The nature of the “red state” and “blue state” shorthand necessarily does not reflect the richness of the differences in politics and culture among America’s states. But if the cliché illuminates anything these days, it is on the issue of expanded health insurance for the working poor.
Take the very red state of Wyoming, which is, like Louisiana, a Republican-led state where there are significant income differences in the population because of capital-intensive energy production.
Matt Mead, the Republican governor of Wyoming, recently announced that he is going to work with his legislators to expand Medicaid insurance for the working poor. That is part of the much-attacked Affordable Care Act, aka “Obamacare.”
Mead made it clear that he still opposed “Obamacare,” but the state has found a way to expand coverage with a Wyoming plan that will require deductibles and other changes in the traditional Medicaid formula.
This ought to be a lesson for Gov. Bobby Jindal and the Louisiana Legislature.
Expanding Medicaid coverage is not only the right thing to alleviate suffering, but it makes sense financially. Hospitals and doctors charge for uncompensated care for indigents; it just doesn’t show up on the bills of insured patients as a line-item. If it did, it would demonstrate that the expanded Medicaid coverage is a good deal not just for the hamburger-flipper but also the middle-class policyholder.
Another example of the positives of Medicaid coverage: The Los Angeles Times reported on the impact of a series of policy changes over several years that first expanded and then cut back on Medicaid coverage in Arizona.
The consequences were noteworthy among people with diabetes or pre-diabetes. If not treated inexpensively with medication and doctor visits, the number of foot amputations and other grievous losses from diabetes escalated. Their feet were literally killing them, one doctor told the Times.
Those operations are costly. Under expanded Medicaid coverage, more of the cost is shared with the federal Treasury. Yet the real savings would be in avoiding these and other substantial medical costs that can be reduced or eliminated with primary medical care.
That is what happens when the low-wage workers must choose between medical care and putting food on the table for children and, often, grandchildren. Louisiana is one place where this is not an abstract problem but a very real one.
Arizona is generally a red state, too. Yet it is finding the leadership to expand access to medical care for workers who make too little money for either health insurance or preventative care. Tennessee’s Republican governor is also looking at the possibility.
Louisiana should be among the red states seeking to expand Medicaid coverage.