Forty-six years ago today, Dr. Martin Luther King Jr. was assassinated in Memphis, Tenn. If he were alive today, Dr. King would be on the march again, demanding that governors stop standing in the way of justice and endangering the lives of the vulnerable by refusing to expand Medicaid in their states under the Affordable Care Act.
King recognized health care as a human right. Two years before his death, he made it plain in a speech to the 1966 convention of the Medical Committee for Human Rights, which was organized in 1964 to support the Mississippi Freedom Summer. “Of all the forms of inequality, injustice in health care is the most shocking and inhuman.”
King understood, in a way that is rare and desperately needed, how racial inequality is inextricably tied up with economic inequality, health disparities, and a host of other man-made injustices.
King would understand the urgent need to remedy huge health disparities related to race and income. As I have written earlier, the major difference between progressives and conservatives on health care reform is whether we see it as an injustice or merely unfortunate that millions of Americans are uninsured, and have limited access to medical care. King — who reminded us that, “We are caught in an inescapable network of mutuality, tied in a single garment of destiny” — would see it as an injustice that demands action on the part of society as a whole.
Along with the good news that 7 million Americans have enrolled in health insurance through the ACA, it turns out that 3 million more Americans have signed up for Medicaid as a result of the ACA. But King would have tempered our celebrations by reminding us how many Americans are still denied the opportunity to do the same by politicians wielding the same “states rights” arguments King fought against decades ago.
Since the 2012 Supreme Court decision upholding the ACA, but also ruling that states could refuse the ACA’s Medicaid expansion without being penalized, 21 states have refused to expand their Medicaid programs. All of them, including the former-confederate states where King led the fight against segregation, have Republican legislatures or governors who refuse the Medicaid expansion.
According to an article in Harvard Medical School’s Health Affairs, nearly 8 million people in the states that have rejected the Medicaid expansion could be insured by Medicaid today if their states had opted in. According to the authors of “Opting Out of the Medicaid Expansion: The Health And Financial Impact,” between 7,115 and 17,104 people in the states that have refused the Medicaid expansion will die needlessly. Medicaid has been shown to save lives by providing access the needed medical and preventive care. Republicans governors who refused to expand Medicaid in their states have ultimately convened their very own “death panel”
These Republican governors and lawmakers claim their states can’t afford the Medicaid expansion. But with the federal government picking up 100 percent of the cost now and no less than 95 percent of the cost in future years, most could easily afford to make up the difference by raising taxes on the wealthy or eliminating some tax breaks. There is no good reason for their refusal to expand Medicaid, and help the poor and vulnerable in their states.
Conservative economist Tyler Cohen distilled the ethos of conservatism on health care reform when he wrote, “We need to accept the principle that sometimes poor people will die just because they are poor.” King would have rejected that in 1966 and he would reject it today.
King would march with and go to jail with Moral Mondays protesters in Georgia, where the governor tried to use his power to kill any hope of Medicaid expansion for over 600,000 Georgians who could be covered by Medicaid today. He would march in Louisiana, where the governor spews lies about the Medicaid expansion, and has crafted his own plan to cap Medicaid spending and repeal the ACA — even as over 270,000 are left out of the Medicaid expansion. He would march in Arkansas, where Republicans tried to dump 85,000 out of Medicaid after its Democratic governor found a way to expand the state’s program. And he would march once again in Tennessee, where over 300,000 could be covered by Medicaid,
King is not here to march with us and lead us in action. But his spirit and his legacy call upon us not to rest until justice is available to all, and even the poorest among us claims the right to good, affordable, life-saving health care.