As a follow-on to the discussion of the disproportionate number of people needing health insurance living in states governed by Obamacare- and Medicaid-hating Republicans, National Journal‘s Ron Brownstein offers a district-by-district analysis of the uninsured for the whole country.
He finds, unsurprisingly, that an awful lot of the uninsured are represented by Republicans in the House, and comments:
In the confrontation that precipitated this week’s government shutdown, the near-universal refrain of Republican House members has been that they will “do whatever we can, as much as we can, to protect the people of our districts from the harmful effects of this law,” as Rep. James Lankford of Oklahoma put it. Regardless of what other provisions they consider harmful, that posture unavoidably means House Republicans are seeking to “protect” a surprisingly large number of their constituents from the right to obtain health insurance with federal assistance.
Recently released census data show that, on average, the share of residents without insurance is almost as high in districts represented by House Republicans as in those represented by Democrats. Slightly more Republicans (107) than Democrats (99) represent districts where the uninsured percentage is above the national average. Even about half of the 80 conservative members whose letter hatched the strategy of funding government only if Obama agreed to defund the 2010 Affordable Care Act represent districts where the uninsured share exceeds the national average.
I’m not the least bit surprised by these numbers. First of all, some of the uninsured are the “young invincibles” who don’t necessarily want health insurance even if they ought to have it. But second of all, Republicans in the South and West famously represent a lot of districts where African-Americans and Latinos are a significant minority, even if they have been removed from such districts by redistricting to the extent necessary to make them red.
I’m going to be blunt about this: your average very conservative southern Republican House member doesn’t much think of black folk as “constituents.” And they are elected not to tend to black folks but to keep them from “looting” the resources of the GOP Member’s real constituents, via Obamacare or other socialistic means. So this idea of Members looking at their districts and weighing constituents’ interests with furrowed brows before taking a position misses the whole race- and class-based nature of politics in these areas.
Brownstein understands this, of course, so he puts a lot of emphasis on the argument that Obamacare-hating Members are ignoring to their potential peril the interests of “hospitals, doctors, and other providers who now are delivering significant levels of uncompensated care.” These are the same interests, of course, that were supposed to convince southern Republican governors and legislatures to enact the Medicaid expansion that would have directly placed many billions of dollars in federal money into their health care economies. Didn’t happen, did it?
Conservative politics isn’t just about short-term economic self-interest, though that remains a big part of it. Much of it’s about denying nearby enemies access to the political power they might use to redress both public and private injustices. So that’s why Republican House members from districts with poor and black folks–or next door to heavily poor and black areas–are very likely to be more savagely opposed to Obamacare than anyone else. They aren’t really representing those people. They’re keeping them down.