COGNITIVE DISSONANCE is the discomfort experienced when simultaneously holding two or more conflicting cognitions: ideas, beliefs, values or emotional reactions. In a state of dissonance, people may sometimes feel “disequilibrium”: frustration, hunger, dread, guilt, anger, embarrassment, anxiety, etc

The St. Louis Post-Dispatch ran a very informative first page article on Missouri’s potential “Medicaid gap” today. The term refers to the situation of folks who are too poor for the Obamacare health insurance care exchanges, those the plan had intended to cover by expanding Medicaid eligibility. Unfortunately, after the Supreme  Court ruled the Medicaid expansion optional,  Missouri’s Republican pols were unwilling to accept the federal money that would fund the expansion – full federal ride for three years, thereafter an increasing share to be paid by Missouri until the state reaches the 10% cap on its contribution in 2020. Expanding Medicaid is unarguably a good deal that would bring lots of Missouri’s federal tax dollars home and cover hundreds of thousands of currently uninsured  Missourians. The result of the GOP’s intransigence is nearly 300,000 uninsured individuals who will remain uninsured after Obamacare’s full implementation unless the legislature relents.

The article suggests that many of our GOP state legislators are in a state of denial about what federal funding means, as witness this statement from state Senator Gary Romine (R-3):

With our budget as tight as it is, to add anyone else to the rolls only takes dollars away from another area […]. So for us to find ways to cover those in need, we’ve got to find a way to come up with funds.

But this type of idiocy is not the cognitive dissonance I am concerned with. I rather suspect that Senator Romine knows very well that the funds for the expansion will be available from Washington (and without busting the federal deficit either). He also knows that funds are  tight in Missouri because of the desire of the GOPers in the legislature to lighten the tax burden for their corporate patrons. He’s just trying to put a good face on a decision that will hurt many Missourians for almost no reason at all.

A statement from one of those poor souls who will probably not be able to obtain subsidized coverage on the exchanges, however, not only exemplifies the definition of cognitive dissonance, but indicates just how the GOP can use it to get away with cutting off so many Missourians’ noses to spite the Obamacare face:

Count Jennifer Rosa, 40, of Ellington, Mo., in Reynolds County, in that group. She works full time at a grocery store, handling carry-out for customers and stocking shelves. The store doesn’t offer insurance to its employees.

Her son is on Medicaid – the cutoff is higher for children – and Rosa said she pays $75 a month for that. But she makes too much to be eligible herself.

“You get up every morning and pray you don’t get sick, don’t have a toothache, don’t need glasses,” she said.

About twice a year, her chronic bronchitis flares up.

“You just don’t go to the doctor,” she said. “You get sick and just tough it out.”

While she would like to have affordable insurance, she’s not a fan of the Affordable Care Act, dubbed Obamacare.

“I don’t like the idea of them forcing this down our throats,” Rosa said. She opposes subsidizing people who “sit at home and draw a check. I don’t want them to do everything for me, but as a working person, some help would be great. We’re people who work for a living.”

Get that? Somehow, Ms. Rosa is sure the beneficiaries are unworthy, folks who sit on their butts and “draw a check,” even though she herself is exactly the type of person who would be covered by the expansion. She wants health care, she needs health care, but she knows, thanks to the tireless demagoguing of the GOP, that making it available to her is “stuffing it down our throats” – which we all know is very bad. There’s a little mean-mindedness here – the phobic response to the the mythical “welfare queen” stereotype – but otherwise, cognitive dissonance anyone?

This mental disjunct may be good short-term politics for the GOP in Missouri, but long-term it’s very bad for the state. Remember the products of cognitive dissonance? A misinformed, inflamed citizenry raddled by “frustration, …  dread, guilt, anger, embarrassment, anxiety” isn’t going to do anybody any good and may indeed be responsible for lots of very bad future events.

2nd paragraph slightly edited for clarity.

