Punishing the Clinic Door Strategy in Texas and Florida at the Polls

la-1394654-me-0324-enroll2-ac-jpg-20130324Baton Rouge   There is a desperate and cynical political strategy at work in the efforts of Florida Governor Rick Scott and Texas Governor Rick Perry in their attempts to bar people from the clinic doors trying to enroll under the new Affordable Care Act on October 1st.  This Rick-o-say strategy will in fact ricochet on them, and I believe they know it.

            Scott issued an order in Florida barring navigators, the outreach and enrollment workers funded by HHS to facilitate folks figuring out this brave new world and getting insurance, from all county health clinics.  Perry is lobbying his own Insurance Commission only days before enrollment opens to require navigators in his state that will have already completed HHS navigator certification to undergo another 40 hours of testing and re-testing and further scrutiny before they can begin to enroll people.   In both cases HHS has pushed back.  Secretary of HHS Sebelius barnstormed Florida cities to help beat the bushes there.  In Texas HHS scolded the governor for trying to get navigators to turn over the names of everyone they helped as against the privacy regulations that bar them from keeping any Personal Identification Information or PII as they call it.

            What’s this all really about?   There will be on-line registration via www.healthcare.gov, regardless.   There will be paper applications.  Why are these guys and many of the other schoolhouse door opponents of healthcare coverage going so wild about stopping enrollment?

            I think the answer is straightforward.  They know they are self-administering political poison.  No politician likes to make permanent enemies of voters especially when the responsibility lies so undeniably at their own doorstep.  They easily imagine the horror of people streaming into clinics and hospitals that the state is helping fund and finding out that despite everything they have heard and read, they will not be covered with health insurance, because the governor with the help of docile state legislatures refused to extend coverage.   There is no way that the words, “Sorry, but the Governor didn’t extend coverage here,” are not going to come out of thousands of mouths to millions of unhappy people.

            Enrollment is going to be huge.  In Texas for example in a matter of a few days recently one navigation program got more than a half-million commitments to distribute literature not only throughout the Houston and Dallas schools systems but in several mega-churches and, ironically, hundreds of thousands are being demanded by the state’s own health services and prison systems.   Many will get on Obamacare, will be excited about that, and confused why their own governors are fighting against them and their health.   Others will be disappointed to find out that they could have been covered but their own governor blocked them from the benefits.  

            Both are going to vote with their feet and whether in happiness or anger are going to vote against the governors standing in front of the hospital and clinic doors to block them from going in.  We’ve seen what happened to that same strategy when it was schoolhouses.   We are about to see it happen again at hospitals.  There’s a reason why Perry is running away from the governor’s chair in Texas.    He, Scott, and others like them fear deeply the wrath of the voters that they will reap from their harvest of hate about healthcare, and like winter, it’s coming.

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