Republicans advocating for the repeal of the Affordable Care Act, better known as Obamacare, are out of touch with a reality many Latinos face on daily basis; the reality of limited resources.
Republicans have mostly discussed health care in terms of market efficiencies and freedom from government mandated health insurance, but the latest attempt to destroy the ACA illustrates the devastation it would impose on the poorest and weakest of our fellow citizens. The Congressional Budget Office released a review of the GOP plan and said it would leave 22 million more American without insurance by 2026.
The expansion of Medicaid under the ACA has greatly benefited Latinos. Hispanics have the lowest rate of health insurance coverage in the United States and made significant gains under Obamacare.
According to Gallup, the net change in the uninsured rate dropped the greatest among Latinos, with a 10.4 percent change in coverage. Health insurance can mean life or death for those with limited resources, because among other things having health insurance opens up access to preventative care, like screenings for mammograms for women and prostate cancer for men, according to FamiliesUSA.
The decimation of Medicaid targets those least likely to afford health insurance on their own.
“It would essentially end Medicaid as we know it,” said Janet Murguía, president of the National Council of La Raza. Half of all Medicaid enrollees are children, and of the 74 million Americans who count on Medicaid for coverage, 18 million are Latinos.
Yet, Republicans seem determined to strip health care from these people in an effort to hand over hundreds of billions of dollars in tax cuts to wealthy families. Many Republicans genuinely believe that if someone does not have health care it's because they do not want it enough to make the sacrifices necessary to pay for it.
Representative Chaffetz of Utah said that Americans have to make choices, "And so maybe rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on, maybe they should go and invest in their own health care."
Speaker Paul Ryan defended the health care plan by saying that many of those 22 million uninsured would be exercising their freedom to not pay for health insurance.
“What they’re basically saying at the Congressional Budget Office is if you’re not going to force people to buy Obamacare, if you’re not going to force people to buy something that they don’t want, then they won’t buy it.”
This is a preposterously disconnected statement but for the grain of truth that many people would indeed elect to forego the costs of health insurance if they had a choice. However, social scientists have done research to explain why people may make seemingly irresponsible decisions, such as passing on health insurance.
In their book, Scarcity, researchers Sendhil Mullainathan and Eldar Shafir explain that when people face situations with scarce resources, they focus on immediate needs, oftentimes neglecting unrelated considerations. For instance, a person may skip their workout that morning because they have a tight deadline at the office. In this instance, the person faced scarcity related to time.
For people in poverty, this kind of focus is necessary for short-term survival, but it results in what the authors call tunneling, a “narrowing of the visual field in which objects in the tunnel come into sharper focus while rendering us blind to everything peripheral, outside the tunnel.”
Decision-making with tunnel vision changes the way we make choices, and indeed research in poor countries has found it's difficult to get poor farmers to buy insurance for their crops, despite the protections insurance provides.
Similarly, poor people often say they do not have insurance because they cannot afford it, when paradoxically, what they really can’t afford is a visit to the hospital in the event of a catastrophe. But tunneling encourages these people to make these decisions.
Latinos know this situation well, seemingly more so than the people Speaker Ryan and Republicans must be talking to about the realities of healthcare in America.
In a report by Pew Research Center, Rakesh Kocher and Richard Fry found that white households have more than 10 times more wealth than Latino households. The median wealth for white households in 2013 was almost $142,000 dollars, while the median wealth for Latino households was less than $14,000 dollars.
In other words, the wealth disparity between white households and Latino households create different realities that make it difficult for the Republican world view to be even compatible with the reality that Latinos face every day.
It's not like Republicans do not know this reality exists, they simply refuse to care or have convinced themselves that whatever solutions exist in their reality would also be good for someone else’s.
Then there's the Republicans who simply don't have an issue with making distinctions between those who are wealthier and healthier and those who are poorer or sicker. Representative Mo Brooks from Alabama said that the GOP plan will free healthy people from having to pay the costs for the sick.
“It will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy,” explained Brooks.
This was a remarkable statement not so much for its cruelty but for its honesty.
Latino Republicans who support the GOP should take stock of these sentiments and take a long look in the mirror.