Monday, May 19, 2014

Why Texas (And Other States) Should Expand Medicaid

(The Medicaid image above is from the website of Doctors for America.)

As you probably know by now, the Republican elected officials in about half of the states have prevented those states from taking advantage of the Affordable Care Act (Obamacare) and expanded Medicaid. Instead, those states still operate under their old Medicaid law and qualifications -- thus denying millions of poor people the health insurance they need. In Texas alone, this means more than 1.5 million people are denied health insurance.

I am convinced that there is no good reason for this failure to expand Medicaid. The denial is purely political -- with the Republicans trying to sabotage Obamacare, and deny the president credit for improving the health care system in the United States. They have come up with numerous excuses for this failure to expand, but most have already been exposed as just not being true.

Instead of once again trying to expose these GOP lies, I would like to be more positive -- and give a few reasons why I think it would be good for everyone in every state if Medicaid was expanded in all states. Here are the reasons I came up with:

* Expanding Medicaid would save the lives of thousands of people every year. It has been estimated that between 7,000 and 17,000 people will die because they have no access to health insurance (and therefore no access to the preventative care that could have saved their lives).

* Refusing to expand Medicaid does not save state residents any federal tax money. Residents in states that refuse to expand Medicaid are paying for that expansion, even though they are getting nothing for that money. Shouldn't these residents be getting what they are paying for?

* Expanding Medicaid will help to keep local taxes low. Currently public hospitals have their emergency rooms flooded with poor people who see that as their only access to health care. This care must be paid for, since the hospitals cannot afford to give free care -- and for public hospitals, it falls to the local taxpayers to pay for that care thru higher local taxes. If these poor people had Medicaid insurance, they could afford to go to a doctor instead of the emergency room -- and when they did need the emergency room, it would be paid for. There would be no need for higher local taxes to pay for this care.

* Expanding Medicaid will help keep hospital costs and private insurance premiums low. Private hospitals must also provide emergency room care to the poor, but they can't go to the taxpayers to pay for that care. Their only choice is to increase the costs of their services for all customers -- and this increased cost not only means more in co-pays for patients, but an increase in insurance premiums as the insurance companies pay those higher patient costs.

* Expanding Medicaid will boost the economy of the state. The money spent on health care through Medicaid will circulate through the economy several times, increasing sales and profits for businesses, creating new jobs, and increasing the amount of money raised by sales taxes (which could be used to help pay for Medicaid expansion after the initial 10 years of 100% federal coverage are up, and the state assumes a 10% share of funding Medicaid).

* The productivity of low-wage workers would be enhanced, since they would be healthier due to their having access to preventative care. This would help both workers and employers.

* Many of the uninsured poor work full-time at difficult jobs -- but they don't make enough to buy private insurance, and make too much to get Medicaid in states that didn't expand Medicaid. It's bad enough that full-time workers earn a wage that keeps them in poverty -- but it's unconscionable that they must also be forced to do without health care.

* It's just the right thing to do. Access to decent and affordable health care should be a right of all human beings -- and denying access to health care to the poor is just mean and hard-hearted. As all decent people know, we are our brother's keeper.

Refusing to expand Medicaid makes no sense. It's is lousy social policy, stupid economic policy, and mean-spirited political policy. Other developed nations provide all of their citizens, whether rich or poor, with decent health care -- and there is no legitimate reason why the United States, the richest country in the world, cannot do the same.

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