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When Will Republican States Do Their Duty?

When Will Republican States Do Their Duty?

Last updated on: November 2, 2015 at 12:48 pm by Rebecca Todd Peters

When Will Republican States Do Their Duty? 2015-11-02T12:48:21-04:00 Rebecca Todd Peters

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There is no doubt that Obamacare has had a significant impact on providing health insurance for millions of people in the U.S. The first quarter of 2015 showed 10.7% of the population remained uninsured, down from a peak of 18.2% in 2010 when Obamacare was passed.

The New York Times has produced a series of maps that show the remarkable shifts that have happened in the last three years as Obamacare has worked its way across the country.

What is most remarkable about these maps, however, are the massive pockets where the uninsured still remain. The map is a stark visual witness to the power of governors and state legislatures to use poor people as pawns in their games of power and politics. In many Republican-governed states, resistance to Obamacare has taken the form of arguments about “states’ rights.”

In theory, I support the idea of states’ rights. It follows the basic Christian ethical principle of subsidiarity – namely, social problems should be addressed at the smallest, most local level possible. The underlying assumption is that the closer people are to a problem, the more knowledge and resources they will have to develop meaningful solutions that can address the problem.

This is the basic ethical principle that undergirds the important move toward “buying local” and encouraging people to support local farmers, local businesses, and the health of local communities. Moving toward strengthening and supporting local, regional, and state economies helps to build a stronger country in ways that benefit everyone more broadly.

The Constitution designated certain powers to the federal government and all other powers reside with the state. Conservative politicians who feel that the federal government is “too big” and is interfering with a states’ right to govern will often cry “states’ rights!!” when the federal government seeks to address large problem facing the country.

Poverty is clearly a significant national problem, although it does manifest itself in particular ways in different parts of the country and there continues to be a persistent problem of poverty in the South. The precipitous rise of healthcare costs over the past 40+ years have meant that many people in the country either go without adequate healthcare because they can’t afford it or they are burdened with astronomical health related debt that makes it impossible for many people to stabilize their economic situations.

When Obama decided that all the citizens of this country deserve access to affordable healthcare and moved forward with his plan that became known as “Obamacare,” conservative politicians and many Republican-led states called “states’ rights” and challenged that the federal government was interfering with their business.

One of the major bones of contention was the provision to expand Medicaid in all states to 138% of the federal poverty line. Previously, states had been allowed to set their qualifications for Medicaid wherever they chose. Often, it was the working poor who fell through the cracks. They made “too much” money to qualify for assistance with medical care through state Medicaid policies, they worked jobs that neither offered health insurance nor paid a salary decent enough to cover health care expenses. The Medicaid expansion program was intended to standardize Medicaid access across the country in ways that would benefit the working poor.

Conservatives balked at this provision and the Supreme Court eventually ruled that Medicaid expansion was optional. Sixteen states, mostly Republican-controlled states, have refused to expand their Medicaid coverage – Alabama, Florida, Georgia, Idaho, Kansas, Louisiana, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Virginia, Wisconsin, Wyoming. If you look at the NYTimes map again you will notice that the states that chose to expand Medicaid are outlined in black. It is no coincidence that these states show a remarkably higher rate of health insurance coverage than most of the states that chose not to expand Medicaid.

The principle of subsidiarity only works if the responsible local agents, be they farmers, business owners or politicians actually do their duty and adequately address the social problem at the local level. If there were no local farmers, “buy local” would not be a realistic or effective strategy to address climate change or to support our local economies. If Republican-dominated states think they can do better at providing health care for their citizens than the federal plan, then by all means – do it!

These maps raise very serious questions about whether or not the leadership responsible at the state level really care about or have any intention of addressing the crippling problems of poverty in their states. Healthcare is but one marker of this problem and these maps attest that little is being done in too many places to heal the sick and care for those in need.

Jesus is clear about his concern for the poor, the sick, and the lame. Those people who society had cast aside and forgotten, ignored, or actively reviled. He sought them out and he healed them, witnessing to us in his deeds as well as his words about what it means to follow in his footsteps.

The whole social justice tradition of the Hebrew Bible/Old Testament is a witness to the importance of structuring our society in ways that care for the vulnerable and the neglected. Christian tradition teaches that we are to set up our societies in ways that make sure people are cared for. Look here for more detailed theological arguments about supporting healthcare reform.

Given the evidence, Republican legislators and governors have a lot of work to do to demonstrate that they actually care about the poor, the sick, and the marginalized citizens of their states more than the ideological purity of their arguments.

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