Think Progress reports that Missouri is one of the six states refusing to enforce essential consumer protections in the Affordable Care Act, also known as Obamacare. The states identified:

…  are refusing to oversee even Obamacare’s most basic – and popular – consumer protections and insurance market reforms. That includes the law’s ban on denying coverage or charging more because of a pre-existing condition and discriminating against women on the basis of gender. The decision could present major hurdles to Americans who buy health insurance through federally-run marketplaces in the Lone Star State, Arizona, Alabama, Missouri, Oklahoma, and Wyoming. […]The Centers for Medicare and Medicaid Services (CMS) will instead be responsible for enforcing Obamacare’s insurance industry reforms and reviewing consumer complaints in the states refusing to do so on their own.

Think Progress’ Sy Mukherjee points out that this situation could lead to serious confusion and lots of unnecessary back and forth for those who suspect that an insurer on the exchange is not acting in good faith with the provisions of the law. Navigating the agencies responsible for enforcing the law becomes far more fraught for those who have questions about their insurer:

Usually the answer is your state’s insurance department. But the answer is CMS [the Center for Medicare and Medicaid Services if you live in one of the six states that won’t enforce the consumer protections. Unfortunately, if you don’t know that, you could spend months oscillating between the state and federal government, trying to figure out if you’re getting hoodwinked by your insurance company. And in the meantime, the bills are piling up.

When will this stupid obstruction for obstruction’s sake end?

No, don’t bother to answer. We all know that as far as Obamacare goes that it won’t end until the dead enders have been voted out of office.  Until that probably distant day, it’s all down to a bunch of rightwing clods, slapping themselves on the back in mutual recognition of their ideological purity while enjoying the goodies gleaned from corporate lobbyists in the ethics-free zone that is Jefferson City.

Remember the Simon and Garfunkel oldie, “The Sound of Silence”? Very existential, as I remember. Here in Missouri the sound of silence isn’t, however, a symptom of urban twenty-something angst. It’s simply what we’re hearing as the October 1 deadline for implementing the Affordable Health Care Act (a.k.a. Obamacare) health care exchange nears.

Actually, included in this sound of silence is the sound of the proverbial Zen one hand clapping. That single hand would be the non-profits that are stepping up to help get the word out about the Obamacare health care exchange that is due to open on October 1, going it alone while state and local governments are M.I.A. The Missouri Hospital Association has set up a great Website with information about the exchanges: http: //www.enrollmissouri.org/. Other private groups have also stepped up. Missouri Health Care for All has been working to help educate people in the state about the provisions of the law, and the Missouri Foundation for Health will dedicate $8 million dollars to assist uninsured Missourians. These agencies are on the side of the angels, but the fact remains that, as the New York Times observes about Missouri that “looking for the new health insurance marketplace, set to open in this state in two months, is like searching for a unicorn.”

If Obamacare is going to work, the exchanges are vital. They’ll provide online shopping for offerings from participating insurers, and, if properly implemented, they’ll offer a good deal for everybody who isn’t already insured through their employer, Medicare or Medicaid. Subsidies will be available for those who meet the income requirements. Many of the 850,000 uninsured Missourians will qualify for coverage through the state’s exchange, but it might not happen if Missourians don’t get reliable information about what is on offer and what they need to do to get it.

Since the exchanges are so important, everybody must want them to be implemented in the best way possible, right? Wrong. Let me count for you the ways our state Republican pols are trying to sabotage the Obamacare health care exchange in Missouri:

1.Refusing to create a state exchange and hindering formation of the federal exchange for Missouri: The legislature passed a law forbidding the state to build it’s own exchange, leaving the job to the federal government. The law, however, goes an extra step, revealing the extent of GOP anti-Obamacare spite. It stipulates that “state and local officials cannot provide ‘assistance or resources of any kind’ to a federal exchange.” A final measure of GOP virulence is the provision that would make any government officials liable to wingnut lawsuits should they attempt to cooperate with the exchanges.

2. Refusing federal funds to extend Medicaid coverage in Missouri: Not only will this mean-minded action deny health care coverage to many poor Missourians, it will affect perceptions of the exchanges among members of a population that has already been lied to again and again about what the law will do. While the exchanges will offer subsidies based on income to insure that eligible individuals can afford coverage, it will not subsidize coverage for those below a certain income point since the intent of the law was to provide health care to those individuals through the Medicaid expansion that the GOP jackasses in Jefferson City have so far squelched.

