Steve Benen explains the (ahem!) deal down in Georgia:
Georgia Gov. Nathan Deal (R) has a problem: rural hospitals keep closing, overwhelmed by financial troubles they can’t solve on their own. The obvious solution – accepting Medicaid expansion under the Affordable Care Act – is the one thing Deal refuses to even consider.
There is no great mystery here as to why the rural hospitals can’t keep their doors open. These facilities have routinely covered low-income Georgians who don’t have insurance, leading to facilities that can’t pay their bills. Medicaid expansion would “help rural hospitals by turning many of their uninsured patients into paying patients,” but the governor and GOP state policymakers won’t budge.
But don’t worry, Deal is ready to think outside the box.
So what’s the deal with Deal? The Georgia Republican has decided he has a problem with the 1986 EMTLA—Emergency Medical Treatment and Labor Act—which formalized hospital obligations to care provision. In other words, the deal is that Gov. Deal wants hospitals to stop treating the poor.
Yes, really. Sigh.
Jim Galloway, along with his Atlanta Journal-Constitution fellows Greg Bluestein and Daniel Malloy, sketch the overview:
Gov. Nathan Deal has often called on Congress to reconsider the Affordable Care Act. But on Monday evening, he pushed his former Washington colleagues to revisit a separate health care law that fewer politicians openly critique.
The Emergency Medical Treatment and Labor Act is a 1986 law that requires hospitals to provide emergency health care treatment to anyone who needs it, regardless of citizenship or their ability to pay. It’s provided life-saving care to countless people, but it’s also strained hospital resources and turned emergency rooms into the first stop, instead of a last resort, for some.
“If they really want to get serious about lowering the cost of health care in this country, they would revisit another federal statute that has been there for a long time,” Deal told a crowd of dozens at a University of Georgia political science alumni gathering. “It came as a result of bad facts, and we have a saying that bad facts make bad law.”
Legislative supporters in the 1980s cited cases of pregnant women being turned away from emergency rooms because they couldn’t pay. Deal, who long served on a key House health panel, said lawmakers can build in protections for pregnant women and others while tightening access to ERs in other ways.
So, if we turn back to Benen for a moment, what really stands out is the stupidity. Not of the MSNBC analyst, producer, and blogger’s response, but the range of points Benen feels obliged to cover. And he’s not wrong; while it might be difficult for some to tie the idea of extraordinary evidence for extraordinary claims, one variant of the notion would simply remind that there are some notions that just aren’t so extraordinary.
There is, for instance, the obvious political juxtaposition; restricting emergency room access is a counterproposal to Medicaid expansion under the ACA. That expansion would send these rural hospitals some money in exchange for the unpaid medical services they have provided.
Or the question of prevention versus treatment: “If you expand access to insurance and guarantee easy access to preventive care, unnecessary visits to the emergency room would go down”.
And, while restricting emergency room access “as a matter of hospital financing … is not without merit”, there is more at stake here than mere numbers in a ledger. Benen reminds: “on the other hand, people would die from treatable ailments, paying with their life because they had the nerve to be poor”.
So, quick show of hands: Conservatives, is the best solution to poverty that the poor should simply die off?
What’s that? Nobody? Really?
(Okay, look, if you did raise your hand, we’re happy to hear the argument.)
Benen also notes that Deal’s outlook is a complete flip from sentiments expressed by his fellow Republicans, from hardline former Sen. Jim DeMint to 2012 GOP presidential candidate and former Massachusetts Gov. Mitt Romney. That argument would suggest that the poor don’t need health insurance, since they can just go to the emergency room.
Party unity is not any sort of divine obligation, but it does remain a viable question. Watching which route the GOP follows will be enlightening, but hardly an extraordinary revelation.
Meanwhile, really? Is it just some oddball political tactic that says we ought to keep it simple so that Republicans don’t have to actually figure anything out for themselves?