Republished with permission from Thom Hartmann.

The easiest and laziest way for a state government to deny its citizens a benefit to which they’re entitled is to wrap it in so much paperwork, make people jump through so many hoops to qualify, that they give up in confusion or exhaustion.

Texas Governor Greg Abbott, one of the nation’s cruelest—he’s shipped refugees out of state based on lies, put a $10,000 bounty on the heads of pregnant women, and is alleged to have ordered his own police to throw children and nursing babies into the Rio Grande River where razor wire awaits them—is all-in on this with regard to Medicaid.

As the Texas Tribune reported this week:

“Half a million Texans have lost their Medicaid coverage since April, mostly for procedural reasons like not responding to messages from the state.”

This is a big deal: 45,000 Americans die every year because they lack health insurance, including those who can’t access Medicaid.

The state could have easily confirmed their eligibility with public records; most states do. But Texas’ Governor Abbott wanted people to have to jump through long, complex, confusing hoops. It would mean fewer Texans would have health insurance, which is explicitly his goal and that of 10 of his Republican gubernatorial colleagues, including Ron DeSantis.

And Medicaid is consequential: it covers roughly half of all American children, pays for 40 percent of childbirths, covers 1 in 5 parents, and is the largest funder of long-term care for the elderly. It’s also a key funder of substance abuse and addiction treatment, and covers more people than Medicare.

The federal government covers 90 percent of the cost of Medicaid, and 39 states have expanded their programs under Obamacare to cover all low-income people within their borders. But 11 Republican-controlled states continue to refuse to insure their low-income working people except under strict rules that limit the insurance to small groups like those who are disabled.

When the pandemic hit, the federal government forbade states from dropping people from their Medicaid rolls, but that protection expired in April and, in the months since then, Republican governors in those 11 states have been systematically stripping people of their insurance protection. None have been as enthusiastic to put their citizens at risk as Abbott’s Texas.

Roughly 45,000 Americans die every year from a lack of health insurance. Many uninsured people postpone medical tests and concerns until they’re fatal; others simply can’t afford the cost of treatment or ongoing medications to keep them healthy or alive.

Every one of these people has a story, a family who cares about them, friends and neighbors. Every one of these deaths—which don’t happen like this in any other developed nation on Earth—is a tragedy that is completely unnecessary.

Every one of them dies because of choices made by Republican governors who hate the idea of billionaires having to pay income taxes to cover the healthcare costs of working class or poor people.

In this, these governors subscribe to the all-American rich man’s slogan of, “I’ve got mine and screw you.” It was laid out in detail in 1980 when billionaire David Koch ran for vice president with the Libertarian Party, an organization created by the real estate lobby to give an air of legitimacy to their efforts to outlaw rent control and end government regulation of their industry.

His platform included a whole series of positions that were specifically designed to roll back and gut FDR’s “big government” programs (along with those added by both Nixon and LBJ’s Great Society) that had created and then sustained America’s 20th century middle class.

The amazing thing is that his list reads like today’s MAGA Republican agenda. Ending low-cost healthcare and gutting our public schools is just the beginning:

• “We urge the repeal of federal campaign finance laws, and the immediate abolition of the despotic Federal Election Commission.
• “We favor the abolition of Medicare and Medicaid programs.
• “We oppose any compulsory insurance or tax-supported plan to provide health services…
• “We also favor the deregulation of the medical insurance industry.
• “We favor the repeal of the fraudulent, virtually bankrupt, and increasingly oppressive Social Security system. Pending that repeal, participation in Social Security should be made voluntary.
• “We propose the abolition of the governmental Postal Service.
• “We oppose all personal and corporate income taxation, including capital gains taxes.
• “We support the eventual repeal of all taxation.
• “As an interim measure, all criminal and civil sanctions against tax evasion should be terminated immediately.
• “We support repeal of all law which impede the ability of any person to find employment, such as minimum wage laws.
• “We advocate the complete separation of education and State. Government schools lead to the indoctrination of children and interfere with the free choice of individuals. Government ownership, operation, regulation, and subsidy of schools and colleges should be ended.
• “We condemn compulsory education laws … and we call for the immediate repeal of such laws.
• “We support the repeal of all taxes on the income or property of private schools, whether profit or non-profit.
• “We support the abolition of the Environmental Protection Agency.”
• “We support abolition of the Department of Energy.
• “We call for the dissolution of all government agencies concerned with transportation, including the Department of Transportation.
• “We demand the return of America’s railroad system to private ownership. We call for the privatization of the public roads and national highway system.
• “We specifically oppose laws requiring an individual to buy or use so-called ‘self-protection’ equipment such as safety belts, air bags, or crash helmets.
• “We advocate the abolition of the Federal Aviation Administration.
• “We advocate the abolition of the Food and Drug Administration.
• “We support an end to all subsidies for child-bearing built into our present laws, including all welfare plans and the provision of tax-supported services for children.
• “We oppose all government welfare, relief projects, and ‘aid to the poor’ programs. All these government programs are privacy-invading, paternalistic, demeaning, and inefficient. The proper source of help for such persons is the voluntary efforts of private groups and individuals.
• “We call for the privatization of the inland waterways, and of the distribution system that brings water to industry, agriculture and households.
• “We call for the repeal of the Occupational Safety and Health Act.
• “We call for the abolition of the Consumer Product Safety Commission.
• “We support the repeal of all state usury laws.”