3. Controlling and limiting information about the Missouri exchange: GOP lawmakers have learned a thing or two from their “War on Women” strategy of regulating reproductive choice almost out of existence, and seem to be using the same regulatory approach to sabotage the Obamacare exchange. Otherwise religiously anti-regulation GOPers have decided that they must rigorously regulate individuals, known as navigators, hired to help Missourians use the exchanges lest they engage in “fraud.” And if they manage in the process to slow the information stream to a trickle, well, what can you do? Requiring unnecessary “on-going” training – all navigators are already required to take extensive federally provided training and pass a test – charging wannabe navigators a fee, and requiring a bond ought to do the trick nicely. Add into the mix a prohibition on actually helping citizens decide which choice works best for their needs and you’ve got a real killer. An added bonus – there’s currently no regulatory framework to define the extra training content, administer it, or handle the licensing process, and, if I were you, I wouldn’t hold my breath expecting it to be in place really soon – certainly not before the October 1 deadline for the exchanges.

What all this obstruction aims to do is retain the unacceptable status quo where far too many Missourians lack access to good health care. No matter how loud folks scream about extreme rhetoric, no or poor health care can be a death sentence. And, no, emergency rooms don’t cut it. Think about dealing with cancer through emergency room services, early detection is unlikely in that scenario and coordinating the often messy and complicated cancer treatment regimes in such ad hoc settings is almost unthinkable.

Why are Republicans trying their best to do the worst thing for their constituents? A partial answer lies in the traditional deference they show corporate allies – the law to “regulate” exchange navigators was based on model legislation drafted and distributed to several states by the National Conference of Insurance Legislators, which opposes federal involvement in the insurance industry. Insurance agents and brokers are “worried about losing market share” so compliant GOPers have come to their aid.

A more potent reason, though, may be the cruel, brain-dead, conservative ideology that animates today’s radicalized Republican party. For example:

State Senator Rob Schaaf, the Republican author of a 2012 ballot measure that prevented the state from setting up its own insurance exchange, said: “We can’t afford everything we do now, let alone provide free medical care to able-bodied adults. I have a philosophical problem with doing that, and I’m also worried about our country’s financial situation.

This is wrong on so many levels that it makes one’s head hurt to contemplate the many layers of stupidity. First, to restate the obvious, our country’s financial situation is far from dire, and its structural problems will not be improved by killing Obamacare – actually the opposite is probably true as long as the implementation goes well. As Jonathan Cohn observes:

Obamacare can help a great many people, while improving the short- and long-term budget oulook. But its success will depend, at least partly, on the willingness of states to go along. And although they should, if only for pure self-interest, that doesn’t mean that they will.

The more important point, though, has to do with Mr. Schaaf’s philosophical inclinations which reflect those of many in his party. Right now we’re all subsidizing, through our health care premiums, very expensive, but very bad care for low-income adults. I have a serious philosophical problem with that. I have an even greater philosophical problem with doing nothing at all and letting poor folks die while those who got rich off of government subsidized corporate welfare live high on the hog and enjoy the best health care on offer. Americans are better than that – or at least we should be.

THE MOTIVATING EVENT(S): Most parts of the The Affordable Care Act (ACA), popularly known as Obamacare will be implemented in 2014.

THE GENERAL PROBLEM: The GOP has made opposing Obamacare their raison d’etre; they have, with some success, managed to recast what was at one time a Republican response to health care into a symbol of repressive government overreach, inculcating baseless fears among those poorly informed Americans who are susceptible to the GOP narrative. This very useful propaganda structure will be threatened when the law goes into effect and has few or no negative consequences for most Americans, while making health care available to others for the first time. If Republicans don’t want to be exposed as weak and corrupt, they have to intensify their kicking and screaming while lobbing spanners into any part of the Obamacare works that are vulnerable.

THE OPPORTUNITY FOR MISCHIEF:The Obama Administration has delayed until 2015 the requirement that businesses with 50 or more employees that are not already offering insurance begin to do so. Many health care policy types have  argued persuasively that the delay will have little negative impact while allowing the administration to concentrate on more crucial aspects of ACA implementation. Only 2% of businesses that meet the criteria for the delay, those with 50 or more employees, do not already offer insurance. There is, however, a symbolic risk and opponents of the law are already attempting to parlay the change into yet more anti-Obamacare hysteria.

