Medicaid Expansion: Red States Choose Politics Over Saving Lives


The Affordable Care Act mandated that people earnings over 133% of the poverty level ($23,550 for a family of four) must sign up for health insurance and provided financial subsidies in order to make that insurance more affordable. To require families earning below that level to purchase insurance would probably have required the cost of insurance to be completely subsidized. In order to provide free health insurance to those too poor to afford private insurance, the Affordable Care Act proposed increasing Medicaid’s income cut to from the Federal poverty line to 138% thereof.

However, in June 2012, the Supreme Court ruled that the Federal Government could not require states to expand Medicaid eligibility. The Affordable Care Act requires the Federal Government to cover all of the cost of Medicaid expansion through 2017. Starting then the Federal Government covers 95% of the cost and the states cover 5% until 2020, when the states are asked to cover 10% of the cost. In the meantime, there is no cost to the states, yet many states with Republican governors and/or legislatures have refused to expand medicaid.

This leaves eight million Americans in Health insurance limbo. They are “too poor” to qualify for health insurance market place subsidies, and they are “too rich” to qualify for Medicaid. This leaves them without any affordable options for health insurance.

Even worse, a new study found that in states with no expanded medicaid, those who earn 138% of the poverty line or less suffer more often with high blood pressure, heart problems, cancer, stroke and emphysema.

Since this costs the states nothing to provide this coverage over the next 3 years, the only possible reason to refuse this grant is political. The Red States are worried that people will appreciate the benefits of this coverage, reward the Democrats that provided it, and demand that the coverage be continued past 2017 when the states will be asked to make a small contribution to the cost.

This is a very cynical view of politics. Politicians should be looking out for the interest of the country, not of themselves nor their party. Instead these “leaders” who rejected medicaid expansion are putting the lives of their citizens at risk to score political points.

A group of researchers from the Harvard Medical School published a peer-reviewed study in Health Affairs concluding:

Nationwide, 47,950,687 people were uninsured in 2012; the number of uninsured is expected to decrease by about 16 million after implementation of the ACA, leaving 32,202,633 uninsured. Nearly 8 million of these remaining uninsured would have gotten coverage had their state opted in. States opting in to Medicaid expansion will experience a decrease of 48.9 percent in their uninsured population versus an 18.1 percent decrease in opt-out states…
We estimate the number of deaths attributable to the lack of Medicaid expansion in opt-out states at between 7,115 and 17,104. Medicaid expansion in opt-out states would have resulted in 712,037 fewer persons screening positive for depression and 240,700 fewer individuals suffering catastrophic medical expenditures. Medicaid expansion in these states would have resulted in 422,553 more diabetics receiving medication for their illness, 195,492 more mammograms among women age 50-64 years and 443,677 more pap smears among women age 21-64. Expansion would have resulted in an additional 658,888 women in need of mammograms gaining insurance, as well as 3.1 million women who should receive regular pap smears.

Do not despair though, not all Republicans value obstructionism over life. Ohio Governor John Kasich (R) explained why he expanded Medicaid to include 300,000 Ohioans:

When you die and get to the meeting with St. Peter, he’s probably not going to ask you much about what you did about keeping government small, but he’s going to ask you what you did for the poor. You’d better have a good answer.

Cartoon courtesy of Mike Stanfill.

Why Not Replace Texas With Puerto Rico And Make Everyone Happy?

Last week on election day, Puerto Ricans were asked their preference for the future of their island, currently an unincorporated territory of the United States. A large majority 809,000 voted for statehood, while 73,000 voted for independence and 441,000 voted for sovereign free association. Becoming a state would require approval by Congress. However, Republicans can be expected to oppose statehood of heavily Democratics Puerto Rico, just as they opposed attributed Congressional representation to Washington DC.

However, while Puerto Ricans are eager to strengthen their ties with the United States, some conservatives living in Red States are so disappointed with the election results that have petitioned the White House to allow their states to secede from the union.

According to Dana Milbank,

The White House, in one of those astro-turf efforts that make people feel warm about small-d democracy, launched a “We the People” program on its Web site last year, allowing Americans to petition their government for a redress of grievances. Any petition that receives 25,000 or more signatures within 30 days is promised a response (though not necessarily a favorable one) from the Obama administration.

