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Hullabaloo


Saturday, November 10, 2012

 
Opting out of human decency

by digby

They would rather see people die than implement Obamacare:
If you're poor and you live in the South, there's a good chance health care reform won't reach you. Intransigent Republican governors from Florida to Texas remain steadfastly resistant to President Barack Obama's plan to expand Medicaid to their neediest constituents.

The health care reform law Obama enacted in 2010 depends heavily on Medicaid, a joint federal-state health benefits program, to reach the goal of near-universal health care. If every state participated, 17 million uninsured people would gain coverage through Medicaid and the Children's Health Insurance Program between 2014 and 2022, according to the Congressional Budget Office. The law extends Medicaid to anyone who earns up to 133 percent of the federal poverty level, which is $14,856 this year.

But at least a half-dozen governors say they simply won't go along with the law. When the Supreme Court upheld Obamacare in June, justices ruled states could opt out of the Medicaid expansion. The decision threatens to leave 3 million of the poorest Americans without health coverage, the Congressional Budget Office predicts.

Florida Gov. Rick Scott, Georgia Gov. Nathan Deal, South Carolina Gov. Nikki Haley, Mississippi Gov. Phil Bryant, Louisiana Governor Bobby Jindal and Texas Gov. Rick Perry -- all Republicans -- are on record so far as resistors to expanding Medicaid, according to an analyses updated Thursday by the Advisory Board, a Washington-based health care consulting company.

Readers of this blog know that I have long been anguished over the Medicaid provisions of the law. Insuring large numbers of the working poor was the main incentive for progressives to support the bill, but it was always been obvious that the funding of it was the most vulnerable part. The Supremes' decision that states could drop out was just another layer of insecurity for a group of people who desperately need health insurance and will now wind up in limbo.

The greatest irony, of course, is this:

The states least likely to join in the Medicaid expansion also happen to be among those whose residents are in the greatest need. The poor and uninsured in these parts of the U.S. will likely continue to go without unless their political leaders have changes of heart.

Texas had the highest rate of uninsurance in the nation last year: 24 percent, according to census data compiled by the Henry J. Kaiser Family Foundation. In Florida, Georgia, South Carolina and Louisiana, it was 20 percent. Nineteen percent of Mississippians were uninsured in 2011. Nationally, 16 percent of people had no health insurance last year. In Massachusetts, which enacted a comprehensive health care reform program in 2006, only 4 percent of residents are uninsured.

States that refuse to cover more poor people will do so despite the fact that Uncle Sam will pick up most of the tab. From 2014 to 2016, the federal government will pay 100 percent of the cost of covering newly eligible people, after which the share will gradually go down to 90 percent in 2022 and later years.

If I didn't know better, I'd think some of these governors are trying to get their uninsured working poor to "self-deport" to other states. I wonder how well they'd get along without those low wage workers. They may just find out.


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