The world is made up of “makers” and “takers,” these rightwing billionaires (who pay an average income tax of 3.4 percent) will tell you. The morbidly rich “job creators” shouldn’t be taxed to support those damn “moochers” who want everything from union rights to a living wage to Medicaid. How dare those moochers? They only provide the labor and consumption!

Why, these eleven Republican governors ask, should their brilliant billionaire patrons be forced—at the barrel of an IRS agent’s gun!—to pay taxes to support these ungrateful masses through “big government” programs like Medicaid, even if it’s federal money and costs the states virtually nothing?

Isn’t it up to each of us to make our own fortunes? Wasn’t Herbert Spencer’s interpretation of Darwin right? Aren’t Elon Musk and Mark Zuckerberg examples of the finest human beings our species offers? Don’t they deserve millions of times more wealth and power than average Americans because of their innate social, moral, spiritual, and intellectual superiority?

So what if 45,000 Americans die every year because of this callous attitude? What does it matter to the rightwing billionaires and their pet politicians and Supreme Court justices? They’re very careful to never have to interact with the riff-raff, after all, insulated by their private jets and yachts and gated, guarded mansions.

These Republicans will tell you, on behalf of their billionaire owners, that they believe our government should only have a few simple mandates: maintain a strong military, tough cops, and a court system to protect their economic empires. That’s why they’ll support massive prison expansions and nosebleed levels of Pentagon spending but (metaphorically) fight to the death to prevent an expansion of Social Security or Medicaid.

If almost a thousand Americans die every week for lack of Medicaid-type insurance, Greg Abbott and Ron DeSantis will tell you, that’s the price of “freedom.” The kids, spouses, siblings, and parents of these dead Americans just need to get over it: there’s a principle at stake here!

Earlier this week, The New York Times laid out the Trump/GOP plan for the next Republican presidency, organized by the Heritage Foundation and other billionaire-funded think tanks. It would gut most federal agencies that protect average working people and the environment, and turn those with punitive police powers—like the IRS, DOJ, and FCC—into political arms of the presidency to reward friends and punish enemies, particularly, Trump says, in the media.

Six Republicans on the Supreme Court are also working at this agenda as hard as they can, most recently ignoring the black-letter wording of the Clean Water Act to strip federal protection from half the nation’s waters, and ending the EPA’s power to regulate CO2. Both of those decisions will also result in more dead and diseased Americans. Thousands a year now, perhaps hundreds of thousands a year in the future if climate change isn’t reigned in.

But do the rightwing billionaires and their Republican groupies care? Not a bit. Psychopathy is their thing; cruelty is their delight; “the greater good,” they say, is “idealistic pablum” that is simply “not feasible” (even though it’s been achieved by every other developed country in the world: even Costa Rica has a national healthcare plan that covers everybody in the country).

Fiscal brutality, ignoring the consequences of your actions, making routine decisions that destroy peoples’ lives, is how many people become billionaires, after all.

They see us voters as an impediment to their oligarchic plans, so every Red state in the country is working today to make it harder to vote and, since five Republicans on the Supreme Court legalized it in 2018, they’re also working to throw people in largely Democratic precincts off the voter rolls in massive purges.

The campaign to reshape America that Lewis Powell envisioned in 1971 and David Koch declared in 1980 is near fulfillment, and it’s being built on the dead bodies of hundreds of thousands of American citizens.

If the GOP can take control of the entire federal government in 2024, even living in a Blue state won’t protect your Medicaid, abortion and healthcare rights, or even the right to publicly disagree with Republican politicians without losing your job or being sued into bankruptcy (yes, the GOP wants the slander and libel laws “reformed” so, like Putin, they can fine or imprison anybody who criticizes them).

Eleven states denying healthcare to their citizens to keep taxes on billionaires low will become 50 states with no healthcare for working class people if Republicans win in 2024; millions more Americans will die unnecessarily, and the morbidly rich who set it all up will be laughing and diving into their money bins like Scrooge McDuck.

If that is not the America you want, double-check your voter registration every month (particularly if you live in a Red state) and help wake up friends, family, and neighbors. The stakes have never been higher.