If Obamacare—the Affordable Care Act—really is socialized medicine, as its right-wing critics claim, then why are millions of low-income people left uncovered by it? Well, in many cases, because of those very same right-wing oppositionists.
The New York Times reports Wednesday that its analysis of census data has found that Obamacare “will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help.” The bulk of them live in GOP-controlled states that, out of ideological pique, have refused to expand Medicaid for their residents, an apparent ploy to reduce the chances the program will succeed. From the story:
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.
“The irony is that these states that are rejecting Medicaid expansion — many of them Southern — are the very places where the concentration of poverty and lack of health insurance are the most acute,” said Dr. H. Jack Geiger, a founder of the community health center model. “It is their populations that have the highest burden of illness and costs to the entire health care system.”
The disproportionate impact on poor blacks introduces the prickly issue of race into the already politically charged atmosphere around the health care law. Race was rarely, if ever, mentioned in the state-level debates about the Medicaid expansion. But the issue courses just below the surface, civil rights leaders say, pointing to the pattern of exclusion.
Obamacare has been criticized by some on the left for not going far enough; they argue that President Obama should have pushed for a single-payer system or some other mechanism that would have extended health coverage to more Americans. Even if all the states go along with Medicaid expansion (the Supreme Court decision upholding most of Obamacare also said states could refuse that part of it), Obamacare still would not cover some 30 million people, according to Health Affairs. That’s a bit higher than what the Congressional Budget Office estimated last year.
But that’s a different slice from these willful acts by GOP oppositionists—from tea partyers in Congress to conservative governors in poverty-ridden states—to deny affordable health care access to millions of their fellow Americans. From the Times piece:
Mississippi has the largest percentage of poor and uninsured people in the country — 13 percent. Willie Charles Carter, an unemployed 53-year-old whose most recent job was as a maintenance worker at a public school, has had problems with his leg since surgery last year.
His income is below Mississippi’s ceiling for Medicaid — which is about $3,000 a year — but he has no dependent children, so he does not qualify. And his income is too low to make him eligible for subsidies on the federal health exchange.
“You got to be almost dead before you can get Medicaid in Mississippi,” he said.
The silver lining? At least the poor won’t be fined for not having health care.