How Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming cheat the poor.

Actually, if you live in Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming,  your poor fellow citizens are not the only ones being cheated.

Poor or rich, if you live in those states, you are being cheated, too.Common Issues and Barriers to Access - Accessibility at UB - University at  Buffalo

Medicaid incentive fails to sway holdout states

By Geoff Mulvihill and Jeffrey Collins Associated Press

COLUMBIA, S.C. — Democrats’ nearly $2 trillion coronavirus relief package includes a big financial incentive for the states that have opted against expanding Medicaid to provide health coverage for more low-income Americans. It’s proving to be a tough sell.

Top Republican elected officials in the dozen states that have resisted expanding coverage under a key provision of former President Barack Obama’s health care law. Some have softened their opposition, but the key gatekeepers— governors or legislative leaders — indicated they have no plans to change course.

The federal government already pays 90% of the costs of expanding Medicaid coverage to more low-income adults.

If you are a political leader of any of these dozen states, all you needed to do was allow your low-income residents to receive health care.

The federal government would have been paying essentially the full cost for more than four years.

But you have refused free money from the federal government.

Thirty-six states have signed on to the expansion. Two more — Missouri and Oklahoma — are scheduled to begin their expansions in July.

Under the enticement included in the new coronavirus relief bill adopted by Congress and signed by President Joe Biden, the federal government would boost its share of costs in the regular Medicaid program, which offers coverage for the poorest Americans. 

An analysis by the Kaiser Family Foundation found the additional federal money would cover 150% to 400% of the cost for the holdout states to expand Medicaid.

In Texas, the incentives would send the state about $5 billion over two years. More than 1.4 million people in the state could become eligible for coverage.

For Georgia, the estimate says it would add a net $710 million to state coffers and in Tennessee, $900 million.

But your Republican state leaders have refused the money. Why? Two reasons?

  1. It would help low-income people, and the GOP is the Party of the Rich. It cares nothing for the poor. Remember, when it gives tax breaks, it gives them to the rich.
  2. It is a program initiated by the Democrats. Because the GOP hates the Democrats, they refuse everything proposed by Democrats. You, a taxpayer in those dozen states, are punished by that hatred.

“It’s the literal offer you can’t refuse, but let’s see if anyone refuses it, anyway,” said Katherine Hempstead, a senior policy adviser at the nonpartisan Robert Wood Johnson Foundation.

In Mississippi, one of the nation’s poorest states, advocates say up to 300,000 people — about one-tenth of the state’s population — could become eligible for health coverage if the state adopted the expansion.

Gov. Tate Reeves, a Republican, said he’s not going for it. He opposed it, even as the Mississippi Hospital Association said it could bring up to 19,000 jobs to the state.

“My position has not changed,” he said this week. “I am opposed to expanding Medicaid in Mississippi. I am opposed to ‘Obamacare’ expansion.”

Who cares that the poor can’t afford healthcare? Not Reeves. Not the GOP.

He calls it the “Obamacare expansion,” so naturally he opposes it, no matter the benefit to Mississippi.

In three of the states — Kansas, North Carolina and Wisconsin — the Democratic governor favors expansion but can’t convince a Republican-controlled legislature.

“It’s not a big enough bribe,” said Richard Hilderbrand, the chair of the Kansas Senate health committee.

Most politicians see the political advantages in helping the disadvantaged. After all, it is the American way, to help the underdog. Healthcare is a fundamental benefit that states provide to all their citizens.

But when your mind and heart are so hardened against the Democrats and against the people who traditionally vote Democratic, even money and jobs aren’t enough to reward you for being moral.

Many Republicans remain concerned about the long-term costs of the program and are ideologically opposed to expanding government health care to working-age adults.

These are the same politicians who themselves receive free health care insurance compliments of the voters, but are “ideologically opposed” to others receiving such a benefit. (“I’ve got mine; who cares about you.”)

“I acknowledge that there are some gaps in coverage that need to be addressed, but I think they can be addressed in ways that do not require us to create a whole new level of entitlement in the state of North Carolina,” said state Senate Leader Phil Berger, a Republican

“Some gaps” is a euphemism for “poor people are screwed.” And “they can be addressed” means “I don’t have a plan and I have no intention of creating one, and every time someone comes up with a plan, I vote against it.”

It’s a similar story in Wisconsin, where the GOP-dominated Legislature and Democratic Gov. Tony Evers are at odds over the expansion. The Democrats’ coronavirus aid package doesn’t change that, Assembly Speaker Robin Vos said earlier this month.

“It’s a non-starter, and we will continue to oppose the liberal wish list item of Medicaid expansion,” he said.

“Oppose the liberal wish list” means “I will vote against anything that helps our poor Wisconsinites or is proposed by Democrats. I’m against both those things.”

