A recent Washington Post story tracked the efforts of an Affordable Care Act navigator, Courtney Lively, to help uninsured residents of Breathitt County, Kentucky, enroll in Medicaid now that it has been expanded under the Affordable Care Act, or in a private health insurance plan on the state’s exchange. Kentucky is the only southern state to both establish its own exchange and embrace the Medicaid expansion. Not coincidentally, it has a Democratic governor.

The article shows the ACA working as intended to help those most in need of health insurance. Breathitt County, for example, has a per capita income of just $15,000; 15% of Kentucky’s population or about 640,000 people are uninsured:

Lively, who has been signing people up since the exchanges opened in early October, said one woman cried when she was told she qualified for Medicaid under the new law. She said people have been “pouring in” to her office, an unused exam room in the back of the clinic, where her set-up includes a table, a two-drawer filing cabinet, manila folders, a planner to track her schedule, a notebook to track her numbers and a laptop that connects to the state health-insurance exchange, Kynect.

Here is a sample of the sort of people featured in the piece:

“So, is that Breathitt County?” she asked Woodrow Wilson Noble as she tapped his information into a laptop Thursday morning.

“Yeah, we live on this side of the hill,” said Noble, whose family farm had gone under, who lived on food stamps and what his mother could spare, and who was about to hear whether he would have health insurance for the first time in his 60-year-old life.…. “All right,” she said. “We’ve got you eligible for Medicaid.”

“I got some warts on me I got to take off, some moles,” he said. “I might have that colonoscopy done. My mom had colon cancer twice. I never had money to do it.” He said he was told it could cost at least $2,000.

“I got this pain in my left shoulder,” he said, lifting his arm and rotating it. “Might be arthritis, I guess. I don’t know.”

And another

“All right,” she said to her next client, a 52-year-old disabled master electrician who said his mother, two brothers and two sisters all died from lung cancer. He had been ignoring a spot on his lung discovered during a visit to the emergency room after he had broken his ribs several years ago.

He also vaguely recalled being told at the time he had something called “wedging of the spine.”

“What do I need here?” said Jeff Fletcher, who was being sued for those medical bills. “Proof of income?”

After a few questions

“All right,” Lively said after a while. “You are covered.”

“I’m covered?” Fletcher said. He slapped the table. He clapped twice.

“Woo-hoo! I can go to the doctor now?” he asked Lively. “I’m serious. I need to go.”

And finally Ronald Hudson

…a skinny 35-year-old who worked as an assistant director at the senior center and had just been released from the hospital after a blood-sugar spike.

He’d never had insurance before and said his hospital bills were up to $23,000 at this point.

“Good night,” Lively said, tapping in his information.

Kids: five. Salary: about $14,000 before taxes.

“You’re going to qualify for a medical card,” she told Hudson.

“Well, thank God,” Hudson said, laughing. “I believe I’m going to be a Democrat.”

Lively printed out his papers.

“RONALD’s Health Care Coverage Options,” one of them read.

“Oh, man,” Hudson said.

This is a side of America that most of us don’t see and many of us choose not to; the sort of poverty that shouldn’t exist in a society as rich as this one but does, and to an alarming degree. What follows, however, is a sample of the comments to the article from what I think we can safely say is the conservative side of the American divide:

funowobama1 11/25/2013 10:22 AM PST Is there poverty in the U.S. yes – but giving out free things does not make it better – a woman with 5 kids making 14k – no info on who the father(s) is/are – I have pay for her not being able to cross her legs – please show me the logiic in all of this make her pay something so she can feel the pain.

Skunk at the picnic

11/25/2013 10:12 AM PST

I’ve always wanted to forsake my own financial goals in order to subsidize a bunch of people who smoke, drink, never exercise or eat right or do anything else remotely associated with good health.

dwpm

11/25/2013 10:09 AM PST

There is no such thing as poverty in America. The only people who believe there is poverty in America are the individuals who have never really seen it. Real poverty is no shelter, no food, no education and no healthcare (note I didn’t say “no health insurance”). I have seen real poverty very, very up close and personal and believe me it doesn’t exist anywhere here. Everyone in America (and Europe) has access to shelter, access to food, access to education and access to healthcare (note I didn’t say “access to health insurance”). Poverty in America is all about extracting tax dollars from the working class segment and redistributing it to the dependent class segment to create life long democrat voters. And that is truly evil.

