Recently Wisconsin congressman and former vice presidential candidate Paul Ryan came to West Virginia to campaign for Shelley Moore Capito in her bid for the U.S. Senate.
Ryan is an interesting person. His professed religion is Roman Catholicism, but his policy preferences seem to be little influenced by that tradition.
Catholic social teachings have their roots in the prophets and gospels and have been articulated over the centuries by its saints and scholars. They call for much more than individual acts of charity and compassion. Rather, the teachings also demand that political institutions promote social justice and the common good. In the words of the U.S. Conference of Catholic Bishops, the foundation of the teachings is “a commitment to the poor.”
By contrast, during his years of leadership in the U.S. House, Ryan has proposed turning Medicare for the elderly into a voucher program, which would drastically reduce benefits for the millions of elderly Americans who depend on this program after a lifetime of hard work. His proposed budgets over the years have advocated tax cuts for the wealthy and corporations and major cuts to programs that affect low-income and working people.
According to the D.C.-based Center on Budget and Policy Priorities, 69 percent of the $3.3 billion in cuts in Ryan’s latest budget proposal come from “programs that serve people of limited means.” Specifically, this means proposed cuts in health care subsidies by $2.7 billion, which would knock at least 40 million low- and moderate-income Americans — 1 in 8 — out of coverage by 2024. Also under the knife would be programs such as SNAP or nutrition assistance, Pell grants and federal college aid, school food programs, and tax credits for working families.
Ryan’s political views seem to owe more to writer Ayn Rand, for whom he has expressed admiration, than to Catholicism. Rand was a Russian émigré and avowed atheist who promoted a “philosophy” she called objectivism, which proclaimed selfishness to be a virtue and called for unregulated capitawwlism. Rand was not only opposed to programs like Medicare: she wanted to abolish public schools, public universities, public libraries, public parks and even public roads and highways.
She also opposed regulations on business and would have hated things like mine safety laws and regulations on water quality, not that those are ever important issues in West Virginia.
As a writer, Rand despised authors such as John Steinbeck, who showed compassion for the poor and dispossessed in novels like “The Grapes of Wrath.” Her novels promote a counter narrative in which working people and the poor are basically parasites or takers feeding off of the heroic wealthy captains of industry. In her bizarre world, the oppressed become the oppressors and vice versa. The southern writer Flannery O’Conner, herself a Roman Catholic, once said of Rand’s writings that “She makes Mickey Spillane look like Dostoevsky.”
In a 2005 speech, Ryan told listeners, “the reason I got involved in public service, by and large, if I had to credit one thinker, one person, it would be Ayn Rand.” More recently, he was quoted in Politico as saying “it’s as if we’re living in an Ayn Rand novel right now.”
(I was thinking of something more like Kafka … or one of those zombie books.)
I guess there’s no accounting for taste but, as Jesus said, “no one can serve two masters.” And “where your treasure is, there your heart will be also.”
But I digress …
Ryan didn’t come to West Virginia to discuss Ayn Rand. He came because he believes that Capito’s vote in the U.S. Senate would help to repeal the Affordable Care Act.
That would be interesting in West Virginia, which has seen the percentage of uninsured residents drop by almost two-thirds this year alone.
Gov. Tomblin’s decision to expand Medicaid — and DHHR’s amazingly successful effort to enroll eligible people — has brought coverage to 135,811 working West Virginians this year. Around 25,000 have gained coverage through the marketplace or exchange. Around 18,000 young adults are now covered under their parents’ policies as a result of the Affordable Care Act. And maybe 15,000 have gained coverage to traditional programs as a result of outreach this year.
It would be kind of hard to get that many people to voluntarily sign up for a really crappy program that quickly.
The Charleston Daily Mail recently reported that “6.59 percent of West Virginians are uninsured today; compared to 17.34 percent of West Virginians uninsured before the implementation of the Affordable Care Act, also known as Obamacare.”
West Virginia now has the most new Medicaid enrollees per capita in the United States and has had the biggest drop in the ranks of the uninsured in the country.
We are used to seeing West Virginia at the top of the bad and the bottom of the good in statistics comparing states, but that is not the case with health coverage. A business website now ranks the Mountain State as having the sixth-lowest uninsured rate in the nation.
It’s starting to look like the ACA has also dramatically reduced costs for providers. The same article notes that Charleston Area Medical Center, West Virginia’s largest hospital system “has seen a dramatic decrease in self-pay patients, charity care, uncompensated care and bad debt since expanded Medicaid and subsidized private insurance policies started becoming effective on Jan. 1.”
That’s a big deal to ordinary West Virginians since uncompensated care drives up the costs for everyone else. Prior to the ACA, it was estimated that this drove up the cost of the average insurance premium here by $1,000 per year.
The number of uninsured patients at CAMC was almost 7 percent in December 2013. It dropped to 1.7 by January 2014 and has been around 1 percent since. It has been projected that this could mean a $20 million or 35 percent drop in charity care this year, along with a $35.5 million or 51 percent drop in bad debt and a $55.5 million or 43.8 percent drop in uncompensated care.
But let’s get down to cases behind all those numbers.
Earlier this year, I heard a woman testify at the state Capitol about the effect Medicaid expansion had on her family. Her husband ran a small business while she worked at a community organization. Neither had health coverage and both enrolled for Medicaid in 2013. At the end of the year, her husband developed serious and even life threatening health problems. He tried to avoid seeking treatment until Jan. 1, when the expansion took effect, and nearly died as a result. Now things are looking better and both enjoy coverage.
There are going to be stories about how access to health care has changed and saved lives all over this state.
But a question comes to my mind: What would happen to that couple and to the nearly 200,000 other West Virginians who now have some kind of coverage if Mr. Ryan gets his way and the ACA is repealed, presumably with Ms. Capito’s help? Is Ryan going to hand out copies of Rand’s “Atlas Shrugged” to people who lose care, like he did to his staff? Will that be consolation for those who will die without coverage?
That’s a lot of people to step on and a lot of lives to ruin, even for a Rand fan, let alone a U.S. senator.
Rick Wilson, director of the American Friends Service Committee’s West Virginia Economic Justice Project, is a Gazette contributing columnist.