Why did Florida's Republicans let a hard-working young mother of three die rather than accept Federal funding which would've provided her with health insurance?

"Sadism."

According to Rep. Alan Grayson, that - along with extreme ideology and a certain amount of political expediency - explains why Gov. Florida Gov. Rick Scott, along with a number of his fellow Republican governors, refused to accept ACA funding to expand Medicaid coverage.

"How (else) can you explain it?" asked Grayson in our recent broadcast interview. "Republicans have been blinded by their own ideology."

"Every single member of the State Legislature in Florida has healthcare - every single one of them - and yet they voted to deny that health coverage to almost a million other people."

As Grayson points out in this clip, they also voted to deprive Florida's economy of billions of dollars in federal funding. And now Charlene Dill is dead.

Deadly Ideology

A Harvard study estimates that 8 million people will remain uninsured as a result of this action by 25 governors. The study estimates that this will lead to more than seven thousand unnecessary deaths per year, a rate of roughly 19 people each day. That includes 1,158 deaths per year - or more than three every day - in the state of Florida as the result of Gov. Scott's actions.

That grim figure is made even harder to swallow because, as Grayson explains here, Gov. Rick Scott made an enormous sum of money from the Medicare fraud committed by his corporation while he was CEO. And, as Grayson explains, Scott continues to make decisions as governor which benefit that corporation.

Some of us feel that the Affordable Care Act's should have provided a public option or some other form of government-sponsored universal coverage, that it depended too much on for-profit health insurers, and that a transition to Medicare for All should have been its ultimate goal.

But it is certainly possible to hold those views and still recognize that Medicaid expansion provides enormous social value - or, to put it more simply, that it can save many lives. David Himmelstein and Steffie Woolhandler, two of the Harvard study's co-authors, are physicians who have been prominent critics of the ACA from the left. They nevertheless recognize that there will be a tragic human cost for failing to implement this part of the bill.

A young woman in Florida has already paid it. We discussed her life and death in this extended segment of an in-depth interview with Rep. Grayson.

The Shameful Death of Charlene Dill

Charlene Dill was everything conservatives claim to admire and support. She was a 32-year-old mother of three who was working three jobs in order to build a better life for herself and her three children. (We discussed her life, and the Republican attitude toward it, here.)

Charlene Dill knew she had a potentially fatal heart condition, but she couldn't afford health insurance. Charlene made $11,000 last year, which disqualified her from standard Medicaid eligibility. She was, however, eligible for coverage under the ACA Medicaid expansion program.

Unfortunately Gov. Rick Scott, like a number of other GOP governors, refused to accept the funds on ideological grounds - and for reasons of partisan political advantage. If he and his GOP colleagues hadn't done that, Charlene Dill would almost certainly still be alive today.

I interviewed Charlene Dill's Congressman, Rep. Alan Grayson (D), on The Zero Hour and asked what kind of political psychology allows Republicans like Rick Scott to deny Federal funds which could save lives like hers.

"One rationale is sadism," said Grayson. "Some people out there might actually enjoy the fact that people are denied the care they need to stay healthy and alive."

But how can they live with themselves?

"I suppose their ideology instructs them that if you can't afford health insurance you shouldn't get it."

Fifty Shades of Red

Grayson's characterization may seem extreme. But, as Grayson reminded us during the interview, attendees at a Republican presidential debate repeatedly cheered the idea of letting the uninsured die back in 2011. Today, with their treatment of Medicaid expansion funds, Red State Republicans seem strikingly cavalier about inflicting suffering and even death upon their own constituents.

Sadism may sell a lot of books and movie tickets, but it's a frightening ideology. As Grayson set of Republicans like Rick Scott, "They're willing to put up with any sort of pain - as long as it's someone else's."

Conservatives insist every poor person should get a job - then they punish them for it. They demand that poor people pull themselves up by their bootstraps, then make them pay for it - perhaps with their lives - when they try.

Sometimes tragedies need a public face in order for their full impact to be felt. The next time a Republican politician talks about the noble and inspiring model of a self-sacrificing mother or father - or tries to say they have a better vision for America's future - Americans should remember Charlene Dill.