Helaine Olen,  April 13, 2015

The Humane Thing to Do

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The stuff of neon lights. / Thomas Hawk
The stuff of neon lights. / Thomas Hawk

Let’s say your husband got fired from his job as a police officer after he was indicted for murder, when video surfaced of him firing eight shots at the back of a unarmed African American man—who fled when he feared arrest for owing back child support—hitting him five times and killing him.

At least when it comes to health care, South Carolina is there to help you. Last week, Keith Summey, the mayor of North Charleston, announced the city would continue to pay the health insurance premiums for the family of Michael Slager, the cop charged with murdering Walter Scott, even though they fired him within a day of his indictment. After all, Slager’s wife is eight months pregnant, and the city plans to keep its contributions up until she gives birth. It’s “the humane thing for us to do,” Summey explained.

Well, yes, and it’s a pity that official humanity doesn’t travel farther in South Carolina, where poor and near poor residents who are newly eligible for Medicaid under the Affordable Care Act have been denied the chance to enroll thanks to the state legislature. Offering anyone health insurance—pregnant or not—in a country that lacks anything resembling universal coverage is the humane thing to do. COBRA is expensive, and many in need can’t afford it. But Summey’s decision to help out Slager’s family begs the question of why other South Carolina residents aren’t worthy of such compassion.

According to a recent report by advocacy group Families USA, an estimated 322,000 South Carolina residents lack health insurance because of the state’s failure to expand Medicaid access. The state’s explanation for this malfeasance? We can’t afford it!

“We emphatically said no to the central component of ObamaCare, the expansion of a broken Medicaid program that is already cannibalizing our budget,” Nikki Haley, the state’s governor, declared last year.

(If you are wondering, the federal government would cover the entire cost of the state’s Medicaid expansion through 2016, and then up to 90 percent through 2020.)

So what else could be going on to account for such emphatic proclamations? Well, as Jamelle Bouie has pointed out, ten of the eleven states that made up the Confederacy in the Civil War are among the twenty-two states that have refused to enact the Medicaid expansion. And what do you know, prime beneficiaries of the Affordable Care Act have been and would still be African Americans. According to the Department of Health and Human Services, nearly one in four—22 percent—of African Americans across the United States lacked health insurance in early 2014. One year later, that number had plunged by almost half to 13 percent.

In the Palmetto state, though, African Americans are 42 percent of the South Carolina residents left in the lurch by the legislature’s refusal to offer Medicaid services that would be paid for by the federal government. And no, they don’t appear to be accessing doctors in other ways. The slightly more prosperous group of African Americans who are not eligible for Medicaid in South Carolina are less likely than poorer African Americans who can access medical services through the government program to receive regular check-ups and undergo breast and prostate cancer screenings.

This lack of medical access will likely be fatal to some of them. One study, conducted by researchers at Harvard University and the City University of New York, predicted up to 17,000 Americans will die as a result of the failure to expand Medicaid coverage. A cynic might say there is more than one way to shorten the lives of African Americans in South Carolina. Some methods are all-too legal.

As for Slager’s family, it seems possible that someone will step forward to pay his family’s health insurance bills even after his former employer, the city of North Charleston, cuts him off. Someone is paying the tab for his high-priced defense lawyer, at an estimated cost of several hundred dollars an hour. Health insurance is comparatively cheap.

But it’s hard to avoid the conclusion that the murder of Walter Scott was preventable in more ways than one. In a state with an actually humane social policy—one that offers financial supports and nourishment to all men, women, and children instead of a chosen few—a man like Scott might have stayed in the car and expected fair treatment.

Helaine Olen is the author of Pound Foolish: Exposing the Dark Side of the Personal Finance Industry, a contributing editor for Pacific Standard, and a regular Slate contributor.

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