By now I had moved on to a new job focused on Medicaid clients, which meant I encoun­tered a pillar of Obamacare, the Medicaid expan­sion. Many more chron­i­cally ill people were now being cov­ered by the gov­ern­ment. This was my oppor­tu­nity to see the costs of unin­sured America, a giant pool of lia­bility so mud­died by the com­plex­i­ties of coding and poor data tracking that no one knew if it was two or 20 feet deep. I sus­pected America was far sicker than the politi­cians described.
One issue that stood out was the number of patients who had con­tracted sepsis, a blood infec­tion. Unable to get med­ical care, patients had lived with infec­tions for weeks, maybe months, until bac­teria caught a ride into their blood streams. Now Medicaid was paying bills as large as $100,000, and those patients who did not die were facing months of recovery, and not a premium pay­ment had been made to com­pen­sate for it.
President Trump has por­trayed Obamacare as a cesspool. The problem was never Obamacare. It was unin­sured America — people who had been cut out of the system, but who were nonethe­less pushing us toward col­lec­tive bankruptcy. Obamacare just cleaned the water enough for us to finally see the time bomb in the depths.

If the pre­ventable deaths of people burning in their homes are not a matter for the state, then what is?

Those who wish to carry out acts of vio­lence always seek to frame them­selves as vic­tims. James Hodgkinson’s attack on Republican rep­re­sen­ta­tives in Alexandria is a god­send for the far right.