Yesterday, on the anniversary commemoration of Dr. Martin Luther King’s birth, I went to see Selma—the movie, not the place. The biopic is everything I expected—a moving, enthralling, inspiring yet immeasurably sad account of Dr. King’s leadership in organizing a march from Selma to Montgomery, Alabama in support of voting rights.
The movie does not cover the next great cause planned by Dr. King, a “Poor People’s March” to call for an Economic Bill of Rights. As journalist Gary May recounts, “King had hoped to recreate Birmingham and Selma: organize the masses, demonstrate, touch the conscience of the nation, and thus force the government to act. It had happened in 1963 and 1965, so surely it could happen again. But it didn’t.” Dr. King was assassinated on April 4, 1968. Just a little over a month later, his widow Coretta Scott King led a march of 5000 people calling for an Economic Bill of Rights (my late father Jack Doherty was one of the marchers), yet “No Economic Bill of Rights was ever created and the campaign produced only minimal results — more food stamps became available and funding for Head Start programs in Mississippi and Alabama was increased” observes May.
“Had King lived, it is doubtful that he could have achieved more” May concludes. “The American political system [today] is incapable of producing the massive changes King prescribed in 1968 . . . That such changes are needed is indisputable but how to achieve them in a time of institutional and political paralysis is the million dollar question that lacks a practical answer. . . The unfortunate history of the Poor People’s Campaign and the failure to deal with contemporary outrages is not a prescription for inaction, however. Quite the contrary. King put it best: "I can’t lose hope," he once said, "because when you lose hope, you die."
What if, though, the country decided to act on a contemporary issue (although it has its roots in the Civil Rights movement of the 1960s) and agreed to expand the Medicaid program to the poor in every single state? While it's risky to speculate on how a person from the past would view any current issue, is there any reasonable doubt that Dr. King would continue to believe, if he were alive today, that the United States has a moral obligation to provide affordable coverage to everyone, and especially to the poor? He reportedly once said that “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” The Affordable Care Act, and particularly the expansion of Medicaid, was created to provide access to coverage for the tens of millions of poor and near-poor, and it is starting to achieve this—more than 10 million previously uninsured persons gained coverage in 2014, and millions more will get coverage this year. But in the majority of states that have refused to accept federal dollars to expand Medicaid, the truly poor (people with incomes at or below the poverty level) have no access to subsidized coverage under the ACA—because the 112th Congress and the Obama administration had never envisioned that the Supreme Court would make Medicaid expansion voluntary, and that a majority of states would then turn expansion down. More than 7 million poor people fall into this coverage gap.
The good news is that there are a growing number of states, with Republican governors, that are seeking to expand Medicaid—but with changes that need to be approved by the Obama administration.
We still have a long way to go before every poor person in the United States has access to coverage. I can think of no better way to honor Dr. King’s legacy than for physicians in every non-expansion state to urge their governors and state legislatures to close the coverage gap for their poorest residents by urging them to expand Medicaid—not next year, not five years from now, but this year, now, because “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
Today’s questions: What do you think Dr. King would say to the states that refuse to expand Medicaid? What will you say to them?