Note: This is a community diary with contributions from many members of the Support the Dream Defenders group.
When using their Capital Punishment systems, Red State governors at a minimum know how many people they are killing, who they are killing, when they are killing them and how they are killing them. Should they know any less about the working poor they are killing? My God, shouldn't they at least try to find out?
Enter the Support the Dream Defenders group with our Let Our Poor People Live campaign. With our Freedom of Information Act requests, we aim to force these ignoble politicians to give an accounting for each life that they have allowed to fall by the wayside. To accomplish our goal, we are sending Freedom of Information Act requests to all of the opt-out governors with some Catch-22 questions, including a demand that they provide us with all of the documents showing what they, as Governors, are doing to discover how many people are dying, or potentially dying, because they have refused to Expand Medicaid.
You can join us as we track these FOIA requests going around the country. This is a United States Postal Service tracking tool that has been uploaded with twenty of our requests. If you click on the plus sign (+) on each of the letters that have already been "delivered," you can see where they went. For example, immediately below is a screenshot of the certified mail delivery last Tuesday of our Freedom of Information request to Governor Sam Brownback of Kansas:
And here is a link to help you track our final four FOIA requests. They are going to Mississippi, Wisconsin, Florida, and Virginia. As you can see, these were mailed out yesterday morning.
Once we have rounded up all the responses, we intend to send them off to the media. It will be interesting to see how these governors respond once the media begins asking the following questions: How many people are needlessly dying in your state because you will not Expand Medicaid? How many people have had to file for bankruptcy because you will not Expand Medicaid? What have you done to find out the answers to these questions?
While we have been working on the FOIA Project, we have marshaled some of the arguments for Medicaid Expansion. In the next two sections of the diary, we discuss some of the humanitarian and economic reasons for saving lives while saving your state from a future health care crisis.
1. The Humanitarian Argument.
A Harvard Study published in 2014 has indicated that as many as 17,000 people will die each year because Red State governors refuse to Expand Medicaid. This makes sense as the New York Times has noted that approximately eight million additional people would receive Medicaid if it were expanded in Republican-controlled states. Like the rest of the population, these folks suffer from heart disease, diabetes, high blood pressure, cancers and other ailments that could be treated. The Study authors noted,
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.
As bad as that is, the problem's even bigger than that. It still doesn't tell the whole story. The eight million or so people who would be helped by Expanding Medicaid, many of whom have undiagnosed or untreated conditions, also have to deal with the pain caused by their ailments--sometimes on a daily basis--as well as deal with the fear that the next cough or lump or tremor will land them in the emergency room and then in bankruptcy court or worse.
A. How Democrats Respond to the Issue.
Bill Moyers is not mincing words about the situation. An article on his website by Joshua Holland is entitled, "Study Shows the Madness of States Refusing to Expand Medicaid." The article leads off with a report from the Robert Wood Johnson Foundation and Urban Institute that shows Republican-controlled states are missing out on $423 billion in federal health care money through 2022. But the article goes further to note other studies that show Texas leading the nation in percentage of uninsured, followed by Florida in third, and it links to the Harvard Study discussed above, which warns of up to 17,000 needless deaths each year.
Last Monday, White House Press Secretary Josh Earnest showed exasperation with Republicans for "literally prevent[ing] individuals in their states from getting badly needed health care coverage." In fact, his entire response to a question about ObamaCare is worth repeating, with the quote above highlighted near the bottom:
B. How Republicans Respond.
Another way to look at the humanitarian argument for Expanded Medicaid is to look at it through the eyes of a Republican. For that, we have enlisted Scott Walker of Wisconsin. He has taken a position on the issue that is literally comedic in its villainy. We'll let Snotty speak for himself:
Scott Walker bypassed historical villains, modern villains and book villains and, instead, plagiarized directly from a comedy villain--Judge Smails from Caddyshack:
JUDGE SMAILS: "I think you can still become a gentleman someday ... if you understand and abide by the rules of decent society. Danny, Danny. There's a lot of ... well, badness in the world today. I see it in court every day. I've sentenced boys younger than you to the gas chamber. I didn't want to do it. I felt I owed it to them."How egregious can Republicans get? Again, let's think about that like a Republican would. Let's say, for example, you had a tough decision about whether to give half a million people health care or take it away from them. When it came time to make that decision, would you be smiling? Governor Pat McCrory of North Carolina would:
