Today, the Huffington Post reported that important expansions of Medicaid hinge on several gubernatorial races across the country. About 5 million Americans are too poor to afford coverage under the Affordable Care Act, yet do not qualify for Medicaid. Huffington Post asserts that this gap is due to actions by the Supreme Court and Republican politicians in 23 states, but I am confident the problem is more complex than that.
According to today’s HP article (link above), “Tuesday’s election may have life-altering consequences on the issue of Obamacare. At least six states have close gubernatorial elections featuring an incumbent Republican who has resisted expanding Medicaid — an option states were given by the Supreme Court in 2012. Avalere Health, a strategic advisory services firm, has estimated that in Florida, Georgia, Kansas, Maine, and Wisconsin, almost 2.3 million people have been left uninsured because of that resistance.”
“GOP governors and legislators say they base their opposition to Medicaid expansion on the potential cost to their state, despite the availability of generous federal funding. The result of their refusal to approve expansion are clear: The uninsured rate has declined much more in states that adopted the policy than in those that haven’t, surveys show.”
In Maine, Governor Paul LePage (R) – who blocked Medicaid expansion legislation five times – rolled back Medicaid coverage in 2014, “taking away benefits from tens of thousands and denying it to people … who might have qualified under the state’s old rules.”
Huffington Post continues, “In fact, the Affordable Care Act intended the Medicaid expansion to be national. But the Supreme Court ruling and resistance from Republican policymakers have shortened its reach, leaving the poorest uninsured Americans with no coverage. Because Congress didn’t anticipate Medicaid wouldn’t be available to everyone with earnings below poverty, tax credits for private insurance only are available to people who make more than that, which is about $11,500 for a single person.”
Medicaid must help the poor. If out-dated guidelines prevent truly poor people from access, those guidelines must be changed. This can be called “expansion,” or understood as a return to the fundamental principles upon which the program was founded. A country so great as ours may not tolerate keeping care from the sick and the poor. Hopefully, today is the day that states blocking the expansion of Medicaid step onto the right side of history.