Opposing Medicaid Expansion On Principle--And Still Caring For the Poor

The continuing, partisan debate over Medicaid expansion provides politicians and pundits fuel to feed the popular perception that conservatives just don’t care—a perception that is dead wrong.

The real basis for Republican opposition to federal charity programs has nothing to do with a lack of concern for the poor, and everything to do with a commitment to keeping government in its proper place.

Conservatives are perpetually vulnerable to being branded as heartless and greedy, because their belief in limited government nearly always pits them against federal giveaways. As we learned this month, some schoolteachers have jumped onto the liberal dogpile, training their students to identify the Republican Party as the party that doesn’t care.

This construct may be effective in channeling votes to liberals, but the facts don’t support it. Over a decade ago, American Enterprise Institute’s Arthur Brooks amassed cold, hard data revealing that in fact, political conservatives are far more charitable than political liberals.

In his book, "Who Really Cares," Brooks reported that in 2000, households headed by a conservative gave, on average, 30 percent more money to charity than those headed by a liberal, even though liberal families earned an average of 6 percent more each year than conservative families. And the disparity was not only in financial giving—the same trend appeared in donations of time, and even blood.

More recently, the Chronicle of Philanthropy released a ranking of states in terms of residents’ charitable giving as a percentage of their adjusted gross income. The 17 states at the upper, most generous end of the spectrum were red states, going to Mitt Romney in 2012. By contrast, the lowest 10 states—with only one exception—were blue, Barack Obama-backers.

Faced with the undeniable fact that political conservatives are generous, community-minded people, thoughtful Americans must look beyond political labeling to understand the real reason for resistance to broad-scale government charity programs.

The key is something fundamental to the conservative worldview: the conviction that government must be limited so that people can be free. Not every good work is a work for the federal government.

Tragically, any real commitment to this fundamental philosophy, the very hallmark of our Constitution, today is grounds for burning at the political stake. Last Sunday, The Washington Post’s editorial board went so far as to liken Virginian Republicans resisting Medicaid expansion to racists resisting school integration during the Civil Rights Movement.

According to these editors, “Republicans in Richmond, standing on the ‘principle’ that Virginians bear no responsibility for their least fortunate neighbors, will not budge.”

They offer no evidence whatever to support their assessment of motivation. Nor do they offer any logical basis for their wild-eyed claim that to oppose Medicaid expansion is to “target[]” the needy.

Ironically, having drawn their unsubstantiated and wrong-headed conclusion that the Virginia GOP suffers from an undersized heart, the editors go on to express bewilderment that the selfishly-motivated Republicans don’t snatch up the great federal funding “deal” in front of them. This should have been a clue that their analysis was amiss…

Lucky for Virginia, tenderhearted but principled Republicans seem to recognize that more is at stake here than the terms of a fiscal “deal.” For true conservatives committed to states’ rights and a federal government of specific, enumerated powers, this is ultimately about integrity.

Matters of public health and welfare are traditional state prerogatives, and Congress is therefore limited in its ability to coerce state policy in these areas. What Congress can do, however, thanks to some unfortunate court precedents, is to dangle funds toward states whose lawmakers are willing to forfeit considerable components of their sovereignty.

It is refreshing that the Virginia GOP has the moral fortitude to just say “no.” Relinquishing self-governance is too high a price to pay for a massive, federal, bureaucratic program that cannot possibly do well what liberty-loving Virginians can and should be doing themselves—caring for those among us who truly cannot care for themselves.

Americans who are serious about getting Uncle Sam out of state policymaking for good should look to Article V and work to implement the long-term, constitutional solution it offers. Through a properly framed constitutional amendment-proposing convention, the states can put the feds back in their rightful (limited) place.

Rita M. Dunaway serves as Staff Counsel for The Convention of States Project and is passionate about restoring constitutional governance in the U.S. Follow her on Facebook, and e-mail her at rita.dunaway@gmail.com.

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