Coronavirus and the Republican War on Poor People

By GENE NICHOL

When Republicans secured unfettered control of all three branches of North Carolina government in 2013, they immediately passed two cornerstones of their pioneering crusade against impoverished Tar Heels. First, they literally gutted the state’s unemployment compensation program – assuring that it became, as it remains today, the stingiest plan in the country.

Next, they scurried to enact a statute permanently rejecting Medicaid expansion under the Affordable Care Act. As a result, almost a half-million low income citizens lost proffered heath care coverage, though the federal government would have paid almost the entirety of the bill. The decision cost the state billions of health care dollars, tens of thousands of jobs, an array of rural hospitals, and thousands of lives.

Little explanation was given, beyond conclusory statements that “expansion wasn’t good for North Carolina.” But the decision made two things clear: our Republican lawmakers hated President Obama and they were launching what would soon become a successful campaign to out-Mississippi Mississippi. These two inaugural, defining steps began, instantly, to diminish the well being and life chances of hundreds of thousands of Tar Heels. With the advent of the coronavirus, they now expand exponentially the tragic hardship faced by massive numbers of our sisters and brothers.

To put the Medicaid rejection in context, Dr. Steve Luking, a family practice physician from Reidsville told me:

“I’ve watched my patients with no insurance pay a terrible price. I’ve seen women die of invasive breast and cervical cancer when they couldn’t afford mammograms and preventative checkups. I’ve spoken to the next of kin in funeral homes about symptoms ignored by those afraid of the cost of evaluation. I’ve seen the slow death by invasive colon cancer in the patient who couldn’t afford a colonoscopy, the diabetic who couldn’t pay for insulin and the resulting dialysis. Despite what people say, the emergency room doesn’t provide the care these folks need. When was the last time someone got a pap smear or a screening colonoscopy in an emergency room?”

The sorts of wounds Luking described – now including delaying treatment for coronavirus — have continued over the last seven years as we’ve sent our tax dollars to other states and seen those that accepted expansion (both Democratic and Republican led) notably reduce their rates of uninsured. Our lawmakers effectively pushed their Tar Heel constituents to the back of the national pack. Better to allow thousands to die than to depart from rigid ideological command. The Trump administration augmented the injury by talking pot-shots at the ACA itself – resulting in a diminution of marketplace enrollment by about 1.3 million low income Americans since 2017.

And now comes the virus. Last year (pre-corona) about 600,000 Tar Heels lost health care as the result of the stubborn and surpassingly cruel anti-Medicaid stand. Since mid-March, North Carolina unemployment claims have soared toward six or seven hundred thousand – indicating massive numbers of additional Tar Heels have lost their employment-lodged health care coverage. We marry unemployment woes and health care miseries, leaving multitudes to face a brutal plague without compensation or care.

This life-destroying pandemic, of course, was not caused by our state legislative leaders. But these two horrifying decisions – intentionally destroying our unemployment compensation program and boastfully rejecting federally-subsidized health care for our poorest citizens – dramatically increase, every day, the tragic heartbreak now faced by incalculable numbers of our neighbors, families and friends.

Are North Carolina Republicans at least going to apologize to those whose lives they’ve ravaged?

Gene Nichol is Boyd Tinsley Distinguished Professor of Law at the University of North Carolina School of Law and in 2015 started the North Carolina Poverty Research Fund after the UNC Board of Governors closed the state-funded Poverty Center for publishing articles critical of the governor and General Assembly.

From The Progressive Populist, June 1, 2020

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