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The South Rises Again: Rejecting Medicaid Expansion

By The Reverend Published: October 19, 2013

The progressive portion of Obamacare is the Medicaid expansion provision. Medicaid is government healthcare for the poorest Americans. Individual states set income limits to qualify for the Medicaid program. It should come as no surprise that southern, red states have the stingiest limits....

Two parents and a child living in Alabama, Arkansas, Indiana, Louisiana or Texas with an income of $4,850 a year actually earn too much to qualify for traditional Medicaid. And if you're not a parent, then things are even worse. In most states, if you have no children, you can't qualify for Medicaid no matter how little you make. In most states, even if you make no money at all, there's no Medicaid for you.

Often, the state of Texas is pointed to as a conservative economic success model. Low, lower and going-even-lower taxes on rich Texans and crumbs as a safety net for the non-rich is the model Gov. Rick Perry and other national Republicans tell us should be the template for the nation.

The cost of health insurance in Texas....

The average family premium, across all types of health plans, cost $12,106 in 2007. Workers were expected to contribute $3,281 toward that coverage.

So you see why a Texas family of three earning, say, $6000 per year......and ruled ineligible for Medicaid because they earn too much money.....could not possibly afford health insurance. The affordability of health insurance and health care is the very problem the ACA sought to address.

However, the progressive portion of the ACA is the one provision Chief Justice Roberts helped stingy conservative states nullify by ruling that states could opt out of the expansion. It was Roberts' most heartless, inhumane and nakedly political decision to date. Predictably, red state leaders rushed to microphones announcing that they would reject....reject I tell you....the "massive government takeover attempt" they interpreted it..... in expanding Medicaid to millions of poor working families.

No matter that the cost to states for expanding Medicaid would be zero until 2020, and then only 10% matter that the expansion would funnel billions into state economies.... no matter that millions of poor working families who could never afford insurance could now have access to healthcare other than emergency hospital room state leaders claimed that the "uncertainties" were just too great. Also, too....socialism.

This, then...comes as no surprise....

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.

Southern state Republicans swear they are not waging a war against minorities or women or the poor. They act oh-so-offended when accused of doing so. But the proof of the pudding is in the tasting.....and for single mothers and minorities in southern state leaders rejecting Medicaid expansion is a real life, bitter pill to swallow.

Which leads me to what is surely going to be controversial. Have the American states ever really settled the Civil War? Yes, 600,000 Americans died to end slavery but what followed? One hundred years of mostly southern state leaders sub-humanizing freed blacks. The sub-humanizing ended, legally, during my high school years with the passage of Civil Rights legislation.....but what happened next?

George Wallace...the likes of Strom Thurmond and Jesse Helms....southern leaders who simply would not accept the idea that Washington had the right to tell states what they could or couldn't do with their minorities.Those minorities didn't belong to Washington...and so D.C. had no right to tell the states, the rightful owners of minorities, how those minorities could be treated.

Today, I would suggest, it's Obamacare....and specifically....Medicaid expansion. With an important assist from Judge Roberts, southern state leaders feel vindicated. By gum, they'll treat their minorities and their poor any damn way they chose....because just as before the Civil War, just as before Civil Rights legislation was passed, the federal damn government can't tell southern states what to do with their minorities.

And so, 26 states are refusing to accept Medicaid expansion for their state's poorest working citizens. And for no legitimate reason.....other than that dark skinned guy in the White House ain't gonna tell us southern states what we have to do with our minorities.

Much, much progress has been made during my lifetime when it comes to race relations.....but the current embarrassing fight over Medicaid expansion in southern, red states, I think, is an ugly reminder of the division which has threatened our nation from it's formation.



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