And so a large number of patriotic Americans, mostly from states won by Mitt Romney last week, have petitioned the White House to let them secede. They should be careful about what they wish for. It would be excellent financial news for those of us left behind if Obama were to grant a number of the rebel states their wish “to withdraw from the United States and create [their] own NEW government” (the petitions emphasize “new” by capitalizing it).

Red states receive, on average, far more from the federal government in expenditures than they pay in taxes. The balance is the opposite in blue states. The secession petitions, therefore, give the opportunity to create what would be, in a fiscal sense, a far more perfect union.

Among those states with large numbers of petitioners asking out:

  • Louisiana (more than 28,000 signatures at midday Tuesday), which gets about $1.45 in federal largess for every $1 it pays in taxes;
  • Alabama (more than 20,000 signatures), which takes $1.71 for every $1 it puts in;
  • South Carolina (13,000), which takes $1.38 for its dollar; and
  • Missouri (16,000), which takes $1.29 for its dollar.

The first such petition (94,864 signatures so far) was for Texas:

Peacefully grant the State of Texas to withdraw from the United States of America and create its own NEW government.

This is not a new idea. Texas Governor Rick Perry proposed it three years ago. (See this video for the eager response by Keith Oberman.)

Hardin County Republican treasurer Peter Morrison writes “”Why should Vermont and Texas live under the same government? Let each go her own way.”

Meanwhile Doc Jess of DemConWatch writes:

For one reason, and one reason alone, I was in favour of Rick’s idea back then, and still am now. That’s the redistribution of their 38 Electoral College votes. And to a lesser extent the movement of that fence from the Mexican border to the Texas abutments with New Mexico, Oklahoma, Arkansas and Louisiana.

Of course, there are great benefits to the remainder of America if Texas goes: there are 52 Fortune 500 companies in Texas. While the oil industry might stay in this new country, it’s likely that AT&T, Dell, Whole Foods, Sysco, Kimberly-Clark, Southwest Airlines, Texas Instruments, and a host of others, will be looking for new places for their headquarters. Not to mention the 7 Air Force bases, 4 Army bases, and 3 Navy bases. Plus the economies that depend on them.

It will be tough for Texas when 37% of their income disappears. Not just from those companies and bases mentioned, but from the Federal receipts the state receives.

Texas Judge Stokes Anti-Obama Paranoia

— by David Streeter

CNN reported that a judge in Texas has stoked anti-Obama paranoia by warning of violence if the President is reelected. According to CNN:

An elected county judge in Texas is warning that the nation could descend into civil war if President Barack Obama is re-elected, and is calling for a trained, well-equipped force to battle the United Nations troops he says Obama would bring in.

The comments by Lubbock County Judge Tom Head, who oversees emergency planning efforts, were broadcast by CNN affiliate KJTV. He made similar remarks on radio station FOX Talk 950….

Referring to unexplained ‘executive orders’ and other documents that Obama and ‘his minions have filed,’ Head said, ‘regardless of whether the Republicans take over the Senate, which I hope they do, he is going to make the United States Congress and he’s going to make the Constitution irrelevant. He’s got his czars in place that don’t answer to anybody.’

Obama, Head said, will ‘try to give the sovereignty of the United   States away to the United Nations. What do you think the public’s going to do when that happens? We are talking civil unrest, civil disobedience, possibly, possibly civil war … I’m not talking just talking riots here and there. I’m talking Lexington, Concord, take up arms, get rid of the dictator. OK, what do you think he is going to do when that happens? He is going to call in the U.N. troops, personnel carriers, tanks and whatever.’

Head vowed to personally stand ‘in front of their personnel carriers and say, “You’re not coming in here.” And I’ve asked the sheriff. I said, “Are you going to back me on this?” And he said, “Yeah, I’m going to back you.” Well, I don’t want a bunch of rookies back there who have no training and little equipment. I want seasoned veteran people who are trained that have got equipment. And even then, you know we may have two or three hundred deputies facing maybe a thousand U.N. troops. We may have to call out the militia.’