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People wait to receive a wristband number for medical treatment at the Remote Area Medical (RAM) clinic in Wise, Virginia July 20, 2012.  RAM clinics bring free medical, dental and vision care to uninsured and under-insured people across the country and a
People wait to receive a wristband number for medical treatment at the Remote Area Medical (RAM) clinic in Wise, Virginia, July 20, 2012.
The South has the majority of people in the U.S. without health insurance—44 percent of the nation's uninsured are Texas, Florida and Georgia—and the highest rates of chronic disease. These are among the findings of the Kaiser Family Foundation in a survey they presented at a March meeting of health care stakeholders from the South, released publicly this week. (Note: KFF uses the Census Bureau region, so they include Maryland, Delaware, the District of Columbia in the East, and Oklahoma in the West in their review.) The South also has the states most in need of Medicaid expansion, and most resistant to it.
Bar chart showing health insurance in four national regions.
Nearly four million of the five million people nationally who fall into the Medicaid gap live in the South. That's the population left uninsured because Republican states have refused to take the Medicaid expansion money available to them under Obamacare. The people in the gap make too little to qualify for subsidies on the health insurance exchanges, but too much to qualify for traditional Medicaid. KFF attributes the high rate of uninsurance in the South to the prevalence of blue-collar and service industry jobs, as well as small businesses, that don't provide coverage. Buying in the individual market has been too expensive. Workers in the South earn less than in other regions. And Southerners are far more likely to report having poor health than people in other regions, and the South contains states with the highest rates of diabetes, heart disease deaths, infant mortality and cancer deaths.
Bar chart showing health status of four national regions
Medicaid expansion in these states wouldn't just improve access to health care (also a big problem, with only the rural West reporting less access to care than the South) and health outcomes for the region. It would be an economic boon. Southern states would experience the largest percentage increases in federal funds compared with states in other regions if they were to expand. "If all states expanded Medicaid, Southern states could also experience a 25 percent increase in Medicaid payments to hospitals relative to no expansion—the highest percentage increase of any region."

One regional health leader, Dr. Harry Heiman, director of health policy at the Satcher Health Leadership Institute in Georgia, calls the states' refusal to accept Medicaid expansion "baffling."

"More than anything, [the report] reconfirmed to me the unique challenges in the South. […] It's the juxtaposition of the significant disease burden and significant disparities in the South against this incredible opportunity to leverage federal dollars to address these problems."
The greatest need and the greatest opportunity, squandered by Republicans who are putting politics ahead of people.

Originally posted to Joan McCarter on Tue Apr 29, 2014 at 09:16 AM PDT.

Also republished by Obamacare Saves Lives and Daily Kos.

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Comment Preferences

  •  Tip Jar (27+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Tue Apr 29, 2014 at 09:16:23 AM PDT

  •  Well, that's because "states' rights" (0+ / 0-)

    actually refers to the rights of the state to control the lives of the residents. It's a power issue. Because power, to be felt, has to hurt, the states still clinging to the partiarchal system inherited from the plantation era, need to show the citizenry who's boss. That's why they also hold on to killing miscreants in cold blood. The message from morning to night has to be that the citizenry needs to behave and be glad they're not worse off than they are.

    The only reason these states are in a contest with the federal agencies is because the latter have been, at least in recent history, the champions of individual rights. As long as the Department of War or Defense was requisitioning recalcitrant youth to be shipped off to die in foreign lands, it was perceived as a useful backstop. But, the demise of the active draft (though males still have to register) along with civil and consumer rights has raised a significant challenge to the traditional right to dispose of the citizenry as public officials see fit. Being ordered to recognize marriages is just another example of individuals making determinations to which traditionally they had no right. It is the demise of regular authority made flesh.

    by hannah on Tue Apr 29, 2014 at 09:32:23 AM PDT

  •  More on Growing Red State Health Care Deficit... (3+ / 0-)
    Recommended by:
    Sylv, BMScott, ladybug53
  •  People in red states (1+ / 0-)
    Recommended by:

    are increasingly being left with two options

    1) Leave

    2) Die

    Its sad really but unless the majority of the people in these states stand up and vote these assholes out, they'll either die from poor health, poor water or air quality or get shot.  While we in CT would gladly welcome anyone who wants to get away from the insanity, we'd much prefer they restore sanity to their own states so that at the federal level we all benefit.  

    This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

    by DisNoir36 on Tue Apr 29, 2014 at 11:29:40 AM PDT

    •  that's actually what the states want the uninsured (0+ / 0-)

      to do: leave.

      that way, they become somebody else's problem.