2. The Economic Argument.
Expanding Medicaid makes economic sense. Most people know that under ObamaCare, the states would pay nothing through 2016, and they would never have to pay more than ten percent of the costs. Additionally, there is an opt out provision if the state, for some reason, cannot pay its share of the costs.
States that have accepted Medicaid Expansion will not have to make up for the shortfall when the Federal Government stops paying hospitals and clinics for serving the uninsured. Those states have also seen increased economic activity, including jobs that will provide salaries which will be spent in the local economies. Their employee workforce will be healthier and stronger and more competitive.
A. Federal Funding of Hospitals and Clinics.
A huge economic problem will terrorize Red State governors and their tax-paying constituents in the very near future. That is, the Federal Government had been giving huge grants to states every year so that the states, in turn, could pass the money along to hospitals and clinics that provided care but received no payment from the uninsured. That stops in 2015.
With the Expansion of Medicaid, those grants should not be necessary. So, the program will be cancelled. A few Red State governors have had the temerity, while refusing to Expand Medicaid, to ask the Obama Administration to resume those payments. They have been told, "No." Instead, those governors have been told to Expand Medicaid and get the funding for their state's hospitals and clinics that way. South Carolina Governor Nikki Haley is already earmarking tens of millions of dollars of state funds to give to hospitals--while she ignores hundreds of millions of Federal dollars that would go to help the working poor in her state.
B. Job Growth.
Even Forbes magazine, a vociferous opponent of ObamaCare, has had to admit that Medicaid Expansion can be beneficial to the job market:
"States that agreed to expand coverage of Medicaid to more Americans under the Affordable Care Act have created more jobs than other areas of the country, according to a new report.C. The Vicious Circle.Fitch Ratings said 'healthcare and social assistance jobs grew over 30% faster between December 2013 and December 2014 for 24 states that implemented ACA expansion on Jan. 1, 2014 than those that did not.'”
Republican Governors are not only screwing their working poor constituents by Refusing to Expand Medicaid, but they are screwing them on the price of health care insurance coverage. Even if the working poor in a non-Expansion state could afford to pay any of the few dollars they earn over the federal poverty line on medical coverage, the price of that coverage goes up because Republican Governors Refused to Expand Medicaid.
It is a vicious circle that kills people, costs constituents more money, costs states more money and fails to create the jobs and economic activity that would come about with Medicaid Expansion in that Red State. Let's say you are single person in Texas making $7,500 per year based on two crappy part-time jobs, and you have high blood pressure and have already suffered a stroke. You have to spend the money on the bronze plan, even though you cannot afford it, and take whatever subsidy you can get. Republican Governors have ensured that folks like this are squeezed dry, and, as high-risk insureds, they will drive up the cost for everyone buying insurance in that state. Their effect on insurance rates would be more than cancelled out if all the healthy people in the "Medicaid Gap" were allowed to join. SeeWhy a State's Health Insurers Should Support Expanding Medicaid, Center on Budget and Policy Priorities (September 2012).
You see, if Republican Governors Expanded Medicaid and added those millions of healthy potential working poor individuals to insurance pools in the state, the costs for everybody would almost certainly decrease. Thus, the working poor gets screwed on both sides from their Republican Governors.
Finally, with the Federal Government no longer directly reimbursing hospitals and clinics for their service to uninsured persons, the hospitals and clinics will cost-shift that expense to everybody else--or fire staff, cut hours or close down.
To give you some idea what states are missing out on, please consider this:
Now think about the billions of dollars and all that healthcare that Florida (Rick Scott) and Texas (Greg Abbott) are giving up every year.