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The Quiet Parts Loud: Medicaid Edition

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ryan is a working man

A Republican from Brownbackistan says that repealing Medicaid is fine because poor people want to be unhealthy. No, really:

The law’s Medicaid expansion, which Kansas has not adopted despite support from many hospitals, including some of Marshall’s former colleagues, is one of the big sticking points for Republicans. Many GOP-led states adopted it and want to see it preserved in some form.

Marshall doesn’t believe it has helped, an outlook that sheds light on how this new player in Washington understands health policy.

“Just like Jesus said, ‘The poor will always be with us,’” he said. “There is a group of people that just don’t want health care and aren’t going to take care of themselves.”

Pressed on that point, Marshall shrugged.

“Just, like, homeless people. … I think just morally, spiritually, socially, [some people] just don’t want health care,” he said. “The Medicaid population, which is [on] a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I’m not judging, I’m just saying socially that’s where they are. So there’s a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought [into] the ER.”

This is sort of the ultimate Republican healthcare argument, in that it’s both nakedly sociopathic and either willfully clueless or actively dishonest about the policy details — to state the obvious, repealing Medicaid and/or the exchange subsidies will have the effect of people using less preventative care and relying on emergency rooms. But, of course, this will be a matter of free will! If you choose to use an emergency room because you don’t have access to any other form of medical care, you still have made a choice!

The bigger problem for the country is that however much time the Speaker of the House of Representatives spends getting reluctantly and accidentally photographed at soup kitchens, all the relevant evidence suggests that he’s no less sociopathic. Whether or not they win this particular fight, having people who think like this in control of Congress is terrifying indeed.

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