      (couldn't rec your comment b/c the rec button's disappeared)

      The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness. ~ J.K. Galbraith

      by bluezen on Thu May 01, 2014 at 06:36:14 PM PDT

      [ Parent ]

  •  Kansas already won race to become 3d world (2+ / 0-)
    Recommended by:
    La Gitane, skepticalcitizen

    But the rest of the South can try for second.

  •  The irony of "supply side" economics... (0+ / 0-)

    The grand irony of Obamacare is the very rules of "supply side" economics that republicans worship uncritically will eventually prove true when it comes to the states that buy into Obamcare versus the ones that don't.

    The ones that do will see increased productivity through increased healthcare via a robust, competitive marketplace.

    The ones that don't will drift into recession and failure as they fail to compete with the states that offer better health benefits to their employees citizens.

    If only republicans could understand the basic concept of supply and demand when you substitute states for corporations.

    Sadly, like any cult, they cannot see beyond their doctrine.


  •  I've been thinking about this (1+ / 0-)
    Recommended by:

    for a while now, and can only conclude that the Southern states want to keep poor people poor and sick and hungry. It's not just because they can't say yes to anything proposed by a black president. It's because they really don't want to lessen suffering and would rather keep things as they are.

    Infant and maternal deaths in the south compare to those in third world countries. It compares to the time under slavery when it was illegal to teach a slave to read. And it goes for poor whites as well.

    It's not just incidental to politics - it is the way power in the South wants it to be.

    Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

    by ramara on Thu May 01, 2014 at 05:09:46 PM PDT

  •  Obama is still black (3+ / 0-)

    So they will happily suffer until that changes.

  •  [sigh] (1+ / 0-)
    Recommended by:
    La Gitane

    It's not just a zip code, it's an attitude.

    by sboucher on Thu May 01, 2014 at 05:14:34 PM PDT

  •  This Refusal To Put 2 & 2 Together Is Mystifying.. (1+ / 0-)
    Recommended by:
    La Gitane

    How can they not notice that the people they continually vote for continually refuse to help them?

    It's not rocket science.  If your elected Representative or Senator is against you & your kids receiving healthcare....he doesn't really care about you & your kids.

    Why should he/she deserve to keep representing you?

    Hint:  He or she doesn't care about you.  Not even a little bit.  

  •  How sad it is to understand that there are so (0+ / 0-)

    many poor people,  without  decent, affordable health care.

  •  So why will they re-elect... (0+ / 0-)

    these same Republicans (or Tea Party primary replacements) committed to the repeal of Obamacare?  Count on them increasing their majority in the House and the reason the Senate goes Red.  And then count on them putting forward bills to repeal---not reform, not replace.  Recent arguments---here on KOS and elsewhere---that the wingnuts somehow know repeal is no longer viable vastly underestimate their wingnuttedness.  They will take their victories as mandates and Obama will have nothing to do but collect veto pens.

  •  It's totally worth dying (0+ / 0-)

    as long a we don't have to sit next to a brown person at the Dr. office with one of those fancy socialist ObamaCare cards!

    "Work for something because it is good, not just because it stands a chance to succeed." -- Vaclav Havel

    by greendem on Thu May 01, 2014 at 05:22:24 PM PDT

  •  I am tired of being angry at the southern folk, (3+ / 0-)
    Recommended by:
    Tunk, alx9090, TerryDarc

    it is time for me to see so many of them for what they are; suffering in silence as they were taught to by their preachers and teachers and politicians. I have no idea how their eyes might get opened to the way they are being ripped off but it is important that we make that effort if we are ever to become one country instead of two or three viciously battling tribes...

    •  I know! (1+ / 0-)
      Recommended by:

      They are the victims and the useful rubes. And I have no idea how to help them. It is even more difficult since these people (by voting) impose the same limitations and wants on those around them.

      If I could see how to lead them out of the cave without going back in, I'd shout it from the rooftops.

      protip: don't go back into the cave

  •  My wife and I worked at RAM in Wise for years. (3+ / 0-)
    Recommended by:
    tournesol, alx9090, lina

    The need was so great we had to turn people away.  They waited all night in their cars to try to get a place in the que.Stan Brock now sees the US as one of the neediest countries.  We are a backward and uncivilized country.

    An idea is not responsible for who happens to be carrying it at the moment. It stands or falls on its own merits.

    by don mikulecky on Thu May 01, 2014 at 05:28:52 PM PDT

  •  Ah, the American South (0+ / 0-)

    Our own little China.

    Except, at least China is modernizing infrastructure.

    Maybe we should let them secede, and then the rest of us can outsource jobs there...