SEIZING THE OPPORTUNITY: The GOP has been quick to try to capitalize on  this event, gleefully grabbing their spanners. Yesterday a few GOP senators – including our boy Roy – got together to let us know, totally without irony, how exercised they are about the delay in implementing a law that they otherwise oppose, and what they intend to do about it via amendments to an upcoming spending bill:

1. Deny funds to enforce the employer mandate.

2. Deny funds to enforce the individual mandate.

3. Deny funds for the Independent Payment Advisory Board (IPAB) that sets pricing guidelines for Medicare (and which GOP senators persist in fancifully dubbing “death panels,” in spite of the risible effect that label now has).

ROY’S ROLE: As a member of the Senate leadership, it is significant that Missouri GOP Seantor Blunt put forward the Republican talking points:

Blunt’s main points:

1. The delay of the employer mandate is intended purely for political reasons; Blunt claims that the fallout of implementing the mandate will hurt Democrats in 2014. However, if that were the case, why aren’t provisions that will have much greater impact – the individual mandate, for instance – being delayed? In general, the delays and work-arounds that Roy details will have little major impact, but will ensure a smoother roll-out over all.

2. Blunt suggests that the delay contravenes the law. This contention is, in fact, not true. The employer mandate has not actually been delayed – only the reporting requirements, which are arguably an implementation detail. The effect will be, true, to delay implementation since fines for non-compliance cannot be levied without the reporting mechanisms.

3. Blunt notes that as part of the reporting mechanism, income verification mechanisms for individuals who apply for insurance subsidies are also waived – a better word, however, would have been delayed. Those who attempt to take advantage of the delay to make inappropriate claims will be forced to verify their eligibility for the subsidies within a few months. Hardly justification for doing away with the exchanges or the subsidies for lower income Americans.

4. Rather than allowing the administration to defer minor parts of the law in order to insure that major sections, such as the insurance exchanges, work from the start with as few glitches as possible, Blunt wants us to “permanently delay” what he calls a “flawed law” so that better alternatives can be crafted. Right. Remember when Roy Blunt, recipient of lots of insurance industry money, was the point man in charge of one of those alternative plans? And remember how we all had a good laugh when he offered up his plan.

Good GOP soldier Roy has been pushing these points on the various social media and via emails to his constituents. A copy of the email I received is included below the fold.

WHAT’S IN IT FOR ROY: Although our boy Roy is a relatively junior Senator, he’s a Washington old-timer and has been a big-time GOP inside player. Consequently, he’s already got a place in the Senate’s GOP leadership group and one would probably be correct in assuming that he’s working hard to amass the type of weight that will propel him forward. And, as always with Blunt, there’s his lucrative corporate ties – his ability to pull in the green not only aids his reelection, but it also boosts him as a power player. Never doubt that Blunt’s got skin in the game when it comes time to reinforce the party line.

CONCLUSIONS: I’ll let Steve Benen articlate the more general conclusions:

… They [i.e., Republicans] have a choice between governing and these ridiculous antics, and they clearly prefer the latter.

Keep in mind, there is no precedent in American history for this. Countless measures have passed over the objections of one party or the other, but we’ve never seen a political dynamic in which one radicalized, unhinged party casts literally dozens of pointless repeal votes while actively, shamelessly trying to sabotage existing federal law.

What conclusions can we draw specifically about Roy Blunt and his role in these “antics”? We know he’s not a total ass, like Senator Mike Lee, who  threatened to shut down the government to prevent federal budget funds for Obamacare. Our boy’s been around the block a few times; it’s a safe bet he’s willingly participating in a political charade meant to serve partisan ends despite harmful consequences for his constituents and the nation as a whole. I’ll leave it to you to supply the appropriate descriptive term – I’m trying hard to avoid obscenities.

*1st sentence of 2nd paragraph edited slightly for clarity; link added in third paragraph.

What follows is the text of the email I received from Senator Blunt:

Dear Friend,

I’ve heard time and again from Missourians who are rightly concerned about the impact of ObamaCare. Amid growing criticism, the Obama administration announced last week that it will delay a key component of this law – the employer mandate- until after the 2014 elections.

