A majority of Republican governors and state legislators, driven by relentless political opposition to the Affordable Care Act (ACA), have rejected billions in federal funding, denied millions needed health care and consigned thousands to premature death by refusing to extend Medicaid to their own residents.
Governors and lawmakers in 25 states who rebuff federal support to expand state Medicaid programs to 4.8 million low-income people under the ACA are sacrificing thousands of lives and pushing away enormous economic development opportunities that come with $426 billion in direct funding over 10 years, according to a new report by Health Care for America Now.
Research at the Harvard School of Public Health suggests that the refusal of federal Medicaid funds may result in the deaths of 27,452 Americans in 2014 as those states ensure that mortality rates for low-income adults remain at a significantly higher level, according to the report. Residents of states rejecting Medicaid expansion face a declining quality of life with less economic opportunity and destabilized hospitals -- including some that will be forced to close.
The people who get hurt the most are the working poor, including fast food workers, nursing aides, restaurant servers and child-care workers. These folks live from one inadequate paycheck to the next. Reliable health benefits make a huge difference in their lives: They can get the health care when they need it without risking personal bankruptcy. Coverage provides health security, improved financial security and peace of mind. In fact, studies show that the mental health effects of an uninsured person knowing he or she has gained coverage are profound.
Texas is ground zero for state-sponsored health care denial. It's a shameful example of a morally bankrupt governor waging a health care war against the people of his state. Even though the lives and fortunes of millions of Texans are on the line, Gov. Rick Perry refuses to care. As a sworn enemy of the health law, he won't participate in the ACA's Medicaid expansion. Because of Perry's corrupt ideology and mean-spirited politics, 1,046,430 Texans will be denied health benefits, and as a result 5,946 of them may lose their lives needlessly in the next 12 months.
The Texans denied health care work hard every day. They pay taxes and participate in their communities. They contribute to their state like everyone else. Yet Rick Perry is blocking their health coverage because he won't set aside his personal political agenda. The governor knows full well who's getting hurt by this. He's making a deliberate decision. It's galling. It's immoral. It shocks the conscience.
Adding insult to life-threatening injury, Perry is turning down more than $65 billion in federal funds over 10 years. If Perry accepted the Medicaid funds, he could generate more than 300,000 jobs. He could add $1.8 billion in increased state and local tax revenue spun off by the new tax-paying workers and give Texas an impressive $67.9 billion in added economic output between now and 2017. So what policy basis does Rick Perry offer to account for his decision? Expanding Medicaid would be "like putting 1,000 more people on the Titanic when you knew what was going to happen."
Perry's Texas already has the dubious distinction of having the biggest proportion of uninsured residents of any state. There are about 6 million Texans going without coverage -- one out of every four. As if that isn't bad enough, Perry is doing everything he can think of to make it harder for people with income between 100 and 400 percent of the federal poverty level to sign up for affordable coverage through the ACA's federal marketplace. Perry's sabotage is part of a broader enrollment suppression campaign in several Republican-controlled states.
Not all state Republican leaders are putting rank partisanship ahead of their constituents' best interests. Arizona Gov. Jan Brewer, who famously wagged her finger at President Obama, traveled across her state campaigning for expansion. "As an elected official of more than 30 years, I know that this process was not easy or without political risk," Brewer said in a remarkable statement after the Arizona legislature approved expansion. "We cannot wag our finger at the federal government," she told legislators. "Trust me, I tried that once."
While Brewer and a few other Republican governors may not enjoy the support of the tea party extremists who oppose health care, the public clearly favors full participation in Medicaid. A recent survey found that even residents from states in the Deep South support expansion of Medicaid eligibility by 62 to 33 percent.
It's not too late for governors like Perry, Scott Walker of Wisconsin and Bobby Jindal of Louisiana to do what's best for their people. Expanding Medicaid is the smart thing to do and the moral thing to do. The lives of thousands and the health of millions hang in the balance.