    Money should be treated like any other controlled substance; if you can't use it responsibly then you don't get to use it.

    by La Gitane on Thu May 01, 2014 at 05:31:21 PM PDT

  •  I'm from Louisiana (0+ / 0-)

    and in 2006 I had moved home and wanted to stay home, but my daughter needed a type of doctor that just did not exist within 100 miles of me.  I didn't have my own car (I was staying with my dad) and I didn't feel right asking someone to take so much time out of their day transporting me that far for her appointments.  So I moved back to Ohio.  That was before I realized just how bad things had gotten in the South post-9/11.  Obama wouldn't be elected for another two years.

    I wouldn't go back now if you paid me.  Louisiana is one of the poorest states in the nation, regularly treats its own people like garbage and puts racism and religious fanaticism ahead of the general welfare.  (The fact they elected Bobby Jindal probably stems from him being a "pro-life Catholic" more than anything else.  Also, people from India look like white people with brown skin.)  I probably could have guessed it was a bad idea to move home at all if I'd talked with my brother first, because his son had been born with a dead kidney (as I understand it) and they'd had to take my nephew all the way to VIRGINIA.

    This sort of thing is just unsustainable.  The only reason they even still have any of their children or grandchildren still at home in the state is the oil industry.  Eventually that'll go away, but not before Big Oil completely ruins Louisiana seafood and possibly Louisiana agriculture.  What then?

    •  Oh and it's not just their government reps... (0+ / 0-)

      The last time I went down to visit I spent some time with a maternal aunt and my maternal grandmother.  The aunt was a piece of work.  Complained bitterly about Obamacare costing her more money to get coverage for my grandmother.  My grandmother was in her seventies by then and should have been getting Medicare and anyway, what kind of a person complains about her mother getting health care?

      That's the kind of people voting these idiots in.  I'm ashamed to say I'm related to some of them.

      •  Sorry, her eighties. (0+ / 0-)

        All in the interests of accuracy, since I can't edit.  I last saw my grandmother in 2010 and she died the following year; she was 82 then.

        Not too far off though, and had been on Medicare for a while.  If anything "cost more money" for my aunt it was all that fiddling with Medicare (part D, wasn't it?) that Bush did.

  •  "You Can't Fix STUPID!" -- Ron White (0+ / 0-)

    And STUPID is the Confederacy's pride and joy.

  •  It is the "I got mine so screw you syndrome" (0+ / 0-)

    Those states, and I live in one, simply want to drive the needy out. Florida is full of rich ex-northerners, who have retired with nice pensions, social security, and medicare and who don't give a damn about the locals medical and educational needs. They came for the sunshine and low state taxes.

    When the F**K are we going to wake up and do something about this mess?

    by keyscritter on Thu May 01, 2014 at 05:56:40 PM PDT

  •  not- Sun Belt, but The False Consciousness Belt nt (0+ / 0-)

    Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "I’m not the strapping young Muslim socialist that I used to be" - Barack Obama 04/27/2013 (@eState4Column5).

    by annieli on Thu May 01, 2014 at 05:58:23 PM PDT

  •  Don't see the problem here. (1+ / 0-)
    Recommended by:

    While it is tragic the people of the South are suffering, the bottom line is these officials were chosen by the people through elections.

    The South has only itself to blame.  

  •  White Genocide (0+ / 0-)

    Mass third world immigration and forced assimilation in White countries and only White countries is genocide.

    Anti-racist is a codeword for anti-White.

  •  It's not baffling at all. (0+ / 0-)

    They know that in 10 years, 15 years, the Feds will push more and more of the cost to the states, probably as some sort of deficit/debt cutting legislation.

    Or do unfunded mandates only happen in the past now?

  •  Sad irony (0+ / 0-)

    An item in Friday morning's news reports on a study that lists the most preventable deaths (  It goes on to state that people who live in the southeastern US are most prone to illnesses caused by smoking, excessive use of alcohol, lack of exercise, and poor diet.  Of course, all of the illnesses are strongly associated with poverty and ignorance.  Is it any wonder why people living in this region are so easily convinced by the GOP's toxic rhetoric?

  •  Sad irony (0+ / 0-)

    Those living in the southeastern US are most prone to illnesses caused by smoking, excessive use of alcohol, lack of exercise, and poor diet.  Of course, all of these illnesses are strongly associated with poverty and--significantly--ignorance.  So we needn't wonder why people in this region are so easily convinced by the GOP's toxic rhetoric.

  •  Don't forget Tennessee (0+ / 0-)

    Every time I go to Shoney's and talk to the waitresses there I get so mad that their lives could be so much better if Gov. Haslem and the other Republicans in Nashville could be reasonable for one minute. The really sad part is the people most affected still blame Obama for all that's wrong in their lives. Neat trick Republicans!

    "no more hurting people - peace" Martin William Richard

    by EquityRoy on Fri May 02, 2014 at 03:58:24 AM PDT

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