Hempstead, of the Robert Wood Johnson Foundation, said Medicaid expansion is a way to address one of the biggest shortcomings in the national health care landscape: How to get coverage for a group of adults whose incomes put them below the poverty line — $12,880 for a person living alone.

In states that haven’t expanded Medicaid, there are about 2.2 million such people, the Kaiser study found. They usually don’t qualify for traditional Medicaid programs. They also do not make enough to be eligible to buy subsidized private coverage on the health insurance marketplaces established under Obama’s overhaul.

Another 1.8 million in those states who make slightly more — up to $17,774 for an individual — qualify for subsidized coverage but often can’t afford it. They could be covered through an expansion of Medicaid.

The GOP says, “Who cares about those people? Let ’em get sick and die. Let their kids get sick and die. How much money did they contribute to my political campaign?”

Studies have found that adding coverage for these lower-income people reduces charity care in hospitals, allows some to be healthy enough to work and creates additional health care industry jobs.

The financial benefits partially or totally offset the states’ share of the costs over time.

Even in the holdout states, those arguments catch the attention of some Republicans. In Alabama, Gov. Kay Ivey left open the possibility of expanding Medicaid at some point in the future, but there are no plans to do so.

“The problem has always been how to pay for it,” Ivey spokeswoman Gina Maiola said.

Excuse me, Gov. Ivey, but the federal government already has told you how to pay for it. The feds will pay for it. You can’t get away with the phony “pay for it” excuse. Voters aren’t that dumb.

The real problem is a relatively recent one. It began during the Obama administration. The GOP measures loyalty to party and Trump above loyalty to America.

Any Republican who agrees with anything said or proposed by a Democrat, no matter how beneficial and accurate that thing may be, will be labeled a “RINO” (Republican In Name Only).

The party will attempt to ostracize you. Trump will insult you and work against you in the next election. You will be called a “socialist” and a “communist.”

You only will receive respect from the GOP if you are a Trump bootlicker, who for instance, wishes to eliminate Obamacare with nothing to replace it, or to lie about the CORONA virus.

It was not always thus. There actually were times past when the two parties could pass legislation to benefit America’s less fortunate. (Hard to believe, isn’t it?)

Today, Fox News, NewsMax, and conspiracy theories run the GOP.  Those folks think your patriotism is not measured by how much you care about Americans, but rather about how much you hate immigrants and Democrats, and how hard you wave a flag — especially a Confederate flag.

So you of the “dirty dozen” states that refuse federal money, continue to pay your state taxes, knowing those state tax dollars could be less if there were more federal dollars coming in.

At least you have the good feeling that comes from not lifting a finger, even when paid to do so, to help those in your state who are less fortunate than you.

We only can hope this is temporary. One day, Trump and his Trumpist stooges will be gone, and America can return to being the compassionate beacon of morality most of us want it to be.

We want a return to America the beautiful, not America the mean-spirited, selfish, uncaring, hard-hearted, bigoted . . .

Rodger Malcolm Mitchell

Monetary Sovereignty Twitter: @rodgermitchell Search #monetarysovereignty Facebook: Rodger Malcolm Mitchell …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..


The most important problems in economics involve:

  1. Monetary Sovereignty describes money creation and destruction.
  2. Gap Psychology describes the common desire to distance oneself from those “below” in any socio-economic ranking, and to come nearer those “above.” The socio-economic distance is referred to as “The Gap.”

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics. Implementation of Monetary Sovereignty and The Ten Steps To Prosperity can grow the economy and narrow the Gaps:

Ten Steps To Prosperity:

  1. Eliminate FICA
  2. Federally funded Medicare — parts A, B & D, plus long-term care — for everyone
  3. Social Security for all
  4. Free education (including post-grad) for everyone
  5. Salary for attending school
  6. Eliminate federal taxes on business
  7. Increase the standard income tax deduction, annually. 
  8. Tax the very rich (the “.1%”) more, with higher progressive tax rates on all forms of income.
  9. Federal ownership of all banks
  10. Increase federal spending on the myriad initiatives that benefit America’s 99.9% 

The Ten Steps will grow the economy and narrow the income/wealth/power Gap between the rich and the rest.


2 thoughts on “How Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming cheat the poor.

  1. “….We want a return to America the beautiful, not America the mean-spirited, selfish, uncaring, hard-hearted, bigoted..”

    Not until the pre-industrial scarcity model is replaced by the reality of today’s hi-tech abundance.


    1. It’s people like Trump, Tucker Carlson et al, who create bigotry, not hi-tech. I think Biden is trying to accomplish “America the beautiful,” but he will have to work with the Republicans who prefer the hatred model.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s