Since not every state fully implemented the Affordable Care Act, data now exists that can contrast those who did with those who did not. Thirty-one states and the District of Columbia have expanded Medicaid, with nineteen states still remaining.
For those who do not follow this closely, the ACA uses Medicaid expansion as the vehicle to deliver health care coverage for people beneath 138% of the poverty level. The federal government would front 100% of the cost for three years, eventually declining to 90% thereafter. Yet, the Supreme Court said states could opt out of this feature, which 19 still have done so.
Per the attached article, The Federal Reserve Bank of New York in a study finds a benefit to people in states where Medicaid expansion occurred is debt collections have declined. I have written before that the principal reason for personal bankruptcy is medical debt. The study’s authors note:
“U.S. counties that had a particularly high uninsured rate prior to the implementation of the Affordable Care Act have seen the per capita collection balance fall if their state embraced the Medicaid expansion. If not, the collection balance continued to climb.”
Yet, in states where Medicaid was not expanded, debt collection is noticeably more in comparison. Per The Commonwealth Foundation, Kaiser Family Foundation, RAND Corporation, Economic Policy Institute and a George Washington University study, expanding Medicaid helps those in need, helps a state’s economy and helps hospitals, especially rural ones who have high indigent and uninsured costs. The hospitals in Medicaid expanded states are seeing fewer uninsured patients and seeing better operating margins. Now, evidence shows it keeps more folks out of bankruptcy.
Former Ohio Governor John Kasich, who was the most reasonable GOP presidential candidate in the view of many, said expanding Medicaid was a no brainer. He said it would bring $13 Billion to his state over the next several years when announced. It also helped his constituents. During the campaign he remained a supporter of Medicaid expansion, which swam against the GOP tide. It is hard to be a lone advocate in a sea of political animosity.
It is past time for leaders in the remaining states to stop thinking like party representatives and start thinking like financial stewards. Several states gave serious consideration, such as Oklahoma, Alabama, Idaho and Wyoming, to expanding during the spring, but in spite of strong data showing its benefits to the state, its hospitals and people, Republican animosity toward the ACA defeated the proposals. Medicaid expansion would help many, including those Republican constituents in poverty living In rural areas. It should be noted that these are the same folks who feel their party is not doing more for them.
Make a move legislators and help all your people, but especially your constituents.