I see that my state-of-origin, Missouri, voted overwhelming to nullify the health care reform law, in particular the individual mandate. The ballot proposal to nullify the law, Proposition C, passed everywhere in the state except for Kansas City and St. Louis.
Now, I know the state pretty well, and I know that in some of those counties at least 20 percent of the population is below the poverty line. Further, in big chunks of the state the the kind of jobs that come with full benefits are scarce.
So there’s little doubt that many of the people who voted for Proposition C in Missouri yesterday have no health insurance, have no hope of getting insurance, and are not getting medical care they need. They are also poor enough that when the time comes for them to purchase insurance through the exchanges they will benefit from all kinds of subsidies or will be able to enroll in Medicaid for the first time.
For example, let’s look at Washington County. According to Wikipedia, the per capita income there is $16,095. The median income for men is $27,871; for women $18,206; and for families $38,193. All of those incomes fall well below the cutoff for subsidies. According to the Kaiser health reform subsidy calculator, a median Washington County family with four kids and a 40-year-old head of household would get a tax credit for 82 percent of their anticipated annual premium, leaving them with an actual expense of $1,757 annually, or just under $145 a month.
And I wish it were lower, and I wish it were a direct subsidy and not a tax credit, but you know Republicans like their tax credits, and Republicans insisted that the for-profit insurance companies get a big enough cut so the CEOs can vacation in France. Which has better health care than we do.
But without the mandate, the premiums would be higher for everyone, and we’d be back in the same death spiral pattern we’re in now, with younger and healthier people dropping insurance, leaving the older and sicker in a shrinking risk pool with rising premium costs, causing more people to drop insurance, etc.
The state is far more conservative than it used to be. I haven’t lived there since about 1977, and back then a reasonably progressive, New Deal Democrat like Stuart Symington could do very well. I guess all those years of listening to Rush have done their job. Now the elites of the Right jerk their chains, and the people of Missouri do their bidding.
I understand there’s little chance Missouri would be allowed to opt out of the health care reform law, unless Republicans retake enough advantage in Congress to rewrite or repeal the law. And I’m sure the lemming voters of Missouri will do their best to make that happen. The state motto should be changed from “show me” to “which way to the cliffs, oh master?”
Update: John Cole writes,
Though I’m sure we’ll be hearing how it’s part of a groundswell against Obama and Congress, I’ll take the simpler explanation that everyone wants to eat cake, but nobody wants to get fat. Mandatory insurance is the unpleasant part of HCR that makes the whole thing work, and it’s not surprising that the least palatable part of the bill is unpopular.
Maybe, but I think it’s more likely My Fellow Hillbillies were whipped up by rhetoric about sending a message to Obama and not letting the Gubmint control my health care. Some of those people aren’t getting any health care, but they’re ready to do without rather than have any part of it tainted by connection to the Gubmint, until they turn 65 and can collect Medicare. And then it’s OK, as long as Gubmint keeps its hands off Medicare, because Medicare comes from Jesus, or maybe the health care fairy. Nah, probably Jesus.
Lemmings, I tell you. Stupid, ignorant lemmings. They’re charging for the cliffs as fast as they can charge, and they’re trying to drag the whole country with them.