This article originally appeared at TomDispatch.com. To receive TomDispatch in your inbox three times a week, click here.
It's not complicated. This country, as TomDispatch regular and co-chair of the Poor People's Campaign Liz Theoharis makes clear today, is simply unprepared -- unprepared, that is, to keep all too many Americans even reasonably healthy and well. It matters little that this may be the wealthiest country on the planet. (It certainly has the most billionaires!) I mean, there was a brief period after the Covid pandemic hit when a national public health emergency was declared, but that ended last May. It matters little that this country could, for instance, be experiencing the worst surge of Covid cases since that massive wave of them in the winter of 2021-2022, with deaths significantly lower but still topping 1,500 a week. Who's paying attention? Who even cares?
And is this country faintly prepared for the next pandemic? I wouldn't count on it. Not for a second. Worse yet, it's not prepared for another kind of pandemic that Theoharis lays out so strikingly today -- the gutting of healthcare for all too many Americans. And believe me (as you'll see when you read her piece), that, too, should be considered a pandemic of some sort and the richest country on this planet should truly be ashamed of itself. Tom
The Great Unwinding
The Failing Battle for Health and Healthcare in These All Too Disunited States
The slang definition of "unwinding" means "to chill." Other definitions include: to relax, disentangle, undo -- all words that, on the surface, appear both passive and peaceful. And yet in Google searches involving such seemingly harmless definitions of decompressing and resting, news articles abound about the end of pandemic-era Medicaid expansion programs -- a topic that, for the millions of people now without healthcare insurance, is anything but relaxing.
Imagine this: since March 2023, 16 million Americans -- yes, that's right, 16 million -- have lost healthcare coverage, including four million children, as states redefine eligibility for Medicaid for the first time in three years. Worse yet, the nation is only halfway through the largest purge ever of Medicaid as the expansion and extension of healthcare to millions, brought on by the Covid-19 pandemic, have ended, leaving some families no longer eligible, while others need to reapply through a new process in their state.
This thrusting of tens of millions of Americans out of the national healthcare system at a moment when healthcare outfits, pharmaceutical companies, and health insurance corporations are making record profits has been termed "the great unwinding." And it couldn't be more cruelly ironic. After all, states have the power and authority to expand healthcare to all their residents; the federal government could similarly extend the declaration of a public health emergency that would let so many of us keep distinctly life-protecting access to healthcare. Yet millions have instead been pushed violently and rapidly from such life-saving care.
Some states are feeling the impact especially strongly. In Georgia, for instance, more than 149,000 children lost their pandemic Medicaid enrollment in just six months. Perhaps unsurprisingly, Texas is the epicenter of Medicaid's unwinding. There, more than two million Americans have been removed from the state's Medicaid program since federal pandemic-era coverage protections were lifted last April. As Axios reported, new state data indicates "that's the most of any state and nearly equivalent to all of Houston -- Texas' most populous city, with 2.3 million residents -- losing coverage in less than a year." In fact, 61% of enrollees in Texas have lost Medicaid since last April.
Death by Poverty and the Lack of Healthcare
In my home state, policy analysts predict that more than 1.1 million New Yorkers will be pushed off Medicaid roles in this same unwinding. Fortunately, people are organizing in response, calling for the right to healthcare, living wages, the abolition of poverty, and more.
On Saturday, March 2nd, I stood next to Becca Forsyth of Elmira, New York, at the Poor People's Campaign's Mass Poor People and Low Wage Workers Statehouse Assembly in Albany, New York. Becca was one of dozens of low-income people who testified at simultaneous assemblies held in 31 state capitals and Washington, D.C. These assemblies launched 40 weeks of the mobilizing and organizing of poor and low-income eligible voters in the lead-up to the 2024 elections, while challenging those running for office, as well as elected officials, to confront poverty as the fourth-leading cause of death in America. Becca was not the only speaker to touch on the crisis of healthcare (and its connection to poverty and death), but her words stuck with me:
"Just since December 19th, I have lost more than a dozen people I loved dearly. In 74 days, I've watched as people I've known most of my life were literally squeezed to death by poverty and the catastrophic impact it has on our entire lives. People like Missy, a 47-year-old woman who was found lying beside the railroad tracks, dead" Or Gary, who died at the hands of the police while in a hospital for a mental breakdown. Or Loretta, a friend who was a friend before I even knew what the word friend meant, who is no longer with us because my community won't spend money on substance-use treatment. Chemung County leads this state in way too many negative ways. We rank 59 out of the 62 counties in New York for health outcomes. We have outrageous homelessness, food insecurity, premature death rates, and lead poisoning. Our chances for getting out of poverty are extinguished before we even have a chance!"
Just two days before I stood with Becca in Albany, the state capital, demanding the right to thrive and not just barely survive, I rallied with healthcare workers and community members at SUNY Downstate Hospital. With the support of New York Governor Kathy Hochul, SUNY Chancellor John King recently announced that his outfit may close SUNY Downstate Medical Center in Brooklyn, New York, one of the few remaining public-safety-net hospitals in the state.
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