Republicans must take care with Americans' health care

PUBLISHED: November 14, 2025 | www.baltimoresun.com

Ralph Ellison famously authored “Invisible Man” in 1952.

An integral segment of the Republican Party is similarly invisible and marginalized today. They are poor families, often ill-clothed, ill-housed, ill-fed and ill-cared-for. They are not billionaires. They are not millionaires. They do not form political action committees. They do not retain high-priced lobbyists to sway Congress or the President.

But they labor without weary. They are law-abiding. They subscribe to conservative values: religion, marriage, hard work, clean living and decency. They are naturally attracted to vote Republican over the ultra-liberal, secular Democratic Party alternative.

Republicans are misguided and cruel in seeking to repeal, curtail and malign the Affordable Care Act, otherwise known as Obamacare. The health care it underwrites is often the difference between life and death for the vulnerable or underprivileged. To the extent Republicans attack Obamacare, to that extent they are assaulting Republican or would-be Republican voters — especially in the Deep South.

Consider states that have resisted expanding Medicaid for the indigent, notwithstanding that the lion’s share of the cost would be assumed by the federal government: Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee and Texas. The potential beneficiaries of the expansion largely reside in rural, Southern communities. Their health is commonly precarious. Their diets are suboptimal. They often live in dilapidated housing. The air, water and land that surrounds them is regularly contaminated or toxic. They do not belong to sports or country clubs. They do not enroll in Pilates classes. They are ordinarily the victims of Lady Fortune who deserve our sympathy and support. There, but for the grace of God go I.

Rural hospitals disproportionately serve poor or uninsured patients. They disproportionately operate at a loss. They subsist at the edge of bankruptcy. Stone-hearted Republican plans to gut Obamacare would cause many to fall off the financial cliff. According to reliable projections, Republican proposals to slash Medicaid to the bone would leave 1.8 million people in rural communities without coverage and forfeit tens of billions of dollars in Medicaid funding over a decade for rural hospitals.

At least 50% — and possibly up to 75% — of Obamacare marketplace enrollees reside in states carried by President Donald Trump in 2024. Is this any way to treat political friends?

American writer Pearl Buck, renowned for “The Good Earth,” instructed that “the test of a civilization is the way that it cares for its helpless members.”

If the United States, without blinking an eye, can squander over $3 trillion on fool’s errands in Afghanistan and Iraq, if the United States can shower billionaire Elon Musk with billions in tax subsidies, if the United States can invest tens of billions in overpaid defense contractors; if the United States can bail out super rich Silicon Valley bank depositors, then the United States can more than amply afford to pay for the urgent health care needs of rural Americans. We are not Bangladesh or Burkina Faso.

I am not arguing that Obamacare should be untouchable. The science of government is the science of experiment. But it should be refined with a scalpel, not shattered with a blunderbuss.

Don’t throw the baby out with the bathwater.

Obamacare fraud is a good place to begin. The CATO Institute estimates that $27 billion is lost annually because of improper enrollments. Misrepresentation of income is a prime culprit. Phantom enrollees are another source of fraud. More documentation and verification of income should be required. Rewarding healthy behavior to prevent illness, like avoiding drugs, cigarettes, alcohol or gluttony, should also be considered. An ounce of prevention is worth a pound of cure.

Reform to conserve.

Armstrong Williams (www.armstrongwilliams.com; @arightside) is a political analyst, syndicated columnist and owner of the broadcasting company, Howard Stirk Holdings. He is also part owner of The Baltimore Sun.

©️ 2025 Baltimore Suna political analyst, syndicated