By announcing this delay, the Obama Administration admitted what we’ve long known: This law is fundamentally flawed. But picking and choosing which aspects of the law to postpone is like riding a bike with one wheel – it simply does not work.

I’ve repeatedly voted to repeal and defund ObamaCare. We need a permanent delay of this law for all Americans while we work to implement common-sense health care solutions.

I joined my colleagues this week to call on the president to enact a permanent delay for everyone, and I recently spoke on the Senate floor about this critical issue. I’ve also asked Missourians to share their questions about ObamaCare on Facebook and via Twitter using #AskRoy.

I hope you’ll join this conversation online, and that you will continue to share your stories, questions, and concerns with me regarding this and other important topics facing our state and the nation by visiting my website.

A study-new-medicaid-expansion-could-be-a-lifesaver new report gives us some numbers to support what we already knew – expanding Medicaid would save lives:

Until now, the Medicaid debate has been about budgets and states’ rights. But a statistical study by Harvard researchers in the New England Journal of Medicine found a 6 percent drop in the adult death rate in Arizona, Maine and New York, three states that have recently expanded coverage for low-income residents along the general lines of the federal health care law.

The study found that for every 176 adults covered under expanded Medicaid, one death per year would be prevented.

So let’s just do the math for Missouri where we have about 20.7 thousand individuals who would be eligible for coverage under Obamacare’s expansion of Medicaid. That amounts to about 118 people every year saved from death.

Expanding Medicaid as originally required by Obamacare would also bring Missourians’ tax dollars back to the state. As Senator Claire McCaskill observed:

…it would be unfortunate for federal tax dollars to go to help states around the country, but not Missourians.

I think it would be mistake for Missouri officials to turn up their noses at a Medicaid expansion that is fully paid for by their federal tax dollars, […] A little like cutting off your nose to spite your face.

So why is anyone even contemplating doing otherwise than expanding Medicaid? Another study suggests the reason by once again offering some numbers to confirm what we all already think we know: it’s just more GOP politics as usual. George Washington University’s Elizabeth Rigby analyzed a number of reasons commonly cited by balky states, such as, the magnitude of change in a particular state , cost, and popular sentiment against Obamacare, and found that:

… the driving factor behind opposition to the reform was found to be the partisan affiliation of state elected officials – with greater resistance seen in states in which either the legislative or executive branch were controlled by the Republican party.

More evidence that sore losers hurt us all.  

It seems that Missouri’s Rep. Billy Long (R-7) and a group of fellow congressional freshmen gathered with reporters to warn of a grave threat to liberty: contraception. According to CNSNews.com (an entity that, incidentally, brings us the “news that the liberal media are hiding”), Long waxed uncharacteristically eloquent on the theme that when women get free contraception, “we’re still home of the brave, but we’re not the land of the free anymore”:

Long said, “America 2012.  Land of the free, home of the brave.  Are we still the land of the free and home of the brave? Let’s examine that for just a minute. I know we’re the home of the brave because if we walk off that House floor five days a week, three or four days, they’ll be a wounded warrior sitting there just like the one that was there yesterday.”

“He had no right arm, he had no left arm except for an artificial arm and an artificial hand, he was proud to shake my hand, with his artificial hand to show me how it worked,” Long said.  “He had no legs below the thighs.  His wife was standing next to him with less than a 1-year-old child in her hands.”

“You don’t have to worry about the brave,” he said. “We’re still home of the brave, but we’re not the land of the free anymore. And we need to get that straight.

“When you’re not free to practice religious freedom in this country, what in the world have we come to?” said Long. “Seriously, goodness gracious.”

Goodness gracious indeed. Where is H.L. Mencken when we need him. (Mencken did offer an apt observation about the birth control wars of his day: “It is now quite lawful for a Catholic woman to avoid pregnancy by a resort to mathematics, though she is still forbidden to resort to physics or chemistry.”)

As I indicated earlier, the occasion for this diatribe was simply the old news that under Obamacare, insurers must, starting yesterday, offer women a full range of reproductive health services. Billy and friends, of course, focused on the services CSNNews.com characterizes as “sterilizations, contraceptives, and abortifacients” – the last, of course, a bit of overreach in order to pander to those folks who think a single fertilized cell should have full human rights.

