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April 22, 2014

States’ refusal to expand Medicaid is deadly attack on poor Americans

By Rev. Jesse L. Jackson, Sr.
Weekly Commentary | Chicago Sun-Times

We pledge allegiance to “One nation, under God.” When terrorists attack us, we unite as one to defend our nation and our countrymen and women. Yet, we allow the doctrine of the Confederacy — states’ rights — to divide us, even to the point of costing Americans their lives.

Charlene Dill, a resident of Florida, was a 32-year-old mother of three. She worked three jobs to try to support those children, despite having a serious heart condition. She earned too much — $11,000 a year — to be eligible for Medicaid under Florida law. She would have been able to get expanded Medicaid under the Affordable Care Act, known as Obamacare.

But the conservative justices on the Supreme Court ruled that states have the right to refuse to expand Medicaid, even though the federal government will pay 100 percent of the costs for the first three years, and 90 percent thereafter. This states’ rights decision would cost Charlene Dill her life.

Every member of the Florida state legislature has health insurance. Yet, as zealous opponents of Obamacare, they voted not to expand Medicaid, turning their noses up on billions in federal support. That decision cost Charlene Dill her life.

According to a Harvard study, an estimated 8 million Americans will remain uninsured because of the decision of 25 states to refuse to expand Medicaid. They estimate that will result in about 7,000 deaths per year, or 19 a day. The victims are working people, who earn too much to get Medicaid and too little to afford health insurance. Conservatives, one would think, would want to help those who get the early bus, who clean our streets, take care of our children, work the midnight shift. But they hate Obama far more than they care for low-wage workers. They choose partisan politics over the common good.

Not surprisingly, the states that have refused to expand Medicaid include almost the entire South, the states of the former Confederacy, as well as the Republican bastions in the Midwest and West (from Kansas to Idaho). These are among the poorest states in the union, with the most residents who have no health insurance, and the worst health care indices.

Texas Senator Ted Cruz spent 20 hours in a fake filibuster against Obamacare, while his state ranks among the worst in the country with more than one in five of its residents without health insurance. Georgia State Insurance Commissioner Ralph Hudgens brags that the state is doing “everything in its power to be an obstructionist,” while 18.4 percent of Georgians go without health insurance.

Mississippi residents, not surprisingly, are most likely to lack access to basic necessities. One fourth report that they didn’t have money for food at some point in the last 12 months. Mississippi residents have the lowest life expectancy, the highest obesity rates (over 35 percent), the lowest household income, and nearly one in four reports they lack the money to purchase health care. Yet the governor of Mississippi refuses millions in federal aid to expand Medicaid.

People of color — primarily African Americans in Mississippi and the former confederate states, Latinos in Texas and elsewhere — are disproportionately the victims of this cruelty.

That should not surprise. From John C. Calhoun’s South Carolina Ordinance of Nullification to secession, the Civil War to segregation, states’ rights has always been a doctrine wielded to oppress minorities, even at the cost of depriving poor working people of all races.

These governors and legislators assume that poor people do not register and do not vote (and they are passing laws to make it harder for them to do so). They assume that most Americans won’t care if thousands die needlessly. They assume that states’ rights can allow America to move from one nation to two nations, separate and unequal.

Charlene Dill is neither the first nor the last to be lost to this callous calculation. But I believe we are a better country than that. Working and poor people have an insult level that is being violated. People of conscience will not turn their eyes forever. This is a moral disgrace that cannot be simply ignored.