Unsatisfied with their embarrassingly callous performances as governors of their respective states, some of the GOP’s cruelest politicians have decided to ratchet up their psychopath game to the level of voluntarily endangering the lives of the very taxpayers who employ them and dole out their salaries. This time, they’ve decided to make an ideological stand (at least on the face of it), at the expense of the health of millions of their constituents. While their right-wing ideology itself serves as a proxy for corporate interests, we should really pause to reflect on what Republican governors are sacrificing to boycott any provision they can in the health care overhaul.
The full mandate is set to take effect in 2014, but, thanks to the nuances of the recent Supreme Court ruling, it’s up to individual states to set up the health care exchanges. The recent Supreme Court ruling also left it up to individual states themselves to decide another key provision of the big new changes in the health care reform package: whether to extend their Medicaid coverage to those with incomes of 133% of the federal poverty level. The 2012 poverty level for a family of four is $23,050 as of 2012, meaning the extension in Medicaid coverage would cover families earning up to $30,657.
Yet again we see how profit and ideology matter more to right-wingers than the basic urge to relieve human suffering. In Florida, Governor Rick Scott (not to be confused with his less evil twin) has vowed to continue fighting health care reform, planning on using his state-level discretion to refuse to expand the Medicaid rolls to the new level. What makes this an especially ugly barter of ideology-for-health is that per-capita, Florida is the second least health insured state in the country. As explained by Jeffrey Young at HuffPo
“Florida won’t take part in the Medicaid expansion, Scott said in a statement Sunday, despite the fact that 25 percent of the state’s residents younger than 65 are uninsured, the second-highest rate in the U.S. That was 3.9 million people in 2010, based on data compiled by the Henry J. Kaiser Family Foundation. According to the Urban Institute, 1.8 million Floridians would would qualify for Medicaid benefits under health care reform starting in 2014.”
This means that Florida Governor Rick Scott would rather risk the health of 1.8 million people (a number ten times higher than the population of Tallahassee, the state’s capital) then allow health care reform to have any more legitimacy than it already has. This is a terrible and inhumane trade-off to be making for any ideology.
But Republicans aren’t short of ideologue Governors willing to risk the health of their constituents for the sake of ideology (and ultimately, the all-flighty buck). Governor Bobby Jindal of Louisiana, not particularly famous for caring for others, also promised not to implement the Medicaid extension and the insurance exchanges. This despite the fact that 17.8% of Louisiana’s population is uninsured (10th highest in the nation), about 800,000 people.
In Texas, Governor Rick Perry has sent numerous signals he will resist extending Medicaid and setting up the exchanges, despite the fact that Texas has the nation’s highest rate of people without health insurance. According to the Urban Institute study, some two and a half million Texans would be covered under the Medicaid extension. To make a point, and serve his corporate sponsors, Rick Perry has decided to endanger the lives of Texans–who strangely enough, are not only his victims, but in a very real and legal sense, his boss.
Never one to be out-done in heartlessness, Arizona Governor Jan Brewer has also signaled she will not set up either the exchanges or extend Medicaid, forcing over 400,000 Arizonans, who would qualify under the extension according to the Urban Institute, to live without the health insurance they need.
This means at least 4.7 million in people in the states of Arizona, Texas and Florida will have to live without health insurance because their governors want to make some sort of ideological stand.
But nothing illustrates how heartless this ideological stand is better than the realization that the federal government is actually paying for 100% of the extension’s new additions to medicaid rolls from 2014 to 2016 (slowly tapering off its contributions to 90% by 2020). Even when the feds are picking up the tab, Republican governors would rather endanger the health of their constituents than give in to an opponent’s ideas (however popular or legal or helpful that idea may be).
But when we say “this is suffering for ideology” — we should really qualify that. This isn’t just ideology–it’s ideology as a proxy, as a “mechanism towards,” as a fulcrum for profit and power. It’s not just right wing intellectual snobbery that keeps Republican state leaders from helping their own constituents. It’s not merely some possibly present puritanical streak in their greed-obsessed thinking. It’s also the Republican governors’ quite specific drive to return investments for their corporate sponsors that motivates right wing governors to threaten the health of millions of Americans. They’re not just being heartless ideologues–they’re being heartless ideologues for profit.
As we all have painfully learned over the last few years of union-busting, commons-theft, minority disempowerment/disenfranchisement and cut-throat budget-gutting, state level politics have long been targeted and consequently won by massive corporate interests. The same can be said with these ideological Republican governors and their corporate sponsors in the health care racket. Their specific ideology, one that heavily favors “austerity,” shows itself as a proxy for corporate interests, in this case the health insurance racket that is visibly threatened to its very corporatist core by having to deliver on its own health promises.
The medical loss ratio, a provision of the health care law that requires health insurance companies to spend 80% of their revenue on delivering health services (or provide a rebate check to policy holders for the remainder at the end of the year), has begun signalling a death knell for the health insurance giants. All the medical loss ratio requirement does is force insurance companies to actually deliver on the services they promised. Problem is, for all the high-paid gum-flapping about the “efficiencies of the free market,” the health insurance industry is a rank canker of administrative waste and mismanagement. Check out these numbers.
As many in the health insurance industry are starting to realize, if the insurance companies are compelled to follow through on their basic promises to customers, the sheer size of the administrative bloat of companies like Cigna and Aetna (where non-medical services account for more than 20% of overhead) will cause them to collapse under the new regulations. As explained by Rick Ungar at Forbes:
This is the true ‘bomb’ contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time. Indeed, it is this aspect of the law that represents the true ‘death panel’ found in Obamacare—but not one that is going to lead to the death of American consumers. Rather, the medical loss ratio will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry.
Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most.
Health insurance companies have recognized the honest delivery of medical services as a threat to their warped racket. When Republican governors who are so deeply in bed with this racket suddenly throw health on the fire of ideology, we should remember–there’s more than craziness or callousness in this sacrifice–there’s also corporate greed and institutionalized avarice.
As millions of Americans unnecessarily go without health insurance for an extra three years, Republican Governors like Rick Scott, Rick Perry, Bobby Jindal and Jan Brewer will be doing their best to make sure that unhealthy condition continues indefinitely into the future. Surely, thousands of us American peons will die along the way–but that’s the price we pay for the insurance companies’ freedom to continue exploiting the nation’s deteriorating health. Breaking free of the tyranny of good governance, lowered long-term budget deficits and a healthy population, Republican governors have boldly declared their independence from any trait of basic human decency and compassion. By now, these truths should be self-evident.