Now that the current phase of the Affordable Care Act (ACA) is showing success it is time for the states who did not do their part to seriously consider expanding Medicaid, maybe taking a cue from a successful, bi-partisan variation in Arkansas. As of March 27, over 6 million Americans have signed up for the exchanges under the ACA, with another over 6 million benefitting from the expansion of Medicaid in the states that did so. Further, you cannot be excluded from coverage due to pre-existing condition nor can your be kicked out once you become ill or disabled, which is a huge plus.
This success is on top of what had happened in earlier phases of the ACA. Over 3 million adult children under the age of 26 have been able to remain on a parent’s plan, which is in addition to the above. Among other early adopted features prior to 2014, the ACA eliminated the lifetime benefit limits, eliminated the preexisting condition for children, required some additional health prevention benefits and limited profit margins on policies for insurance companies which resulted in some premium refunds the past two summers.
The ACA is here to stay, but could stand some additional improvements. While complex, it has moved the ball forward in a major way and will continue to do so. Yet, part of the ACA has been hamstrung by various states that chose not to expand Medicaid for those beneath the poverty level, including the two Carolinas. For example, like other states who failed to do this, the two Carolinas rank low on overall healthcare and child poverty, per the United Health Care Foundation and Center on Budget and Policy. NC ranks 33rd in healthcare and 39th in child poverty. SC is worse off ranking 46th in healthcare and 48th in child poverty. More on this can be found on the following post.
According to the RAND Corporation, The Commonwealth Fund and Economic Policy Institute expanding Medicaid would not only be good for those in need, it will help the economies in those states. In my home state of North Carolina, for example, the reason stated for not expanding Medicaid is the administration problems it already has. That is true as the current leadership is not steering the ship very well. An unstated reason for these states is political as the leadership are not advocates for Obamacare. Yet, other Republican states have embarked down this path.
But there is another option for Medicaid expansion, which has been successfully rolled out in Arkansas with 83,000 enrollees so far. This bi-partisan alternative uses the federal support for Medicaid expansion covering the enrollees in the exchanges. This transfers the state’s administrative burden to the insurance companies. In North Carolina and other states with Medicaid administration issues, the Arkansas model would be worth consideration.
As a retired benefits professional, covering more people will benefit not only those in or near poverty, but hospitals who are struggling and our economies. People with coverage will seek treatment before troubles get worse, seek treatment from the more appropriate source and have dollars to spend on other basic needs. Since the absence of good healthcare coverage is the number one reason for personal bankruptcy per The American Journal of Medicine, having coverage can help people weather the storms in their paycheck to paycheck living.
So, it is time for these states to make a move. Under either Medicaid expansion model, people in need would benefit. So, would their state economies and hospitals, especially in rural areas where poverty is so prevalent.