Compassionate conservatism – a rallying cry of the old Republican Party – where has it gone? The Affordable Care Act, also known as Obamacare, aimed to cover everyone. For the poorest, it relied on moving them into Medicaid, along with the money to pay for it.

However, the Supreme Court surprised everyone by deciding that states may decline the Medicaid transfer. About half of the states, all run by “new” Republicans, considered it and decided against the transfer. This includes Georgia and South Carolina. Without Medicaid, the poorest in these states in no way can afford health care insurance, so for them, they will use emergency rooms and go home to die. So much for our supposedly world-class health care system. For those interested in business, our hospitals will really suffer without Medicaid for these people.

Republicans are hoping this off-year election will have a typically low turnout and may strengthen their hold on the U.S. House, and might even give them the U.S. Senate. Their decisions here to ignore the poorest should make it obvious that the current Republican Party cares not a whit about them. We should expect the Democratic Party then to remind potential voters that Republicans are unworthy of their vote, particularly that of the poor, giving strong ammunition in an effort to get more people registered to vote this summer, and to vote in November as though their lives depended on it, as they very well may.

Unless Republicans reconsider and accept their poorest citizens into Medicaid, they will be blamed for the truly horrible consequences. They should not believe they can avoid blame, as the transfer is an essential part in getting to universal care. If they refuse, they may not recover their place in the minds of us all, for what they have done in their hatred for “Obamacare.” And we need a nearly equal two party system.

Victor Reilly