Here come the health care refugees

It is stunning—and revolting–the depths to which ultra-conservative Republicans will go to harm their fellow Americans.  Particularly fellow Americans of color.

Living in Massachusetts, a state with an especiallly progressive health care safety net (thanks in part to the efforts of then-Governor Mitt Romney, a then-moderate Republican), I hadn’t been paying that much attention to what was happening with health care reform out in the rest of the country.

This morning’s headliner in The New York Times—“Millions of Poor Are Left Uncovered by Health Law”—was a real wake-up call.

How could it be that “two-thirds of poor blacks and single mothers and more than half of low-wage workers without insurance” will be left stranded by Obamacare?

Simple.  The Supreme Court, although it upheld the health care exchange idea, also allowed states to choose to opt out of the expansion of federally funded Medicaid benefits.  Even though the federal government would cover the cost of the expansion through 2016, and at least 90% of Medicaid expenses thereafter, Republican-controlled state legislatures have balked at the prospect of picking up the tab for even 10% of an expanded Medicaid program that would provide health care for millions of people in their states.

It seems they’d rather let those people suffer and die.

According to The Times, “The 26 states that have rejected the Medicaid expansion are home to about half of the country’s population, but about 68 percent of poor, uninsured blacks and single mothers. About 60 percent of the country’s uninsured working poor are in those states. Among those excluded are about 435,000 cashiers, 341,000 cooks and 253,000 nurses’ aides.”

What would happen if those working poor, the minimum wage earners who clean those Republican legislators’ houses, take care of their children, cook their meals, and tend to their aging parents in nursing homes—what would happen if they just up and left?

I have a vision of a vast migration of health care refugees, fleeing the red states just like they did after it became clear that the end of chattel slavery did not mean the end of bondage—it just morphed into debt bondage and serfdom.

If states can say “No thanks” to Federal Medicaid coverage, citizens should be able to say “No thanks” to states.  Let’s see how they like it down in Mississippi and Alabama when there’s no one left to flip their burgers and shine their shoes.

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  1. This is precisely why I am so disgusted with the lot of them. The Democrats do something we are led to feel is good or useful, only to discover someone (the Court, some hidden attachment to a law passed by Congress, the Republicans, or the President himself) has watered it down or otherwise altered it so that no, it’s not really the solution we thought it was but much less of one. And of course those most dramatically affected are ALWAYS the poorest among us, and/or people of color. I cannot see this turning around until as a nation we are able to send every one of our elected officials home and choose people willing to put human need before their own greed and pompous self-aggrandizement.

  2. Robert D. Ludden

     /  October 3, 2013

    Margaret, much as I like what you say, I do not think that will work. I think we need to find ways to amend the law to provide unquestionably for those who cannot afford even this protection–or believe that they cannot. This means creating a process where they can counsel with the states to provide that necessary income when they must–even at a sacrificial maneuver, which would least affect those who make those sacrifices. Difficult, yes, but a way. Otherwise those who battle with greed, will never be willing. Whatever our solution, we must ask, “Will it work?”

  3. I agree that solutions hold the most promise when we ask “will they work?” My problem is that I see gross ineptitude and often criminality at all levels and in all areas of government. My solution is not “no government.” But I have become exhausted with patching one hole only to witness another open up. I am left wondering how we can amend a law that has been vitiated from the beginning by concessions to the large insurance and pharmaceutical companies and then watered down even further by adjustments and delays. The only real answer to healthcare for everyone, in my opinion, is universal healthcare. Sadly, I don’t see that as a possibility, not in my lifetime at least.

  4. Jennifer Browdy de Hernandez

     /  October 3, 2013

    I share your sense of disillusionment, Margaret and Robert. That’s why it suddenly occurred to me that citizens could vote with their feet, simply up and moving from states that refuse to provide a safety net, to those that do. Of course, I can also anticipate the outcries of all those states and countries that end up taking in humanitarian refugees–we can’t afford it! But in this case, the Federal government has already agreed to pick up the cost. So it’s just a matter of will, not economics.

    I wonder what those red states do if all the working class people up and left? Would they start to import “guest workers” from other countries, who wouldn’t make any noise about wanting health care benefits? Or would they finally realize that the Scroogish retort, “are there no workhouses?” simply won’t cut it in the 21st century?

    Truly these are complicated problems and I know I am over-simplifiying here to make my point. I think the answer lies in what Margaret was talking about recently–getting up off our couches and away from our screens and out into the streets! We started to do it during the Occupy movement, but with over-reliance on the young to be on the frontlines. If older people got out in front, the battle might play out differently.

  5. Robert D. Ludden

     /  October 3, 2013

    I agree with you, Margaret, of course. And, Jennifer, I practiced streets action for sometime before my stroke a little while back, which left me with severe balance problems. I dearly wish I could have continued that.

  6. People massively moving from red to blue states is a great visual. The sad thing is, no one who is poor can really get up and move anywhere. How? With what resources?

  7. Robert D. Ludden

     /  October 4, 2013

    The conservatives do not see it. They think the rest of us are the holdouts.


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