e. the 2nd Congressional District. Liberal legislators may not be able to -- or want to -- save Eastern Oregon Medicaid recipients from themselves.

I sense a growing attitude among Democrats, whether it be the loss of Medicaid or deportation of an essential workforce for people in red states. Republicans are running the show. Let the people experience exactly what they voted for.