Republicans must be getting nervous about their refusal to expand Medicaid in Montana. Last Wednesday’s Gazette published not one but two opinion pieces making the case that the Legislature was right to oppose Medicaid expansion.

Weighing in were Tom McGillvray of Billings, the House majority leader, and Joe Balyeat, a former state senator who is now state director of Americans for Prosperity-Montana.

Rep. McGillvray, it seems, is having bad dreams about the Legislature giving Montanans money to buy Cadillacs. By “Cadillac” he doesn’t mean a car; he means health insurance. In his view, the rising cost of health insurance can be blamed on requirements that insurance companies cover a broad range of conditions instead of a limited menu of options people choose for themselves. If you want insurance that covers maternity care or treatment for autism or mental illness, for example, you are shopping for a Cadillac.

Sounds good, but his plan does turn health insurance into a bit of a lottery. We all go through life full of optimism that we will never have a child with a terrible illness or drug addiction or that we will never need exotic treatments and screenings with long names that we have never heard of and would never think to buy insurance against. But some of us are bound to be wrong about that.

It’s not clear in any case how much money McGillvray’s approach would save. Health insurance is expensive in America because healthcare is expensive in America – twice as costly as in most other industrialized countries, all of which offer some sort of universal coverage.

Continue reading: Medicaid arguments don’t quite add up