Mississippi Gov. Haley Barbour, an all-but-certain GOP presidential candidate, has spent the past several months making outrageous, racially loaded statements about the people he represents, and the pattern is starting to seem calculated. As a policy maker, he has thus far hung much of his national profile on his eight-year war against Medicaid, the primary program for getting poor people access to healthcare. And yesterday, he had this to say to the Boston Globe:
"There's nobody in Mississippi who does not have access to health care,'' Barbour said. "One of the great problems in the conversation is the misimpression that if you don't have insurance, you don't get health care.''
An aide later explained to the Huffington Post that the governor meant uninsured people can go to the emergency room, as if that makes the statement less shocking. But there's more. Barbour also offered this insight to the Globe:
"Most of the health disparities in Mississippi are not because of the inability to get access or afford health care,'' said Barbour. "They are because of diet, alcohol, because of drugs, the very high incidence of illegitimacy that leads to high incidence of low-birth weight children.''
Those aren't legitimate children in the first place, you see, so of course they aren't healthy.
Where to begin? How about with a few facts about the state Barbour runs. It is the poorest state in the nation; 28 percent of its residents live below the poverty line. More residents than any other state or territory die of heart disease, it's in the top four for residents diagnosed with diabetes, and it's bested only by Puerto Rico for rates of low birthweight. And you guessed it: racial disparities among all of these things are striking. A whopping 61 percent of people in the state who get health care through Medicaid are black, second only to Washington, D.C., and 37 percent of all black people are covered through Medicaid.*
In Barbour's eight years leading the state, he has responded to this crisis with an unrelenting effort to cripple Medicaid--and he wants credit for that in the GOP primary.
At the core of President Obama's health reform initiative is a massive expansion of Medicaid through federal funds. Starting in 2014, all states will have to offer Medicaid coverage to people who earn up to 133 percent of the poverty level, which is currently about $20,000 a year for a family of two. Federal money will cover all of the costs of that expansion for the first three years, then drop to funding 90 percent of it. Barbour has been the most vocal national critic of this aspect of the Affordable Care Act, and he has flaunted his record slowing the growth of Mississippi's Medicaid program as a counterpoint.
Barbour told the Globe that "the principal reason [Medicaid] rolls go down is job creation." But that's not how he has controlled costs in Mississippi, where the jobless rate in March was 10.2 percent, sixth worse in the nation. Rather, Barbour has shoved through rules that have kicked tens of thousands of people out of Medicaid and turned the process of enrolling into a humiliating inquisition. Adults in two-person families that make more than about $6,500 a year don't qualify. Adults without kids can't qualify no matter how poor they are.
Still, more Mississippians got health coverage through Medicaid than any other state in 2009 (not surprising given the poverty and jobless rate) and Barbour continues to position himself for a presidential run by bashing those people and their "illegitimate" children on the national stage. He intends to be the anti-Mitt Romney in 2012, with unimpeachable credentials as a counter to President Obama's health care reform.
Meanwhile, he has seasoned his anti-poor-people policy profile with a healthy bit of old fashioned Dixie politics. Over the winter holidays, he waxed nostalgic in the conservative Weekly Standard about Jim Crow-era Mississippi, declaring among other things that "I just don't remember it as being that bad."
The uproar over that remark at first helped a longstanding campaign to win a pardon for Gladys and Jamie Scott, the sisters who spent 17 years in a Mississippi prison for an $11 robbery in 2004. Two weeks after Barbour's segregation nostalgia seeped out of wink-and-nod rightwing media and into unflattering mainstream headlines, Barbour suddenly showed interest in Scotts' case. But he didn't actually pardon them. Rather, he suspended their life sentences, offering a parole contingent on Gladys donating a kidney to Jamie, who is in dialysis. Barbour cited the cost of that dialysis to the state when he let the women out of jail.
But Gladys Scott isn't free from the health problems that are so legion in Mississippi, either. Doctors have said she is far too overweight to safely undergo the transplant operation, leaving both sisters in violation of their parole and potentially headed back to prison. When Barbour was asked this month whether he'd finally consider pardoning the Scotts, he told AP, "I wouldn't hold my breath."
At least not unless the governor's effort to woo the racist right overreaches again.
Of course, we won't likely have to hold our breath long for that. Barbour's public record is rich with more dismissive statements about poor black people. This time last year, he stood up in New Orleans and told the Southern Republican Leadership Conference that "the federal government gets a very bad wrap about what happened after Katrina. The federal government was very generous to us." Soon after that gem, he dismissed national controversy over Virginia celebrating the Confederacy without acknowledging slavery by telling CNN that slavery "goes without saying."
Last month, Barbour press secretary Dan Turner resigned after outrageous emails he sent to Barbour staffers became public. One email offered a round up of news stories and included the quip "Otis Redding posthumously received a gold record for his single, (Sittin' on) The Dock of the Bay. (Not a big hit in Japan right now.)" Another said of former Attorney General Janet Reno, "It took longer to confirm her gender than to confirm her law license."
This is the sort of conversation that's unfolding inside Gov. Haley Barbour's team.
Barbour will be among the most serious GOP presidential candidates in 2012. He will use his eight years as governor to distinguish himself as a serious policy maker in a field of often cartoonish contenders. He will dress up his coded bashing of poor people as folksy, common sense policymaking. Hey, don't have "illegitimate" kids and they won't be born underweight. Just go to the emergency room if you get sick and can't pay for care. Don't steal $11 if you don't want a life sentence in prison.
Donald Trump, Sarah Palin and many others in the GOP cast of characters are eyeing the White House for a host of ulterior motives--raising profiles for lucrative media deals, positioning themselves as party power brokers. Their campaigns are not genuine. Barbour's is, and if it continues to unfold in the way it has thus far, it will be a troubling addition to American politics.
*A previous version of this post incorrectly reported that 61 percent of all black people get coverage through Medicaid. Rather, that is the share of people in Medicaid who are black.