The GOP’s Fight Against Medicaid

4.4 million more Americans than last year have health insurance—no thanks to Republicans.

Leo Gerard, United Steelworkers President

Texas is just one of the 21 GOP-controlled states that have rejected the Affordable Care Act’s provision extending Medicaid to additional low-income people. (Photo by Ben Sklar/Getty Images)

Doc­tor, doc­tor, give me the news
I got a bad case of lovin’ you
No pil­l’s gonna cure my ill
I got a bad case of lovin’ you

‑Robert Palmer, 1979, Bad Case of Lov­ing You

A study released last month shows what each state will lose in federal funding by rejecting the Medicaid expansion ... No state that refused to expand Medicaid will save money, the researchers found.

On this Valentine’s Day, as many as 4.4 mil­lion more Amer­i­cans than on Feb­ru­ary 14 last year could go to the doc­tor to get the news.

That’s because the Afford­able Care Act pro­vid­ed them with health insur­ance. So they can afford to have a physi­cian diag­nose their light­head­ed­ness or aching hearts.

The Repub­li­can response to that good news, as in the song made famous by Robert Palmer, is WHOOAAA.” They want to stop it. They want to reverse, revoke, rescind, retract the Afford­able Care Act. They’ve tried it all. Near­ly 50 times they vot­ed to repeal the law that so far has giv­en as many as 4.4 mil­lion more Amer­i­cans health insur­ance in the past year and that will, over the next month or so, add a mil­lion more to that num­ber. No pill’s gonna cure Repub­li­cans’ ill. They got a bad case of hat­ing Barack Oba­ma. So bad that they’re intent on tak­ing health insur­ance from mil­lions of Amer­i­cans in an attempt to wound the President.

So far, Repub­li­cans have failed to repeal the Afford­able Care Act. But 21 GOP-con­trolled states reject­ed the Act’s pro­vi­sion extend­ing Med­ic­aid to addi­tion­al low-income peo­ple. They’ve refused to expand Med­ic­aid cov­er­age, even though this will cost their states tens of bil­lions in fed­er­al aid and will cost untold num­bers of their cit­i­zens their lives.

The case of Israel Hilton is an exam­ple of the high price of hate. Hilton, 49, worked his whole life in cus­tomer ser­vice, a job he did well enough to earn an employ­ee of the year award from K‑Mart. But his employ­ers didn’t pro­vide health insur­ance. He earned too lit­tle to buy it him­self and too much to qual­i­fy for Med­ic­aid in his home state of Texas.

Under the Afford­able Care Act, Texas could extend Med­ic­aid to cov­er the work­ing poor like Hilton. The fed­er­al gov­ern­ment would pay 100 per­cent of the cost for three years. After that, the feds would cov­er 90 per­cent. More than 1.5 mil­lion Tex­ans would get health insur­ance. They could see doc­tors when they were ill. In addi­tion, Texas tax­pay­ers and pre­mi­um pay­ers would not sub­si­dize so many cost­ly emer­gency room vis­its by the uninsured.

But Texas Repub­li­cans refused the fed­er­al mon­ey. And so, in Texas, there will be more sto­ries like Israel Hilton’s. Last year, he suf­fered severe headaches and seizures. He went to an emer­gency room, a place that by fed­er­al law could not turn him away despite his lack of insur­ance. It’s not a place, how­ev­er, most appro­pri­ate for deter­min­ing the cause of seizures, and he was mis­di­ag­nosed. With­out health insur­ance, he didn’t seek a sec­ond opin­ion. By the time he returned to the hos­pi­tal and received the cor­rect diag­no­sis of brain can­cer, it was terminal.

A study released last month shows what each state will lose in fed­er­al fund­ing by reject­ing the Med­ic­aid expan­sion. Texas will for­go the most, accord­ing to the researchers at the Wag­n­er Grad­u­ate School of Pub­lic Ser­vice at New York Uni­ver­si­ty, about $9.2 bil­lion in 2022.

No state that refused to expand Med­ic­aid will save mon­ey, the researchers found. In addi­tion, the study not­ed, res­i­dents of states like Texas will sub­si­dize with their fed­er­al tax dol­lars the ser­vices pro­vid­ed in oth­er states and denied in Texas. Ear­li­er research showed the loss to Texas over a decade at $100 billion.

That’s a bad case of hatin’ Barack Obama.

And the prog­no­sis for the Afford­able Care Act is good — which, of course, is bad news for the GOP. Despite the bumpy Oba­macare web­site roll out, it’s work­ing now, and last month near­ly 1.14 mil­lion peo­ple signed up for insur­ance through the exchanges, a num­ber high­er than pro­ject­ed. The so-called young invin­ci­bles, aged 18 to 35, bought insur­ance on the exchanges at a faster rate in Jan­u­ary, so now it’s pro­ject­ed their par­tic­i­pa­tion will be high enough to keep rates from ris­ing pre­cip­i­tous­ly. And, the Gal­lop Poll found the per­cent­age of Amer­i­cans with­out insur­ance last month was the low­est in five years.

Alto­geth­er, 3.3 mil­lion peo­ple bought pri­vate insur­ance on the state and fed­er­al exchanges from the time the enroll­ment peri­od began Octo­ber 1 through Feb­ru­ary 1. And more than 6.3 mil­lion peo­ple signed up for Med­ic­aid just between Octo­ber and Decem­ber. Some of those peo­ple would have qual­i­fied for Med­ic­aid with­out the Afford­able Care Act, and the total num­ber added as a result of the Med­ic­aid expan­sion won’t be known until after the enroll­ment peri­od ends March 31. But it’s esti­mat­ed that at least 1.1 mil­lion were added through Med­ic­aid expansion.

It’s not per­fect. The Con­gres­sion­al Bud­get Office now projects that six mil­lion peo­ple will sign up for cov­er­age. That’s one mil­lion few­er than orig­i­nal­ly projected.

Repub­li­cans tried ear­li­er this month to cre­ate some bad news from a Con­gres­sion­al Bud­get Office report that said the Afford­able Care Act will enable 2.5 mil­lion Amer­i­cans to leave the work­force by 2024. That doesn’t mean jobs will be lost. Instead, the Afford­able Care Act gives work­ers the free­dom to retire ear­ly or work part-time because they can buy insur­ance on the exchanges. Few­er will be forced by the need for health insur­ance cov­er­age to work full-time at jobs they hate or can bare­ly per­form because of chron­ic ill­ness or would like to leave to care for children.

The GOP failed to per­suade Amer­i­cans that gain­ing more con­trol of their lives is some­how a neg­a­tive result of the Afford­able Care Act.

I need you to soothe my head,” Robert Palmer croons in the song, Bad Case of Lov­ing You,” con­tin­u­ing, Turn my blue heart to red.”

What the GOP doesn’t under­stand is that its effort to deny mil­lions of Amer­i­cans access to doc­tors is turn­ing red hearts to blue.

Leo Ger­ard is inter­na­tion­al pres­i­dent of the Unit­ed Steel­work­ers Union, part of the AFL-CIO. The son of a union min­er; Ger­ard start­ed work­ing at a nick­el smelter in Sud­bury, Ontario, at age 18, and rose through the union’s ranks to be appoint­ed the sev­enth inter­na­tion­al pres­i­dent Feb. 28, 2001. For more infor­ma­tion about Ger­ard, vis­it usw​.org.
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