What’s actually going on here that’s got Billy so exercised?

I used to get insurance through my employer in order to take advantage of the economies of scale.  My employer paid for part of the coverage, and every year sent me a statement showing what my actual salary was when the money diverted to benefits like insurance coverage was added in. The fact that insurance paid for by employers is simply another form of income came up during the the debate over Obamacare, and centered on whether or not these diverted wages should be taxed as income.

Now, a group of Republican congressmen think that employers with certain types of religious beliefs have the right to impose those beliefs on American women and tell them what services they can and cannot purchase with the money they earn and that their employers divert from their salaries for insurance. And they call this religious freedom.

Somebody ought to break it to these folks that freedom’s a bigger issue than making political hay out of the hissy fits of our more authoritarian religious leaders. Margaret Sanger, the birth control pioneer and founder of Planned Parenthood, understood that one person’s freedom cannot be another’s subjugation:

Woman must have her freedom, the fundamental freedom of choosing whether or not she will be a mother and how many children she will have. Regardless of what man’s attitude may be, that problem is hers — and before it can be his, it is hers alone. She goes through the vale of death alone, each time a babe is born. As it is the right neither of man nor the state to coerce her into this ordeal, so it is her right to decide whether she will endure it.

I kept meaning to write something about one of government’s big success stories, Medicare, to celebrate it’s 47th anniversary, which was yesterday. Now I don’t need to write a thing since local activist Amy Smoucha has said it all a thousand times better than I could have.  A sample:

The idea of “waiting for Medicare” hit me hard. My mother was waiting for Medicare for years. As a retail clerk at Sears, she didn’t have health insurance for most of her life. My mom was one of those amazing people who got up to go to work each day, took us to church on Sunday, played bingo Thursday nights, and was afraid to go to the doctor because she didn’t have insurance. While she was waiting for Medicare, my mother developed high blood pressure and heart disease. We discovered this just as she turned 65, when her long wait for insurance was finally over. Her golden years involved struggling with congestive heart failure. She died at the age of 67, when I was 23. I take the idea of “waiting” for health insurance personally.

Right now, millions of people across America, in every state, rural community, city, and town, are waiting for Obamacare. I think especially of a friend’s son who is a carpenter with a herniated disc. He was accepted by a local Community Health Center-a sliding scale clinic-and found a wonderful primary care doctor. But because he’s uninsured, he is on a waiting list for surgery. Most recently, his foot started dragging, and the damage is affecting his urinary function. He is 40 years old and waiting for Obamacare.

Read it all here. And remember, if the Democrats lose this election, we could lose Obamacare.

The folks over at Lean Forward have put together an interactive map showing where states now stand in regard to opting out of the part of Obamacare that would expand Medicaid, as per the Supreme Court finding that participation in the expanded Medicaid cannot be compelled. The map’s creators assessed statements from legislators and governors to determine the current likelihood that a given state will participate in the Medicaid expansion, while noting that the situation is still fluid.

According to the map, Missouri is a “leans no” state, based on Jay Nixon’s silence and our GOP legislators’ truculence when confronted with any aspect of Obamacare. So what harm can the latest “over my dead body” GOP posturing do? Lean Forward cites the following details:  

— Missouri Population Uninsured:  853.3K (14% of state);

— Uninsured eligible for expanded Medicaid: 207.7K;

— Federal money available for Medicaid (through 2019): $8.4B.

Let me point out that that $8.4 billion federal dollars are, as my GOP friends like to point out, our tax dollars, and if the GOPers don’t want some of what we send to Washington to come back home, I sure do. Let me ask this (rhetorical) question: What kind of imbeciles have we sent to Jefferson City? This is a good deal:

… states would spend only 2.8% more on Medicaid from 2014 to 2022 than they would have without the law, according to one study based on Congressional Budget Office (CBO) figures. And that doesn’t even take into account the savings states would realize in health-care costs for the uninsured. By opting out, states would be turning their noses up at a very good deal.

