Affordable Care Act, Barack Obama, GOPocrisy — September 24, 2014 at 9:43 am

Republicans blocking Medicaid expansion in states where HIV/AIDS is spreading fastest


weloveobamacareRepublicans like Paul Ryan and Terri Lynn Land are still running on the promise of taking away health insurance from more than 24 million Americans who have health insurance through the Affordable Care Act, at least 10 million of whom did not have coverage before the law went into effect.

They’re sticking with this message, even though repeal is less popular than fixing the law — even in the red states Republicans are relying on to help them win the Senate.

For Republicans who are primarily seeking Republican votes — like Ryan who is hoping to be begged to run for president — and Land — whose few attempts to reach out to Democratic voters have been marked by a fear she’ll lose her not-so enthralled base, repeal is their only option.

That’s is because Obamacare has become a synecdoche for everything the right hates about Obama, and Republicans have no plan, and no real hope of coming up with a plan, that would be any less controversial than Obamacare is. (The likeliest GOP replacement for Obamacare would actually turn Medicare into something resembling Obamacare, an idea that could ultimately cost Republicans the senior vote.)

But the right’s dissembling and babbling about Obamacare is a slight annoyance compared to the real damage they’re doing by denying health insurance to more than 4 million Americans by not expanding Medicaid.

The message that cannot be repeated enough is that the states that haven’t expanded are the ones that need it the most.

In “Southern states are now epicenter of HIV/AIDS in the U.S.“, The Washington Post‘s Teresa Wiltz points to a fact that punctuates this point in a painful way:

States in the South have the least expansive Medicaid programs and the strictest eligibility requirements to qualify for assistance, which prevents people living with HIV/AIDS from getting care, according to a coalition report. In the South, Campbell said, people living with HIV have to reach disability status before they qualify for aid. This is significant, because nationally the vast majority of HIV/AIDS patients rely on Medicaid for their health insurance, according to research conducted by the Morehouse School of Medicine in Atlanta.

None of the nine Deep South states with the highest rates of new HIV/AIDS diagnoses — Alabama, Georgia, Florida, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Texas — has opted to expand Medicaid under the Affordable Care Act. Those states also have the highest fatality rates from HIV in the country, according to the coalition.

Not expanding Medicaid is literally helping spread HIV.

“People who don’t have Medicaid or other health-care coverage rarely visit primary-care doctors and aren’t getting tested for HIV, according to Michael Saag, an HIV/AIDS researcher with the University of Alabama at Birmingham School of Medicine,” Wiltz explains.

Not expanding Medicaid confirms the right’s repeal fantasy based on the premise that you don’t give people something you’re planning to take away. It also plays into the notion that the only way to get people out of poverty is punish them out of it. But mostly it takes a stand against the President himself.

The left can tire itself out by noting over and over how offensive it is that so-called pro-lifers are backing policies that put the lives of mothers and children in danger. But you can’t help but feel that fundamentalists feel the wrath of not having health insurance is apt punishment for certain people.

And in these red states — where there aren’t enough voters willing to vote themselves and their neighbors health insurance — it’s a belief that Republicans are willing to let people die for.

[CC image via LaDawna Howard |]