Southern Republicans Lifting Coronavirus Lockdowns Are Also Keeping the Working Poor From Health Coverage

Georgia reopened much of its economy on Friday, forcing workers back to their jobs and into danger weeks before medical experts and the Trump administration say is safe.

Georgia Gov. Brian Kemp (R) decreed that businesses of all kinds including hair and nail salons, tattoo parlors, massage parlors, gyms, and bowling alleys can all reopen, so long as they practice social distancing. Houses of worship can hold services once again. Theaters and dine-in restaurants can reopen on Monday.

Kemp is one of a half-dozen southern GOP governors who are rushing to lift coronavirus restrictions faster than the experts say they should. Those states also refused to expand Medicaid, leading to some of the highest uninsured rates in the country.

That means if workers do get sick as a result of being forced to return to work, many won’t have health insurance and could face financial ruin if they go get treatment.

“The venn diagram of bad decisions that the elected leaders in these states are making when it comes to people’s health is nearly perfect,” said Maura Calsyn, the Managing Director for Health Policy at the liberal Center for American Progress.

Alabama, Florida, Georgia, Mississippi, South Carolina, and Tennessee formed a regional pact with Georgia to end coronavirus restrictions. They’re all run by Republicans loyal to President Trump who are moving much faster than any other region of the country to lift stay-at-home orders, even as coronavirus cases continue to climb throughout the region.

All six states also rejected Medicaid expansion, even as 36 other states adopted the plan to help more poor people get health coverage.

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These states have refused for a decade to expand Medicaid, largely because it was a major plank of Obamacare, and the Republicans in those states refused to consider any part of Obama’s signature law even though it would have cost them little and helped ensure hundreds of thousands of people.

They make up six of the 14 states that refused to embrace the policy, including nine in the South. These holdout states have almost uniformly higher uninsured rates than anywhere else.

Almost 5 million more people would be eligible for healthcare if every state offered expanded Medicaid enrollment and took up the federal government’s offer to pay for most of the costs of insuring everyone who earns below 138% of the poverty line. Fully 92% of Americans who can’t get health insurance because their state governments have blocked Medicaid expansion live in the South, according to the nonpartisan Kaiser Family Foundation.

In these states, like many others, African Americans and Hispanics are much more likely to lack insurance than white people, and make up large portions of the uninsured.

“The people who are going to be asked to go back to work are the people at highest risk because of systemic racism and resulting public health disparities. And if they go back to work, because these states have blocked expanded Medicaid it’s very likely that a high number of them don’t have health insurance,” Calsyn said.

The Trump administration has said it will reimburse hospitals for treating uninsured patients suffering from coronavirus, provided those hospitals don't bill patients. But they haven't detailed exactly how much money would be allotted for the program. It wouldn't preclude hospitals from deciding to charge people rather than seek reimbursement at the Medicare rate. And it doesn't appear to cover all doctors, including those working at hospitals, and or cover people who get sick from the disease but whose tests come back negative, or people who are ill, seek treatment and end up having something else.

All 14 states who didn’t expand Medicaid are at or near the top of the list of states with highest uninsured rates.

Oklahoma and Georgia are tied for the second-highest percentage of uninsured people in the country — fully 14% of Georgians and Oklahomans didn’t have health insurance in 2018. Florida is next on the list with 13% of people lacking insurance. Only Texas is ahead of them in the rate of uninsured. And Texas Gov. Greg Abbott (R) said Thursday that an order allowing “massive” reopening of businesses was imminent, and could come as soon as Monday.

Oklahoma Gov. Kevin Stitt (R) allowed personal care stores like hair salons, tattoo parlors and dog grooming salons to reopen Friday, and restaurants, gyms, churches and other stores can open on May 1. South Carolina Gov. Henry McMaster (R) has already allowed most businesses to reopen. Tennessee isn’t far behind: Gov. Bill Lee (R) said he won’t extend the state’s stay-at-home order past April 30. Mississippi Gov. Tate Reeves’ (R) stay-at-home order ends on April 27, though he hasn’t laid out an exact plan for reopening he said Wednesday that the state will “continue to loosen restrictions” next week. Alabama Gov. Kay Ivey (R) is the only one in the group who’s yet to announce at least a partial end to her state’s stay-at-home order.

Idaho, a red state without Medicaid expansion, is moving fast to ending stay-at-home orders as well, as are North Dakota and Ohio, two red states that did expand Medicaid. Montana and Colorado, two states that have Democratic governors and expanded Medicaid, already moved to loosen stay-at-home orders.

But the scary prospect of people having to work while being blocked from healthcare access is largely a southern Republican phenomenon.

“They’ve already played politics with people’s healthcare by not expanding Medicaid and continuing this enmity towards Obama. Now they’re playing politics with the pandemic,” said Brad Woodhouse, a Democratic strategist who heads the pro-Obamacare group Protect Your Care. “It’s morally indefensible.”

Cover: In this April 16, 2020, file photo, Georgia Gov. Brian Kemp listens to a question from the press during a tour of a temporary hospital at the Georgia World Congress Center in Atlanta. Kemp plans to have many of his state's businesses up and running again as soon as Friday, April 24. (AP Photo/Ron Harris, Pool, File)