A youngish PR guy spoke at a recent county Democratic function in my home territory of Upstate South Carolina. He was from the South Carolina Hospital Association (SCHA). I’m betting he’s a Republican, having previously worked as a lobbyist for state Real Estate interests, but sometimes special interests collide with party interests at the intersection of “What’s in it for me?” And apparently the state’s refusal to expand Medicaid has rattled the hospital people to their very core.
The SCHA wants to autoclave the moronic decision on the part of the state’s Republican power brokers. Sterilize the idiocy out of their hatred of Obamacare if you will. The earnest young man whose first name was Schipp (sounds like the ritzy part of town to me) gave a wonderfully convincing and informative talk to a roomful of the mostly already converted. I talked with him briefly after the meeting and told him I was likely to include parts of his speech in my next contribution to the progressive Website, PoliticusUSA. He seemed pleased to get the word out. So I’m sharing some of his facts and figures and some of my own that should lend context to the issue.
Yes, South Carolina, as it does with many federal offerings, has rejected the Medicaid Expansion. The simple fact is that the Medicaid expansion money that doesn’t come to South Carolina, goes elsewhere, turning this state into a donor state. Eligibility is based on anyone earning less that $11,500 or $23,550 for a family of four. The Henry J. Kaiser Foundation calculates that South Carolina ranks 4th of the states that would benefit most from the expansion. In terms of numbers, that’s 250,000 plus people who would be impacted.
South Carolina ranks 48th in the nation in the number of children living in poverty; 49th in the number of diabetics, 42nd in obesity, 45th in coverage by Medicaid and 45th in persons not covered by health insurance. That translates to a total of 700,000 citizens with no health insurance.
So the obviously predictable move for the extraordinarily ignorant and Obama-hating red state government would be to reject the expansion of Medicaid (joining 14 other dumb-ass states) in a move that will be devastating to hundreds of thousands, perhaps even millions of South Carolina residents because it’s not only lower income individuals and families that are affected, but those with health insurance, who, according to the Henry J. Kaiser Foundation, pay an estimated $1,000-$2,000 extra dollars in premiums per year (it’s $3,000 for small businesses) because hospitals are legally forbidden to turn away those in need (one of the few positives from the Reagan administration) and the cost shifting is passed along to the already insured.
To save hospitals that are still in danger of going under, the government provides Disproportionate Share Hospital (DSH) adjustment payments for those hospitals that serve a ‘disproportionate’ share of low-income patients that are uninsured and not covered by traditional entitlement programs. The American Recovery and Reinvestment Act of 2009, despised by clueless right-wingers, increased DSH payments for 2 fiscal years to most states by 2.5%. That should have saved those already insured a few bucks if the right-wingers beloved huge insurers adjusted their premiums for at least 2 years to reflect the federal payments.
That’s what the Medicaid expansion program was designed to accomplish. Benefit those earning under poverty minimums and take pressure off of hospitals and the currently insured.
The Advisory Board Company that consults health care and higher education clients has compiled a handy list of states that embrace or reject Medicaid expansion. A total of 15 states (as of this writing) couldn’t care less. The Dunce Cap states are South Carolina (of course) and North Carolina, when not busy obsessing on denying the vote to roughly 600,000 eligible citizens. Alabama’s on board with not being on board. Checked the collective IQ’s of that state lately? No expansion for Mississippi. No anything else for that God forsaken plot of KKK-land either. And there’s Georgia where their Republican Governor told the Atlanta Journal-Constitution that the state “Couldn’t afford expansion.” Of course it’s free for the first 3 years followed by phasing down for a few years to a permanent 90-10 fed/state split. “Georgia can’t afford that?”
Idaho joins the parade of heartless states brushing off help for those strapped for cash for medical emergencies. “Let ’em eat cake.” Iowa is lost in the stalks. Louisiana is a puzzle in their refusal to participate. How can such a smart governor as Bobby Jindal be so dumb? Then there’s Maine and the state’s totally misinformed Republican governor Paul LePage. He took a pass on expansion because it would be a “Degradation of our nation’s premier health system.” Premier??? Governor, have you read even one fact about America’s health care standing among industrialized and universal health care nations? Even one? Back in April, LePage said his state might consider expansion if the feds paid a full ten years of the freight. As it turned out, no long-term freebie, to hell with the poor constituents. Right-wingers love the guy because he’s always blasting liberals and unions.
Oklahoma’s in the mix of Medicaid Expansion-deniers. To paraphrase the joyous lyrics of “Oklahoma”…”OOOOKlahoma, where the callous hate-anything Obama wind comes sweepin’ down the plain. Yeeow! Aye-yip-aye-yo-ee-ay!!!” YEEOW is pretty much what those who end up paying somebody else’s tab are going to be screaming in the Sooner state. Another ‘nein’ comes from the sleazy Republicans of Pennsylvania. You remember the legislature manipulating voting right’s laws in an attempt to get Romney elected. Screwing poor folks over is an easy call for PA’s right-wing leadership. Next in line is South Dakota, another reason to never think about South Dakota when the subject is thoughtful governance. Then there’s Wisconsin, a formerly liberal state now featuring extremist right-wing leadership whose brains are best compared in size to Gulliver in Brobdingnag. Finally, there’s Texas. ‘Nuff said.
According to the consulting firm, 25 states have signed on to expansion, a couple are leaning that way, 3 are leaning the other way and the rest are undecided. The blood-red county I live in is the 4th neediest county (out of 46) in the state for Medicaid Expansion. There are 11,414 uninsured citizens age 18-64 with incomes below 100 percent of the federal poverty level (FPL) according to the U.S. Census Bureau. The local legislative delegation is overwhelmingly Republican; not just Republicans, but right-wing extremists, Tea Party Republican. In other words, not Republican at all, but an amalgam of Obama, fed and Democrat-haters hiding behind a party banner. Any initiative that would bring credit to any of the above would be trashed in the time it would take for a goober to drive to a gun sale at Walmart.
In closing, yet another reminder to keep Matthew, the son of Pastor Rick Warren, in your prayers. The young man, described by his father as mentally troubled and suicidal for years, killed himself Friday morning with a gun kept at his home.
Raised rural & small town, then lived in N.Y., Chicago & LA. Widely traveled. Returned from world wandering to pursue media life of anchorman/reporter and major, medium and small market talk radio. Highly active in politics. Once worked as orderly & security in Mens Lock Ward for the Criminally Insane at a state institution. Much more rational population than current Teapublicans. Great concern for country run by and for the extreme wealthy. The inhumane current running through this country has no precedent in modern history.
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