UPDATED x3: See man hate Obamacare. See man refuse to get Obamacare. See man whine that he can't get Obamacare when he needs it.

UPDATE 5/19/15: SEE IMPORTANT UPDATE TO THE LUIS LANG SAGA!!

Yeah, that's right, I'll say it: Luis Lang is a hypocrite.

Over at Talking Points Memo, Josh Marshall has a story about a guy in South Carolina named Luis Lang who's in a nasty situation due to a combination of bad timing, Republican cold-heartedness and, to be blunt, his own stupidity.

First, the backstory:

As the Charlotte Observer explains, Lang is a self-employed handyman who works as a contractor with banks and the federal government to maintain foreclosed properties. He was making a decent living, enough to be the sole breadwinner in the family. As the Observer puts it, Lang "he has never bought insurance. Instead, he says, he prided himself on paying his own medical bills."

So far, so good, although I'm not sure I understand how paying 100% of your medical bills instead of buying health insurance is supposed to be a source of pride. Did he also pay cash up front for the $300,000, 3,300 square-foot house which the Charlotte Observer says he and his voluntarily unemployed wife live in? If not, then how is getting a mortgage for your house (or a student loan, or an auto loan, or life/homeowner's/auto insurance) any more "shameful" than signing up for health insurance?

Anyway...

All seemed good until this February when a series of headaches led him to the doctor. Tests revealed that Lang had suffered a series of mini-strokes tied to diabetes. (It's not clear to me from the piece whether Lang knew he had diabetes earlier or whether that was the diabetes diagnosis as well.) He also has a partially detached retina and eye bleeding tied to his diabetes. The initial medical care for the mini-strokes ran to almost $10,000 and burned through his savings. And now he can't work because of his eye issue and can't afford the surgery that would save his eyesight and also allowing him to continue working.

I don't mean to sound like an asshole, but this is exactly why people buy insurance in the first place. The whole concept is that you shell out several hundred dollars per month when you're not sick or injured so that you'll have your medical bills covered in the event that you become sick/injured. He made a gamble that he'd never become so sick/injured badly enough that he wouldn't be able to afford 100% of the cost...and it finally caught up with him.

In fact, this is exactly the hypothetical scenario which Ron Paul was asked about during one of the GOP primary debates back in 2012 (the infamous "Let Him Die!!" moment):

The difference between the tea party psychopaths in the clip above and sane people with a soul, of course, is that the sane people don't want to "Let Him Die!" even if the guy in question is a selfish, short-sighted jerk. Those of us with a soul will go as far as reasonably possible to make sure this guy doesn't bleed to death on the Emergency Room floor. That's exactly why the Affordable Care Act was passed in the first place: It may have serious flaws, but it does set up numerous provisions to help ensure that as many people receive decent, affordable healthcare coverage as possible.

However--and this is key--the person in question has to agree to use some of those provisions.

Now, it's very important to note at this point that without the Affordable Care Act, this guy would be utterly screwed. His income/assets are still too high to qualify for traditional Medicaid, and every insurance company would turn him down for coverage due to his pre-existing condition if they weren't legally required to let him sign up.

Thank goodness the Affordable Care Act is around, right? That means that 1) as long as he enrolls during Open Enrollment, the insurance company is required to let him do so; 2) if he needs some help, the federal tax credits are there to smooth things over; and 3) if his income drop moves him below the subsidy threshold, Medicaid expansion will take charge of his dilemma. Yay!!

Yeah, about that...

That’s when he turned to the Affordable Care Act exchange. Lang learned two things: First, 2015 enrollment had closed earlier that month. And second, because his income has dried up, he earns too little to get a federal subsidy to buy a private policy.

Yes, that's right. He's in South Carolina, remember? SC is one of the Republican-controlled states which refused to expand Medicaid, even though they wouldn't have to pay a dime for it the first few years and never have to pay more than 10¢ on the dollar after that. So #3 is out.

