Millions Sick and Untreated, Thanks to Medicaid “Unwinding”

Photograph Source: Images Money – CC BY 2.0

During the pandemic, poor people did not have to renew their Medicaid annually. Now that covid is supposedly over, that has changed. Unwinding, in normal parlance called ending, Medicaid continuous coverage began on April 1. That was after the Consolidated Appropriations Act 2023 terminated the Medicaid continuous enrollment provision on March 31. As a result, by the end of July, roughly four million indigent people lost their health care coverage. They’ve started rationing medicines or skipping them. And as the months pass, more people will lose access to a doctor and to prescriptions. Way to go, Washington! And way to go, Joe “I Would Veto Medicare for All” Biden. The transformation of the U.S. into a “shithole” nation just picked up the pace.

So why are all these people losing their medical coverage? And why does this happen when we already have 27.6 million people without health insurance? Well, it happens mostly, and most infuriatingly, for bureaucratic reasons, not because patients become ineligible. These cutoffs, according to the Washington Post July 28, are due to “renewal notices not arriving at the right addresses, beneficiaries not understanding the notices, or an assortment of state agencies’ mistakes and logjams.” And states quite obstinately keep people off Medicaid, even if they were dropped for one of these flimsy “procedural” reasons. Arkansas, the new Mecca for child labor, is one of the worst, while Texas, of course, followed by Florida, natch, has severed the most people, hundreds of thousands.

Arkansas GOP governor Sarah Huckabee Sanders, one of the nation’s leading far-right fanatics when it comes to pitching her constituents back into deliquescent, early 19th century social conditions, said in a May Wall Street Journal op-ed, “I’m proud Arkansas is leading the nation in getting back to normal.” Normal being booted off life-saving medical care. “It’s time to get [Arkansas residents] off the path of dependency.” The brave new world of astronomical premiums and high-priced medicines on Obamacare, or simply no care at all, awaits!

“Trevor Hawkins, an attorney with Legal Aid of Arkansas, said some people have been told their Medicaid cases were closed at their own request – when that was not true,” the Post reported. Also, children lose coverage when their parents do, even though they still qualify! But the state has a handy dandy excuse: Some people, according to the Arkansas human services department spokesman “have chosen not to return the renewal forms, aware that they are no longer eligible.”

This is probably hokum. But it is to be expected from a Republican party with a long history of hostility to Medicaid and an open wish to bury it. Remember, years ago when the Affordable Care Act expanded Medicaid coverage to nearly all adults at 138 percent of the poverty level, ten states refused the expansion. They are: Wisconsin, Wyoming, Kansas, Texas, Tennessee, Mississippi, Alabama, Georgia, South Carolina and Florida. North Carolina adopted but did not implement the expansion. Those are mostly red states, whose governments basically said they’d rather their poor residents skipped seeing a doctor than accept federal funds for a program they oppose ideologically and slam around enthusiastically as a political punching bag.

So the smart money is on these eleven states contributing inordinately to the U.S.’s dismal longevity and infant mortality stats. When even a nation like Cuba, impoverished by Washington’s illegal, 60-year blockade, beats the U.S. in these two categories, you know something stinks. That something is the lack of a decent public health system.

American private equity-owned, for-profit medicine is a disgrace. People die of cancer every day because they cannot afford chemo. The number of medically-caused bankruptcies shot through the roof decades ago and now is unrivalled anywhere else on the planet. Insulin, a simple, life-saving drug whose discoverer tried to make it cheap, costs so much that diabetics routinely purchase it in Canada. Thank God for other countries. If American patients couldn’t shop online abroad, they’d be dropping like flies. And they will be, if our malevolently creative pharmaceutical companies ever manage to block this avenue of rescue. Given how inventive they’ve been at perverting Medicare, it surely is only a matter of time before pharma finds a way to tighten that noose, too.

How badly has decaying capitalism destroyed our health? According to the KFF Health System Tracker, “The U.S. has the lowest life expectancy among large, wealthy countries, while it far outspends its peers on health care.” Life expectancy in the U.S. lags behind that in Germany, the U.K., Austria, France, Belgium, the Netherlands, Australia, Sweden, Japan and Switzerland. To say nothing of U.S. life expectancy dipping behind China, Lebanon, the Czech Republic and Cuba.

In infant mortality, the U.S. does even worse. It ranked 33 out of 38 Organization for Economic Cooperation and Development nations in 2019 – before the pandemic. And we all know how abysmally the U.S. did during the covid years (which some might note are not over) – over 1.1 million dead, proportionally worse than any other country, rich or poor. That’s because our dysfunctional public health system and our corporate-owned government were uninterested in stopping the virus with any sustained, coherent medical strategy, while the few lockdowns we did have nearly sparked a far-right revolt.

That doesn’t even count the 16.3 million working age Americans who cope with long covid, their health compromised, and as for their longevity – who knows? They’ll probably join the statistics of the multitudes of Americans who die prematurely, while nincompoop right-wingers and our corporate overlords will no doubt rant against any public health moves to assist them, as part of a commie plot to steal our freedoms, since public health arrangements put, uh, health first. So there will be none. Because we are ruled by cruel, greedy people who also happen to be nitwits. If you doubt that assessment, just look at their conduct of our foreign policy.

So yes, in America, along with the freedom to freeze to death sleeping under an overpass in winter or the freedom to drop dead of heat stroke driving an un-air-conditioned UPS truck in summer for a living, the freedom to work 80 hours a week and still not afford an apartment or the freedom to skip meals because you can’s snag enough work for your food stamps, we also have the freedom to die of treatable diseases because we can’t pay. The few best efforts to alter that amoral calculus of our corporate rulers are Medicare, Social Security and Medicaid, and they remain all-season targets of far-right demagogues. And now with the pandemic supposedly over, as the few socially and morally responsible safeguards against it are removed, we will see again that unfailing measure of unfettered monopolistic capitalist success – an uptick in the death rate.

Eve Ottenberg is a novelist and journalist. Her latest book is Busybody. She can be reached at her website.