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The Politics of Spite

Posted by John McDonough  July 2, 2013 07:34 PM

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Since President Barack Obama signed  the Affordable Care Act on March 23 2010, Republicans have pulled out every stop to repeal, reverse, or fatally undermine the law.

Three years and three months later, what do they have to show? 37 repeal votes in the U.S. House of Representatives have led to nothing. A Supreme Court challenge left the law intact when conservative Chief Justice John Roberts voted to uphold it. The big hope, announced by Senate Minority Leader Mitch McConnell (R-KY) in early 2011 as his top priority, was to deny President Obama a second term, a cause blown by Mitt Romney. Even re-taking control of the U.S. Senate in 2010 and 2012, considered slam-dunk early in each cycle, became a matched set of missed opportunities.


(Pictured above: Alabama Governor George Wallace blocks desegregation of the University of Alabama in 1963.)

One might then feel a pang of sympathy for McConnell and his Party, having suffered so many setbacks in such a short window of time. At this point, now that ACA implementation can no longer be stopped, what's left?

Spite. Defined by Merriam-Webster as "petty ill will or hatred with the disposition to irritate, annoy, or thwart," here are two new examples:

First, on June 27th, McConnell and his Whip John Cornyn (R-TX) wrote to the head of the National Football League -- and to the heads of all major sports leagues, including NASCAR -- to urge them to do nothing to help publicize the new health insurance benefits available in January 2014 for millions of uninsured Americans.

The model McConnell fears is the key role the Boston Red Sox played in promoting new insurance benefits available in Massachusetts after our state's 2006 health reform law. It mattered because so many Red Sox fans, in Fenway Park and on TV, are young and uninsured males. Left out of the McConnell letter is any acknowledgement that Massachusetts reform was the model for the ACA?s coverage expansions.

McConnell's efforts will work -- the N.F.L. has already been spooked into denying any interest in educating fans of their new coverage options. Add to this House Republicans' refusal to fund ACA implementation, and add to that public threats against U.S. Health & Human Services Secretary Kathleen Sebelius for encouraging private contributions to Enroll America, the national non-profit educating Americans about the new benefits -- and you have a clear pattern. Republicans will do anything and everything to hinder ACA implementation so that they can later declare the law a failure.

Second, yesterday, the Commonwealth Fund posted a new blog detailing how Republican-controlled state legislatures and Governors are passing laws to thwart so-called "navigators" -- created and funded in the ACA to provide assistance to uninsured persons to help them get enrolled in coverage -- to function. States including Arkansas, Florida, Georgia, Indiana, Iowa, Maine, Montana, Nebraska, Ohio, Tennessee, Texas, Virginia, and Wisconsin, have passed laws to prevent navigators from assisting consumers unless they first obtain a state license, and then refuse to create the regulations to let anyone to get such a license.

These are the same states that refused to establish their own health insurance exchanges/marketplaces as allowed by the ACA; as a result, the federal government is establishing a "federally facilitated exchange" in each of these states. Now, the governors and legislatures in these states -- who are also refusing to expand Medicaid coverage for their poorest citizens -- are making it as difficult as possible for their uninsured citizens to obtain health insurance.

Overwhelmingly, the people eligible for coverage under the ACA are lower and lower-middle income Americans, and they are also disproportionately non-white.

McConnell, Cornyn, the governors and state legislatures are acting like the George Wallaces and the Bull Connors of our time. They are standing in the doorways and letting loose the water cannons to deny their own citizens a measure of health care justice; they are committed to prevent their citizens and constituents from obtaining life-saving health insurance. And they offer nothing to replace their dreaded Obamacare except fear and distortion.

Just as surely as their efforts will hold back progress, they will not defeat it. Just as they have lost again and again, in Congress, in the Supreme Court, at the ballot box, they are heading for failure. 50 years from now, they will be known as the heirs of those who, 50 years ago, blocked racial justice in America.

Congressman Jim Clyburn (D-SC) refers to the Affordable Care Act as "the civil rights act of the 21st century." It is true. As for the petty, spiteful resistance -- we've seen it before and we'll see it again from these folks determined to stand on the wrong side of history. Keep those letters going, Senator McConnell -- after all, it's your legacy.

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »


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