A couple of weeks ago I argued that the real question we should be asking is how are we going to pay for NOT having universal healthcare? Thanks to those who recommended the diary in which I discussed starting a new job and being without health insurance myself for a month. Well good news! As of today I am once again insured and I didn’t get sick in the meantime. My gamble paid off and I saved about $700 that it would have cost to extend my previous job’s health insurance for just one lousy month. Isn’t in fun living in a casino capitalist economy?
To give thanks for my good fortune I wanted to write a fairly short diary reminding everyone that a lot of people are not so fortunate. And you’re downright fucked if you’re out of work and live in one of the fourteen states in orange above.
Why? Because those fourteen states have legislatures and governors that have stubbornly refused to accept the Medicaid expansion provided for in the Affordable Care Act. Now I for one have been fairly critical of the ACA and absolutely feel we need single payer healthcare in this country. But the fact remains that the ACA was a lot better than what we had before but only when the states will let it be.
In those 14 states which, coincidentally, are most of the old Confederacy plus a few in the Plains, you can only get Medicaid if you make less than 40% of the Federal Poverty Level. You don’t qualify for subsidies to buy exchange plans until you hit 100% of the Federal Poverty Level. And if you are a single adult with no children, you usually have no way to get Medicaid at all. This is called the “coverage gap which is illustrated here:
BEFORE the covid19 pandemic there were already 2.3 million people in that gap with more than a million of them in covid19 hot spots of Texas and Florida. That was before a record 3.3 million Americans filled unemployment claims having just lost their jobs in a single week. How many more will be filing for unemployment this week? And how many others are simply unable to file for unemployment because they are classified as independent contractors or rely mostly on tips, cash or under the table income to make a living?
Sadly, in our fractured and broken health system when you lose your job you also lose your insurance AND the income you would have needed to pay for insurance. The Medicaid expansion will cover a lot of people in those states that have it. But it’s absolutely criminal that in the middle of a healthcare AND economic crisis we still have 14 state governments refusing to do the right thing.
In a single payer system the millions of Americans who just lost their jobs would still have full healthcare coverage. They wouldn’t be scrambling for advice on how to get covered quickly at a time when they maybe can’t even make this month’s rent. Even in the states that have fully expanded Medicaid, applying for benefits isn’t easy, especially when millions of others are doing the exact same thing. And that promised stimulus check will barely cover one month’s insurance for those who want to extend their employer’s coverage. And that’s if you want to choose between health insurance and rent.
That millions of people have to scramble to find health insurance in the middle of a crisis is unacceptable. That fourteen states refuse to give people in that situation one of the only affordable options is criminal.