Kevin Drum at Mother Jones summarizes the Medicaid issue with this headline:
The Republican Rejection of Medicaid Expansion is Depraved
...and supports it with this:
The refusal of Republican states to accept Obamacare's Medicaid expansion surely ranks as one of the most sordid acts in recent American history. The cost to the states is tiny, and the help it would bring to the poor is immense. It's paid for by taxes that residents of these states are going to pay regardless of whether they receive any of the benefits. And yet, merely because it has Obama's name attached to it, they've decided that immiserating millions of poor people is worth it. It's hard to imagine a decision more depraved.
Conservatives hate it when you accuse them of simply not caring about the poor. Sometimes they have a point. This is not one of those times.
To see why Medicaid expansion is so important, make sure to read this week's piece by Abby Goodnough, Katie Thomas and Reed Abelson report in
The New York Times Times:
Since his chronic leukemia was diagnosed in 2010, Ray Acosta has paid dearly for health insurance: more than $800 a month in premiums, plus steep co-payments for the drug that helps keep him alive. [...]
He sought advice from an insurance agent who had used his moving company. She connected him with an application counselor at a community health center, who found — to Mr. Acosta’s astonishment — that he qualified for Medicaid under the new health care law, the Affordable Care Act, which gives states the option of expanding the program to include more low-income adults.
“I’m kind of in a disbelieving fog,” Mr. Acosta said last week, two days after completing an application. “I’m just hoping, keeping my fingers crossed, that this might really help me out.” [...] “After being gouged all these years, trying to make ends meet, to all of the sudden get this?” he said. “I’m really blown away.”
More on Medicaid expansion below the fold.
Over at The National Journal, Clara Ritger looks at one study which finds that the refusal to expand Medicaid will disproportionately hurt African-American families:
Had all 50 states expanded Medicaid, 95 percent of uninsured African-Americans would be eligible for some form of federal assistance through the Affordable Care Act coverage—either via Medicaid or premium subsidies—according to a Health and Human Services report released Monday. Instead, only 60 percent will benefit.
In total, 25 states chose not to expand Medicaid, creating a "coverage gap" where some residents earn too much to qualify for the program but not enough to qualify for the tax credits. [...]
More than half of all eligible uninsured African-Americans live in families whose income falls below the federal poverty line. Two-thirds of the total eligible population, however, resides in states that opted not to expand Medicaid.
Even conservatives should support Medicaid expansion, writes
The Times-News editorial board:
Conservatives squirm when they hear “welfare.” But by actually expanding Medicaid, conservative state lawmakers would prove their policy actually squares with their rhetoric. [...] Rep. Fred Wood, R-Burley, a physician and member of the legislative task force, rightly argues that broadening Medicaid to include drug-addicted or mentally disturbed parolees — a provision of the ACA’s expansion package — would no doubt slash prison costs by providing services for people who would otherwise end up back in the clink. [...]
The savings on inmates alone could top $130 million over 10 years, should Medicaid be expanded, Wood said. Expansion proponents expect the figure to grow when the Idaho Department of Correction finishes its analysis for the coming legislative session.
The Time-Picayune editors urged Governor Jindal to expand Medicaid this week:
Gov. Bobby Jindal's decision to reject the expansion of Medicaid looks worse and worse. A new study by the Commonwealth Fund shows that Louisiana will lose out on $1.65 billion in federal dollars in 2022 alone. The federal government will be paying 90 percent of the cost of the Medicaid expansion that year. If the state agreed to the expansion, its share for the year would be $280 million.
The governor has said that Louisiana can't afford even that much. But the co-pay for Medicaid is a small fraction of the $2.2 billion Louisiana is projected to spend on incentives to attract private business in 2022, according the study.
Mira Singer and Ronald S. Hornberg wrote about how Medicaid expansion can help address problems in Virginia's mental health system:
In the long run, the savings in terms of reductions in emergency room costs and reductions in unnecessary incarceration would be very high. Most importantly, fewer people with serious mental illness would experience crises because they would receive timely care. [...]
Sadly, this increase in funding was virtually obliterated by 2011. And the inspector general warned in his 2012 report of “the state’s failure to create sufficient community services to address the needs of individuals with mental illness.” Sustained attention to improving mental health care is needed.
It is time to put partisan politics aside and do what is right for people living with serious mental illness in Virginia. Expanding Medicaid would be a giant step toward achieving this goal.
As
David Entwistle, CEO of University of Utah Hospitals and Clinics, wrote:
Whether it's economics or simply considering the well being of so many people in our communities, embracing Medicaid expansion is an option that will benefit our state for years to come.
Finally, in case you missed it, here's a must-read on
the money behind one fight to undermine Medicaid:
new documents show how [Texas Public Policy Foundation] and another conservative group, the Texas Conservative Coalition Research Institute, coordinate their attacks on the public sector with a far-flung network of conservative organizations and funders. The documents— obtained by The Guardian and shared with the Observer—contain 40 funding proposals from 34 states, offering a glimpse of the conservative agenda for 2014. The proposals were shepherded by the State Policy Network, a coalition of groups that act as incubators of right-wing policy at the state level. The proposals were to be funded by the Searle Freedom Trust, a private foundation that pumps money into right-wing, corporate-friendly organizations. The intermediary between Searle and the State Policy Network, The Guardian reports, was Stephen Moore, an editorial writer with the Wall Street Journal and an occasional speaker at TPPF events, including a January “plenary session” Moore hosted with Sens. Cruz and Cornyn.
The documents include a TPPF grant request to Searle to fund continuing attacks on Medicaid. In its application, TPPF claims credit for blocking Medicaid expansion in Texas and promises to push for looser federal requirements, including a block-grant approach that Gov. Perry has long sought that could result in tighter restrictions and fewer people covered by the government insurance program.