Why are the states with the worst healthcare not expanding Medicaid?

Help me understand why legislators of the states with the worst healthcare rankings and the highest children poverty rates are the ones who are resisting the expansion of Medicaid? This question is in bold, as for the life of me, I cannot think of a logical reason why legislators would not want to help people, especially when studies such as the latest one by the Rand Institute, show that Medicaid expansion will have a positive economic impact on the state. The reason, of course, is GOP led states are doing anything in their power to beat the Affordable Care Act (Obamacare), which ironically is based on a Republican idea. It has absolutely nothing to do with trying to help millions of Americans in need.

A few brief statistics might help. According to the United Health Foundation and Center on Budget and Policy, select statistics from the 2010 Census would reveal the worst states on health (note the rank in parenthesis is their children poverty ranking) who are not expanding Medicaid.

49th worst health (tie) – Louisiana (49th worst in children poverty)

49th (tie) –  Mississippi (41st)

46th – South Carolina (48th)

45th – Alabama (28th)

43rd – Oklahoma (24th)

40th – Texas (47th)

39th – Tennessee (32nd)

36th – Georgia (43rd)

33rd – North Carolina (39th)

I have noted in earlier posts that the lack of healthcare insurance or limited insurance is by far the number one reason for personal bankruptcy. In my home state of North Carolina, we have over 500,000 people who would benefit from the Medicaid expansion and poverty, as noted above, is high. Poverty is also an equal opportunity offender, which knows no political party, color or ethnicity. For example, The Charlotte Observer reported this weekend that of those in poverty in NC – 37% are White, 35% are Black and 20% are Hispanic. They are in rural and urban settings. They are registered Republican, Libertarian, Democrat and Independent.

When I have asked legislators what do you propose to do if you do not expand Medicaid, I receive no response. Since this is largely a GOP idea, it is hard to come up with another one, but they must be against it since Obama passed it. Yet, who is harmed by these stances? It is not the Kings and Queens – it is the pawns. When people are surveyed, the majority support many features within Obamacare, including the expansion of Medicaid. It is just the GOP has done such a good job of labeling this imperfect law as horrible and giving it a lightning rod name, that people say they do not favor it in its entirety. That is unfortunate.

We have a poverty problem in this country that needs to be talked about more. A part of this multifaceted issue is the absence of affordable healthcare. The Affordable Health Care Act has addressed and will address a major chunk of these uninsured. What I find troubling is the pawns in this political game are the ones who get screwed. In NC, there has been a growing movement called Moral Mondays (click on this link to review post https://musingsofanoldfart.wordpress.com/2013/06/03/moral-mondays-the-new-civil-rights-protests-in-north-carolina/ ) where several hundreds of NC citizens protest each Monday. The past seven weeks, 480 people have been arrested for trespassing and failure to disperse. These include people of all colors, ministers of various types of churches and professionals, including doctors, who are pushing back on several laws that harm those in need, including the decision not to expand Medicaid.

But, let me leave the “right thing to do issue” and speak of the economic impact. The Ohio governor who has relented late to do the Medicaid expansion said “we are talking about $13 billion coming into our state over the next seven years.” Also, rural healthcare is in big trouble and has been for several years with high indigent (uninsured costs). The Affordable Care Act would help people get to the doctors and hospitals in a more affordable and best suited way and the practitioners would be assured of payment and not have to chase dollars. This Ohio governor saw it as a win-win for his state and is pushing it through. What he is seeing now is occurring in all of the states above and is actually worse. SC, for example, has a wide swath of poverty down the middle eastern part of the state and no one is doing anything lasting to remedy it.

However, the state stragglers need to act now as they will be in no position to expand Medicaid, if they wait much longer. Yesterday, Arizona’s governor just signed the bill to expand. While not a fan of the Affordable Care Act, she sees Medicaid expansion as the best path forward. And, if these state legislatures don’t expand Medicaid, they will be screwing the pawns in their states yet again.

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10 thoughts on “Why are the states with the worst healthcare not expanding Medicaid?

  1. I have finally figured out the source of your confusion: you suppose that politics has to make sense and be logical. I’m not sure it ever was or ever will be, and those without power are destined to keep being handed the dirty end of the stick. Great blog, by the way.

  2. The single biggest reason is politics, plain and simple. These states have been hijacked by extremists voted in by an apathetic, ignorant electorate. They cannot abide any positive effects from Obamacare, and will sacrifice the poor and the uninsured to avoid them. They care nothing for the economic health of their states, as evidenced by nearly all of the legislation put forward by these so-called conservatives. What do they care for the disadvantaged? Their bread is buttered by the rich and powerful, upon whose coattails they ride toward more power. Their motivations are not for the betterment of society, but for cementing their own place in a wicked regime. That’s my opinion, anyway.

  3. I think that much of this unwillingness to implement the ACA is blind hatred of President Obama, and a desire to see him fail. The uninsured might suffer, but the Republicans will be able to “prove” their point that a black man is unfit to govern.

    • Christine, thanks for reading and commenting. I don’t disagree there that are those with “blind hatred of the President” but there is litte question that many want to see this defeated as it is the other person’s idea. I must win and you must lose in this unproductive zero-sum game that politics have become. The sad state is this is a largely Republican idea which the GOP is arguing against. Many thanks, BTG

  4. Pingback: A few questions for Senator Ted Cruz and friends | musingsofanoldfart

  5. Pingback: With Obamacare showing more success, let’s expand Medicaid in the remaining states | musingsofanoldfart

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