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Cognitive dissonance and Obamacare in Missouri

25 Sunday Aug 2013

Posted by Michael Bersin in Uncategorized

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ACT, Affordable Care Act, Gary Romine, GOP progaganda, Medicaid expansion, missouri, Obamacare

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.

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