That’s not all. As health care writer Maggie Mahar observes about the governors who have indicated they won’t participate in the expansion:

If these governors dig in their heels, hospitals in their states will continue to struggle to care for millions of patients who cannot pay their bills. As the cost of uncompensated care mounts, these hospitals will shift that cost to insured patients, and premiums will rise.

Alternatively, if these states accept Washington’s offer, those Medicaid dollars would create jobs. As more low-income patients have access to care, hospitals, community health centers, labs, and nursing homes will need to hire new workers.

States desperately need those jobs. And their poorest citizens desperately need healthcare.

Of course, our GOP legislators don’t care much about jobs unless they flow from wealthy “job creators” whom they’re willing to feed generously from the public trough. And they sure as hell don’t care about the uninsured poor.

Previously:

Rep. Vicky Hartzler (r): And what will happen to the children? (July 11, 2012)

Well, Vicky? (January 6, 2011)

Uh, would that include bringing a hot meal to everyone without health insurance when they get ill? (November 28, 2010)

A health care story (September 3, 2009)

This week Representative Vicky Hartzler (r) voted again to repeal the Affordable Care Act:

Rep. Vicky Hartzler ‏@RepHartzler

The House has repealed ‪#ObamaCare‬! We must repeal this bill that’s increasing health care costs & making it harder for businesses to hire. 12:57 PM – 11 Jul 12

In 2009 we interviewed Randy Huggins, a resident of Leeton, Missouri – in the 4th Congressional District, about one of his personal experiences with the health care reform dialog. With the republican House of Representative voting, yet again, to repeal the Affordable Care Act we sought out Randy Huggins to ask him how the implementation of health care reform has affected him and his family in the interim, and how repeal would impact them:  

The transcript:

Show Me Progress: I’m Michael Bersin with Show Me Progress and I’m speaking with Randy Huggins from Leeton, Missouri. Randy, could you tell us about your grandson’s quote preexisting condition and the impact of not having insurance?

Randy Huggins: Uh, yes. Uh, my grandson was born in December of two thousand and four. And, uh, all of the prenatal care was taken care of under my daughter’s health care insurance. And then when they determined that he had a congenital heart defects the insurance company denied coverage saying that his policy didn’t start until he was born and so this was a preexisting condition.

Show Me Progress: And so, what happened, uh, from that point, uh, with his, uh, care for his heart condition?

Randy Huggins: Um, he was, uh, seen at Children’s Mercy Hospital [Kansas City, Missouri] and was treated at Children’s Mercy Hospital, um, and charities paid for it, for the most part.

Show Me Progress: In two thousand nine, uh, you attended a town hall by then candidate Vicky Hartzler and you, uh, related your health care story. What was her response?

Randy Huggins: Uh, her basic response was, uh, that someone in the community should bring our family a hot meal. I think that’s a kind of a slap in the face that, uh, she would suggest that the church bring somebody a family, somebody’s family a hot meal. Uh, it’s usually something that’s saved for a funeral.

Show Me Progress: How has the Affordable Care Act changed things for your grandson?

Randy Huggins: Uh, my grandson had a second open heart surgery in March of this year and because of the Affordable Care Act it was covered under his mother’s health insurance.

Show Me Progress: What does repeal of the Affordable Care Act and Representative Vicky Hartzler’s vote to repeal it mean to you and your family?

Randy Huggins: Uh, it means financial insecurity for all of us. Uh, without having health insurance you know you’re going to have something come up. So, basically we would have to set everything aside and save for any health issues that would, would come up in the future.

Show Me Progress: Uh, but at the same time, uh, would saving cover everything?

Randy Huggins: I seriously doubt that we’d be able to save that much.

Show Me Progress: Uh, and, and how would that affect your, uh, grandson’s future?

Randy Huggins: Well. He would never be able to get any health insurance, um, because of the preexisting condition with his heart even if, when he is eighteen, to buy his own policy, he wouldn’t be able to get a policy. Uh, he would never have any kind of financial security.

Show Me Progress: And so the, uh, the Affordable Care Act, um, means that your grandson has a possibility of a future.

Randy Huggins: He, he has a possibility of, of a piece of the American dream, yeah.

Show Me Progress: Well, thank you very much for your time.

Randy Huggins: You’re welcome.

There is a profound human cost to repeal of the Affordable Care Act. A profound human cost.