Health care for all? Catch-22 denies 8 million!

If you live in Texas and are one of the 1.5 million people who have low incomes and hoped to get health care through Medicaid under the Affordable Care Act, you are out of luck. Texas is one of 26 states that opted out of Medicaid expansion.

The Affordable Care Act required states to expand Medicaid to those whose incomes reached up to 133 percent above the poverty line, which is $11,500, or $23,500 for a family of four. The federal government would then carry the lion’s share of health care costs. Presumably, 17 million uninsured people would get coverage. Financial penalties would be levied against states that did not comply.

Washington would also provide subsidies for some purchasers of insurance on the new health exchanges. However, their incomes would have to be at or up to four times above the poverty line — but not below it. No one earning below the poverty level is eligible for federally subsidized health insurance.

On June 28, 2012, when the U.S. Supreme Court approved the Affordable Care Act, the justices handed the right wing a victory. In a 7-2 decision, they ruled that states could opt out of expanding Medicaid — without penalty.

Five reactionary governors immediately said they would not extend Medicaid. To date, 26 right-wing state governments have jumped on the anti-poor bandwagon, denying this vital program to millions of people who desperately need it, even rebuffing billions of dollars in federal funds to cover its costs.

Now, 8 million low-income, uninsured people are trapped in a ridiculous Catch-22, with no health coverage. Denied Medicaid, and yet working 40 hours a week, they are “too poor” to get subsidized health coverage. They are stuck, living in states whose officials refuse to expand Medicaid, where income levels must be extremely low for applicants to even qualify for the program. These states provide little or no coverage for childless adults, even when unemployment is high or wages low.

The New York Times of Oct. 3 reported “Millions of Poor Are Left Uncovered by Health Law.” The article listed the categories of hard-working yet underpaid workers who perform vital jobs for society, but have been denied health coverage: cashiers, cooks, nurses’ aides, sales clerks, waiters, custodians and housekeepers. The workers question how they can be living in poverty and not be eligible for Medicaid or subsidized insurance. It’s a good question.

This situation could only happen with the greediest, profit-driven health care system. The refusal of politicians in 26 states to expand Medicaid to underpaid workers shows to what extent the right wing will play politics with people’s lives. It also exposes the deep racism that is at play here. The impact of such refusal will disproportionately affect African Americans, Latinos/as and other people of color.

Half the U.S. population lives in these 26 states, including 60 percent of all uninsured, underpaid workers. Two-thirds of low-income, uninsured African Americans and single mothers reside in them. Texas, which has the second largest Latino/a population in the country, is a leader in the anti-Medicaid bloc.

Every state government in the Deep South, except Arkansas, has refused to open up Medicaid enrollment. This is a region where poverty, illness and lack of medical insurance are severe. The legacy of segregation and Jim Crow racism still weigh heavily there, affecting government policies.

Dr. Aaron Shirley, an African-American physician and civil rights activist, told the Times that racism influences health care and other programs in Mississippi: “Politicians have used race to oppose minimum wage, Head Start, all these social programs.”

Some 13 percent of this country’s poor and uninsured people live in Mississippi. The Times gives examples of two residents who can’t get Medicaid or subsidized federal insurance. Willie Charles Carter, 53, is unemployed and, as a childless adult, is ineligible for Medicaid, although his income is below the state’s Medicaid ceiling of $3,000. Claretha Briscoe earns $11,000 a year as a fast-food cook.

Carter, Briscoe and all low-income workers, employed, underemployed and unemployed, deserve health care. The federal government must find a way to extend Medicaid to all who’ve been kept off the program. Health care is a right!