ULikeItUKeepIt

11/25/2013 8:54 AM PST

The title should be edited as follows: “Freebie insurance folks sucking off middle class Americans who were struggling to keep their family afloat and now must pay triple for their family’s insurance to keep Freebie people insured are very happy to screw millions of Americans by playing victim.” Disgusting. Vote liars, Democrat party race-baiters, Constitution haters, and others OUT. Return America to the people who actually love it.

4Runner05

11/23/2013 6:27 PM PST

For Dem/socialists to feel self-righteous and morally superior from these poignant stories, how many people have lost – and will lose – their health insurance? Your socialist wet dream is all about screwing 85% of the people (who have some form of insurance) for the 15%. Destroy the current insurance system and replace it with a “caring, helpful” bureaucracy and you have the real reason behind Obamacare. POWER When the government has power over your health care, you’ll surely vote for the party (Dem/socialist) that has that power. One of the people in the story said it all: “Hudson said, laughing. ‘I believe I’m going to be a Democrat.” If he wants to keep his rationed and mediocre health “care”, then he will. How many of you lefties are “pro-choice”, BTW?

FTC

11/23/2013 7:13 PM PST

So “God fearing people” are responsible for people living in squalor? The poor on the most part make bad life decisions their whole lives and pass those horrible values onto their children, who in this day of birth control and abortion on demand, probably should not of had. The problem with Liberal compassion is that it makes everyone a victim of someone else, and never allows for the dysfunctional to take responsibility for their failures. The taxpayer is responsible for every girl that gets pregnant, the children of every boy or irresponsible man who fathers children with multiple women? Our welfare/entitlement state already is unsustainable, where does it end? As Margaret Thatcher so aptly pointed out “Liberals eventually run out of other peoples money”.

And although congressional Republicans and conservative punditry may not be as openly hostile to the poor, their overall message is still remarkably disdainful. While I doubt anyone can recall the last time they heard a conservative congressman or Fox pundit express any concern for the plight of the uninsured in America, nearly all of whom simply had no viable options for obtaining coverage, they have been apoplectic over the cancellation of policies held by relatively affluent individuals and families who can easily obtain other decent plans under the ACA.

Much of this is politics, no doubt. And some is a woeful and probably willful ignorance of the extent of poverty in America. But most of it is simply a stunning lack of empathy and a willingness to accept myths about the poor and peddle them as facts. As Michael Tomasky says in this piece in The Daily Beast talking about the House GOP’s bill to slash $40 billion in food aid to the poor:

…I think maybe you’ll agree with me that the single worst thing the Obama-era Republicans have done is try to push through a $40 billion cut to the food-stamps program. It’s just unspeakably cruel. They usually say publicly that it’s about saving money. But sometimes someone—one congressman in particular—lets slip the real reason: They want to punish poor people.

… The proposed GOP cut is such a piddling amount of money, in terms of the whole federal budget and especially when spread out over 10 years. But nearly half of it is quite literally taking food out of the mouths of children. What’s the point? The point really is that Tea Party Republicans think these people don’t deserve the help. That’s some fascinating logic. The economy melts down because of something a bunch of crooked bankers do. The people at the bottom quarter of the economy, who’ve been getting jobbed for 30 years anyway and who always suffer the most in a downturn, start getting laid off in huge numbers. They have children to feed. Probably with no small amount of shame, they go in and sign up for food stamps.

And what do they get? Lectures about being lazy. You may have seen the now-infamous video of Tennessee Congressman Steve Fincher, who told a crowd over the summer that “the Bible says ‘If you don’t work, you don’t eat.’” This while Fincher, a cotton farmer, has enjoyed $3.5 million in federal farm subsidies. This year’s House bill ends “direct payments” to farmers whether they grow any crops or not—except for one kind: cotton farmers.

Underlying the actions of congressional Republicans and the words of their base is a pernicious belief that if you’re poor you deserve to be so because you must wish it. Or to put it another way: “Find me a poor person and I’ll show you a lazy bum”.

Ignorance of their own country combined with a singular lack of empathy and a large dose of hypocrisy – this, increasingly, is the only side of the modern American conservative movement that we now see. And it is ugly.

About N J Barnes

Retired sixty-something originally from England now a U.S. citizen living in Seattle. Married with a wife and two children. I love Seattle and consider it to have been a wonderful place to live and help raise my daughters. I worked in government my whole life. Whilst I see its flaws I also understand that government can be a strong force for good in democratic societies. My interests are current affairs and military history. I consider myself to be a centrist politically by any reasonable standard but probably left of centre in today's USA.

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