The Affordable Care Act (ACA) seeks to fill the longstanding gap in Medicaid coverage for low-income adults by expanding eligibility to a minimum floor of 138% of the federal poverty level (FPL), or $24,344 for a family of 3 in 2012. However, the Supreme Court ruling on the ACA effectively made implementation of the Medicaid expansion a state choice. If a state does not expand Medicaid, poor uninsured adults in that state will not gain access to a new affordable coverage option and will likely remain uninsured. To provide insight into the potential impacts of expanding Medicaid, this report highlights the experiences of adults in California, Connecticut, Minnesota, and the District of Columbia, which all have already expanded Medicaid to adults. Based on focus groups and interviews with previously uninsured adults who recently gained Medicaid coverage in these states, it examines the personal impacts gaining coverage had on individuals’ health, finances, employment, and overall wellbeing.
Obtaining Medicaid coverage enabled participants to access care for unmet needs and preventive care, which had positive impacts on their health and other areas of their lives. Gaining Medicaid coverage provided a significant sense of relief to participants. They used words like “secure” and “grateful” to describe what it feels like to have Medicaid coverage. Many noted that obtaining coverage enabled them to get medications and needed care they had gone without while uninsured. In addition, many obtained a physical after enrolling in coverage and are hoping to follow up with other preventive services, such as colonoscopies and well-woman exams. For some participants, physicals led to the diagnosis of conditions such as diabetes, asthma, and anemia, for which they are now receiving care. Participants also noted that having Medicaid enables them to seek care from a physician early rather than waiting until conditions worsen or using the emergency room. Many participants have established a relationship with a primary care provider and say they appreciate having a doctor who can get to know them and coordinate their care. Participants also emphasized that, by enabling them to get their health needs met, obtaining Medicaid coverage facilitated their ability to take charge of their lives and focus on other goals and priorities, such as employment.
I know none of you are surprised that access to health care had a “positive impact” on….health, but conservatives are in a persistent state of denial on this, so I thought it was worthwhile to present “findings” taken from actual people.
In order to justify his continued refusal to expand his state’s Medicaid program — which would extend health coverage to an additional 200,000 low-income Mississippians — the governor explained that poor people don’t need a “massive new program” when they can simply visit an emergency room to receive care:
BRYANT: There is no one who doesn’t have health care in America. No one. Now, they may end up going to the emergency room.
During the presidential election, GOP candidate Mitt Romney claimed that “we do provide care for people who don’t have insurance” by picking them up in ambulance and taking them to the hospital.
And here’s Bush:
“The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America,” he said. “After all, you just go to an emergency room.”
I have a larger question, though. Republicans and media insist on discussing the health care law in discrete chunks. The poor. Medicare. Large business. Small business. But that isn’t how it works, and that isn’t how people will experience it. The goal is universal coverage. It’s a system. For every libertarian CEO who owns a large business and bitches about the health care law, there will be three small business owners who benefit from the health care law. Some of them may even be able to compete with the large business owner. We really do live in communities. Really. Whole Foods isn’t out there on an island.
How do GOP governors justify this, for example?
If a state does not expand Medicaid, poor uninsured adults in that state will not gain access to a new affordable coverage option and will likely remain uninsured.
If one adult makes 150% of poverty level they receive a federal subsidy and have health insurance, but if another makes 120% of poverty they are completely shut out? Even for conservatives with their cavalier tossing off of “send them to the emergency room!” this seems cruel and unfair.