The worst place to be poor and uninsured is definitely the Deep South. Ever since Obamacare was enacted, the Republican governors in those red states have rejected the law’s offer to cover people who earn up to 138 percent of the poverty line ($33,000 for a family of four). Bobby Jindal was a classic naysayer, blathering about “centralized government control” while 16 percent of his Louisiana citizens lived without health insurance – one of the worst rates in the nation.
But I’d be remiss, during this holiday hiatus, if I didn’t note the stunning election that took place last weekend. Roughly a quarter million uninsured Louisianans truly have something to be thankful for, because a Democrat won the nod to be the new governor.
That’s amazing in itself, because, in this era, Democrats in the Deep South seem to win statewide elections roughly as often as Haley’s Comet crosses the sky. When John Bel Edwards takes the oath in Louisiana, he’ll be the sole Democrat on the Dixie map. This is by no means the start of a southern Democratic comeback – Edwards won in part because his opponent was family values fraud David Vitter, the Republican senator who was outed in ’07 for canoodling on a regular basis with call girls – but there was another major factor:
He campaigned for Medicaid expansion. He didn’t apologize for the health reform law; rather, he embraced it openly, on the stump. And he won on the issue.
Thirty-one states use this key Obamacare provision, and Edwards insisted that he wanted Louisiana to be the 32nd. He says it would bring “a much-needed spark of life to our state’s health care system,” that “the expansion of health care coverage for working families is among the highest priorities.” Edwards worked on that plan for three years while serving in the state legislature; and post-election, his new chief of staff said: “There are over 240,000 people without medical insurance in this state who go to work every day….I can tell you that there’s many people across this state who’ve suffered tremendously because we’ve refused to expand Medicaid.”
The feds currently pay all the money to cover those working poor, but Louisiana, like other participating states, has to kick in some money of its own starting in 2017. That plan is already in the works. The Louisiana Hospital Association has cut a deal to pool hospitals’ money to help pay the federal match. They’ll do this because it’s financially smart. When more people are covered, the hospitals will get compensated for the treatment they provide. Treating the uninsured is far more costly. (Edwards can OK the Medicaid expansion via executive order, but he’ll need to tweak the details with help from the Republican state legislature. Approval is expected.)
Is it feasible that Edwards’ successful game plan – economic populism (on health care), combined with social conservatism (he’s anti-abortion) – could be replicated by Democrats elsewhere in the red-state South? Doubtful. There’s too much general animosity toward the national Democratic party, and Republican candidates generally tote far less sleaze-baggage than David Vitter.
But perhaps all is not lost for the uninsured people who have the misfortune of living under southern Republican rule. Have you heard what Alabama’s governor has been saying lately?
Robert Bentley appointed a commission to study the option of Obamacare Medicaid expansion; it has concluded that Alabama should get with the program, calling it “a win for the state budget.” And here’s what Bentley says now: “I was personally against the Affordable Care Act…But we lost, folks. We lost. We lost in court. So what we have to do now is move past that, take the resources we have available and try to improve the quality of life for the people of Alabama, and that’s exactly what I’m going to do.”
In this shameful season of Trump and Carson, how refreshing it is to hear a Republican speak sanely about reality. Something else to be thankful for.