The language Alabama leaders don't speak

Yahoo

14-04-2025

A hallway at Vaughan Regional Medical Center in Selma, Alabama on Tuesday, Sep. 3, 2024. Congress is considering major cuts to Medicaid that could affect health care delivery around the state. (Will McLelland for Alabama Reflector)
A few weeks ago I started learning Irish via an app.
The lessons progress like any foreign language course. Start with food and water and how to get them. Gloine uisce, le do thoil. A glass of water, please.
Step outside and describe the weather. Tá sé grianmhar. It's sunny. Or Tá sé dorcha agus scamallach. It's dark and cloudy.
Then point out buildings. Cá bhfuil an ospidéal? Where is the hospital? And languages. Labhraím Béarla. I speak English.
I don't know what drew me to this. My mother grew up in County Mayo in western Ireland, but outside of math she never spoke Irish around me. I doubt I'll use Irish conversationally around the Alabama Statehouse, unless my cousins in Éire get commanded to do some kind of penance on Goat Hill.
But maybe it's a feeling that the people in charge speak a patois the rest of us don't.
Take health care.
Alabama has nation-leading rates of death from heart disease and strokes. More Alabamians die from gunfire each year than in New York State. Infant mortality is about twice as high among Black Alabamians as among whites.
Those are the fruits of poverty and systemic racism. Our ability to cope with all this, never great to begin with, is shrinking. Hospitals are closing. OB-GYNs don't want to come here.
But instead of alleviating this misery, the Legislature seems determined to maintain it. Even exacerbate it.
In the last decade, they've forced women to travel hundreds of miles for basic health care. Lawmakers made it easier to get killed by a firearm. They've cut off life-saving treatments for gender dysphoria, sitting stone-faced amid parents' pleas for their children. And their vindictive stubbornness in refusing Medicaid expansion continues to imperil state hospitals.
Now our elected officials want our kids exposed to preventable diseases, in the name of unverifiable 'religious belief.'
And they've been rather meek about a looming assault on Alabama health care.
Congress is considering massive cuts to Medicaid — up to $880 billion — to pay for tax cuts for wealthy Americans. If they go through with it, Alabama could lose $824 million in funding for the program.
That's a tsunami on the horizon.
Medicaid covers over 1 million people in Alabama. It pays for about half the births in the state. It's critical to the functioning of Alabama's hospitals and nursing homes in Alabama, which pay special taxes to the state to keep Medicaid going.
The program should get over $1 billion in state money next year, but that doesn't come close to covering the costs. The federal government pays for about 73% of Medicaid in Alabama.
And if that funding gets cut? On paper, the state could raise taxes to replace what's lost. But come on. This Legislature will not do that. That leaves one option: cutting Medicaid services.
That will hurt everyone because everyone's health care in Alabama depends in some part on Medicaid. More hospitals will close. Pediatricians will scale back or end services.
The least bad outcome would be longer wait times for basic care. The worst outcome, especially in rural areas, is health care vaporizing. More illness; more avoidable death; more misery.
This ought to enrage our leaders, who lose their minds when a teacher acknowledges the existence of gay people.
But many of them got into government by claiming to hate government. So their vocabulary is an argot with many words for 'cuts' and 'bureaucracy' and none for 'vital program' or 'public servant.' They want a government so small that it can't prevent powerful men from drowning Alabama in a bathtub.
You may remember President Donald Trump's efforts to repeal the Affordable Care Act in 2017. The bill he backed included an attempt to turn Medicaid into a block grant program. Enacting that would have slashed Alabama Medicaid to ribbons.
Hospitals and health care providers in the state all but screamed about the grave harm that would do to Alabama. The people who could stop the damage couldn't understand. Every single Alabama Republican in Congress — eight of our nine representatives and senators — voted to kill state health care.
People who understand the importance of these and other public systems — whether trade or education — know that a conservative number-go-down approach to governance is poison to both the economy and the well-being of the governed.
And by and large, they're ignored. Because those with power don't understand.
They're shoving hard-won expertise aside and tearing through fragile systems of public health care. Programs critical to our safety and well-being, erected over decades, are under attack from people who feel zero duty to those who elected them.
Rebuilding these services could take decades. Those who work to keep us healthy understand this. They have explained the dangers of what our decision-makers are doing in plain English.
But all our leaders hear is Tá sé dorcha agus scamallach. Cá bhfuil an ospidéal?
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