Number 2 is out because the law was passed with the provision that every state expand Medicaid. Since the Supreme Court allowed some states to refuse expansion but didn't change anything else in the law, the tax credits for private policies are still cut off at a higher income than Mr. Lang is now at...thanks to the SC Republican Party.

That leaves #1, enrolling in a private policy during Open Enrollment. Even without the tax subsidies, he should've been able to find at least one decent policy which would've helped him out of his situation (a low-end Bronze plan, perhaps). Unfortunately, due to his misguided "pride", he missed the cut-off date.

But perhaps he didn't know about the deadline (despite the massive advertising/outreach campaign), and perhaps he's a Democratic or non-political victim of SC GOP politics?

Lang, a Republican, says he knew the act required him to get coverage but he chose not to do so. But he thought help would be available in an emergency.

Oh. Never mind.

For the record, "thinking help would be available in an emergency" is otherwise known as "BUYING INSURANCE".

So, this guy spent years refusing to get insured when he could afford to do so, votes for & supports the political party which put him in his current situation, so naturally...wait for it...

He and his wife blame President Obama and Congressional Democrats for passing a complex and flawed bill.

Of course they do.

Because, again, if the ACA hadn't been passed, their situation would be...well, exactly the same as it is now.

In fact, it would be worse because without the ACA, even if his income does pick back up again, pre-ACA insurance companies would still refuse to touch him with a 10-foot pole, whereas under the ACA he at least has a shot at getting covered if he can stick it out for another 8 months.

This, of course, leads to the most jaw-droppingly honest look at the conservative mindset I've seen in months:

“(My husband) should be at the front of the line because he doesn’t work and because he has medical issues,” Mary Lang said last week. “We call it the Not Fair Health Care Act.”

Astonishing.

"Screw you, everyone else!! We spent years helping enact policies which shaft the poor, and even deliberately blew off taking steps to help ourselves if we ever fell on hard times, but now that we need help, everyone else should get the hell out of the way and move us to the front of the line."

As Marshall recaps:

  • Lang broke the law by refusing to get health insurance coverage.
  • He then got sick and actually had too little savings to cover even relatively small health care bills.
  • He knowingly waited until after open enrollment had closed, figuring he'd be able to buy in if he got in a jam
    (note: this mindset is exactly the reason for having a limited open enrollment period in the first place)
  • If he fell on hard times, the ACA's Medicaid expansion would cover him...but (GOP controlled) SC refused to accept Medicaid expansion even though the federal government would pay for it.
  • According to the original news story, his doctor is even providing some pro bono care and a local eye clinic is offering sliding scale payments.
  • Lang is left in precisely the situation that would exist if the ACA had never been passed...due to his own (& his political party's) refusal to take part in it.
  • So naturally, he blames...President Obama.

There's your party of personal responsibility, folks.

UPDATE: I want to be clear about why I'm so furious about this: Normally, I would simply roll my eyes and sigh deeply about this guy's situation. We all make poor decisions, and I can see how he got into the situation itself in the first place...and if he had chalked the whole mess up to "lessons learned" and correctly concluded that he and his wife had made a big mistake by not taking advantage of the options available to them, then I wouldn't be too upset about it.

HOWEVER, he and his wife have, by their own words, learned absolutely nothing from the experience. They're still trying to blame anyone but themselves for their predicament, pinning the blame on the Democratic Party (which bent over backwards to make sure they were covered) while (presumably) still supporting the Republican Party which did everything in their power to prevent this guy from having any form of coverage at all.

And no, I don't expect this to change, because it's baked into their internal "logic", as actor Craig T. Nelson perfectly illustrated a few years ago:

UPDATE x2: Thanks to Christian K. for the better title. Also changed "idiot" to "fool" in opening sentence, since I don't technically know Mr. Lang's intelligence level but I sure as hell know his wisdom level.

