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Jack Bernard: Medicaid, Georgia and Nixon's 'Southern Strategy'

"Of all the forms of inequality, injustice in health care is the most shocking and inhumane."

-- Martin Luther King Jr.

On MLK's birthday a few weeks ago, I thought it appropriate to look at the health care issue here in his home state. Although we are one of the most religious states in the most religious democracy, we have tens of millions without insurance nationally... and Georgia is one of the worst states in this regard along with Florida and Texas. Why?

I believe the real answer predates our current stalemate between the two parties.

Although they deny it, all political parties are motivated by the quest to obtain power for right or wrong. The Republican Party, my party, came up with a strategy in the 1970s to get and maintain power.

The idea was to convert the "Solid South", a Democratic stronghold since the Civil War, into a sure vote for Republicans, the party of Lincoln. Nixon's "Southern Strategy" was formulated by Harry Dent of South Carolina, a colleague and friend of Sen. Strom Thurmond, a well-known racist. The strategy dictated that the GOP ignore the needs of poor blacks while appealing to the insecurities of Southern whites, especially working-class people.

The idea was further refined by Lee Atwater, born in Atlanta and raised in South Carolina, when he worked for Ronald Reagan. In Atwater's own words: "By 1968 you can't say 'n-----' -- that hurts you. Backfires. So you say stuff like forced busing, states' rights and all that stuff."

A lay preacher who knew better, Dent felt guilt in his later years, once stating: "When I look back, my biggest regret now is anything I did that stood in the way of the rights of black people." Too late, the South was with the GOP for the next 40 years, but for all the wrong reasons.

How does this "states' rights" philosophy affect us today in Georgia? The resistance by the governor and legislature to Medicaid expansion, which inordinately affects people of color in Georgia, is a perfect example of "code word" ideology overriding common sense.

In an interview a few years back, the governor stated that 620,000 people would be added to the Medicaid roles if it were expanded in Georgia. These are citizens who presumably did not have insurance and, therefore, received inadequate health care services, affecting

their quality of life and mortality rates. But he looked at this addition to the roles of the insured as a total negative.

The cost of Medicaid expansion is borne almost entirely by the federal government (100 percent for three years and 90 percent after that). According to the Georgia Budget and Policy Institute, the cost to Georgia of expansion would only be $35 million a year. This is a minuscule amount compared to the billions in the state budget, especially when considering that before the ACA, we had 22 percent of Georgians who were uninsured. Plus, according to a Georgia State University study, expansion of Medicaid would create 70,000 jobs, almost all in the private sector, at a time of substantial unemployment and underemployment In Georgia, especially among minorities.

Yet we have a governor who at the time was so afraid of the Tea Party and a primary challenge from the right that he did not approve expansion (which he could have done unilaterally then under Georgia law).

Worse, at his urging Deal's buddies in the legislature then passed a bill which says that the legislature must also approve of expansion before the federal money can flow, taking the heat off of Deal in an election year.

Deal is still subtly using the old states' rights argument by indicating that "states need more flexibility"; inaccurately stating that the ACA has a "one size fits all Washington mandate" although other states have had innovative waivers; and advocating that Medicaid should be a "block grant" controlled entirely by the state. When he ran for president, I heard similar chatter from Democrat George Wallace on the steps of our Capitol.

There is a clear tendency in our state for our current legislature and governor to break down the electorate into "them" (minorities) and "us" (middle-class white people). The GOP continues with the Southern Strategy in Georgia, playing to the baser instincts of the white electorate, dividing the citizenry and violating Judeo-Christian concepts regarding taking care of the downtrodden.

My hope is that my party leaders will soon realize both the moral inconsistency of this path and its long-term political consequences for the GOP given the changing demographics of our state.

Jack Bernard, former chairman of the Jasper County Republican Party, is a former Director of Health Planning for the state of Georgia;