UPDATE x3: Some additional points brought up by myself and/or others:

  • Lang is a smoker and has diabetes, which he admits to being lackluster about treating
    (In other words, he took absolutely zero personal responsibility for his health in the first place)
  • Lang's income (until recently) came from contracts with "banks and the federal government" to "maintain foreclosed properties"
    (In other words, his income came mostly from taxpayer-funded contracts and/or the very banks which caused the foreclosure crisis in the first place...and which were then bailed out using taxpayer funds)
  • Nowhere in the Charlotte Observer article does it suggest that he and his wife are considering, say, refinancing or selling their $300K house to help offset the expenses, or his wife getting a job, perhaps.
  • According to the article, he "ran up $9,000 in bills and exhausted his savings". So to be clear: The dude is self-employed, in terrible shape, uninsured and has only $9,000 in total savings...but lives in a 3,300 sq. foot house worth $300K? OK...

Finally, I took a look at the guy's inevitable GoFundMe page (no, I'm not linking to it from here). Here's how he describes his situation (verbatim except for my emphasis):

My name is Luis Lang and Several months ago I was told that I had suffered several mini strokes over a period of 3-5 days. Because of this a eye condition that I have has come back with a vengeance. I suffer from Diabetic retinopathy. Because of my condition I have not worked since December. I tried to sign up for the affordable healthcare act but I was refused. And since in SC tghey have not expanded the medicaid program I have fallen into the so called dounot hole. I was told about 1 1/2 years ago about my eyes and found a doctor that worked on a sliding scale for paitints like myself without insurance.My visit were $80.00 per treatment. And I had 3 treatment but when I went in for my next appointment the cost went from $80 to $610. I asked why and was told since the healthcare act was now in place that he could not give me the discount that he was giving me. So at that point I stop treatment but that was ok becouse my eyes were much better. But because of the strokes and stress it has come back with a vengeance like I said before. At this point I'm looking at $10,000 - $30,000 in treatment or I will go blind. At the moment I am down to about 20% in my left eye and about 30% vision in my right eye. So I do need to apologize about my spelling because I can not see very well. I have tried every organization out there but I'm either to young ot to old for there program. I am to old because i am older then 10 and to young because i am not 65 yet I am only 49. As each day goes by my vision get worst. And if I do go blind it will take surgary to get my vision bac if they can.Thank you and god bless.

On Tuesday may 5 I went to the ophthalmologist. The news that he gave me was worst than we thought. I have a partially detached retinal in my left eye. This will require eye surgery to reattach. And he found that my diabetic retinopathy in both eyes was so far advanced that I will need laser surgery in order to try to correct it now. Between both procedures I am looking at any ware from $18,000 - $30,000. I have reach out to almost every organization out there and I am either to old (over 10 yrs old) or to young (under 65) for them to help. That is why I am reaching out for help. My eye sight is getting worst day by day. And if I don't get the surgeries done I will go blind.

First of all, Mr. Lang, the reason you "were refused" enrollment is because you missed the 2/15/15 deadline, which has been relentlessly advertised for months. You had 3 solid months to enroll but refused to do so because you were "too proud".

Second, you're openly admitting that you've known how screwed up your eyes are for at least 1 1/2 years (almost the exact same time that the ACA exchanges, subsidies and Medicaid expansion went into effect, as it happens), but you still refused to actually buy insurance, instead choosing the "sliding scale" pricing from your doctor (apparently you weren't "too proud" to accept medical treatment at an 87% discount from the doctor).

Third, I may be wrong about this, but I know of no provisions within the ACA which would force your doctor to discontinue that 87% discount. My guess is that what your doctor actually said was something along the lines of "Y'know, with the law in place, you could simply enroll in affordable healthcare coverage with tax subsidies, so it's a bit unreasonable to expect me to continue subsidizing your treatments."

Fourth, nowhere in your sob story do I see anything explaining why you weren't insured in the first place, even though you clearly could afford it prior to your current situation.

Quite frankly, Mr. Lang's situation reminds me an awful lot of a classic story (told beautifully by Karl Malden in The West Wing):

Even so, I did donate $5.00 to help you out, figuring that this blog entry about your stupidity will likely generated at least $5 in banner ad revenue.

Have a good day.