Ashvegas Op-Ed: Expanding Medicaid makes moral and financial sense

Jason Sandford

Jason Sandford is a reporter, writer, blogger and photographer interested in all things Asheville.

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By Leslie Boyd

As we come off the high of making the goal of more than 7 million enrollees for health insurance in the federal-run Marketplaces, we need to know we still have a ways to go before everyone has access to affordable, quality health care.

Now, the 7.1 million (and counting) who enrolled were only from the Marketplaces operated by the federal government. The states that built their own Marketplaces enrolled a couple million more, and another 3 million young adults remain covered under their parents’ plans. That’s not to mention the 3 million people who gained coverage when their states expanded Medicaid.

But nearly half the states have refused to expand Medicaid, the federal insurance plan for people in poverty. In those states, 5 million people remain without access to health care, and an estimated 17,000 of them will die this year.

I can tell you what that means to a family since I lost my son six years ago because he couldn’t get insurance and without it, he couldn’t get the care he needed to save his life. My family will never recover from his loss. Now multiply that by 17,000 families and try to imagine the grief.

I can also tell you what it’s like to help someone sign up for insurance who has been ineligible either because of cost or because of a pre-existing condition. I have seen people weep when they realize they can afford insurance and they can’t be turned down because they had cancer years ago or they have mild asthma or a mental illness.

People who have insurance are able to manage chronic illnesses and live longer, healthier lives. And it’s a lot less expensive to manage chronic illness than it is to let it go until a person is in crisis – both in financial and moral terms. I know a number of people who refused to sign up because they refused to go to a government web site or because they think the law is “Socialist.”

Let me define Socialist: It means owned and operated by the government, as in Great Britain, where health outcomes are far better than ours.

Our new “system” is nothing more than some regulation of a private system and financial assistance for people who need it. We buy from private insurance companies, not from the government. Medicare, the system for people over age 65 and some people with disability, is a single-payer system, where you go to the provider of your choice and the government foots the bill. We pay for it through taxes, and it is one of the most efficient – and most popular – systems in the world.

Expanding Medicaid makes moral sense, but it also makes financial sense.

States that don’t expand Medicaid are losing billions in federal dollars. The Affordable Care Act was written assuming that all states would expand Medicaid, so the money that was going to hospitals and clinics go help pay for what’s called indigent care now is going into the Medicaid expansion pool and is headed for the states that expanded Medicaid.

We still pay into that pot of money, but we get nothing back. Not a penny. That money goes to states like Kentucky, Arizona, Michigan and Ohio. The hospitals there aren’t losing money hand over fist the way we are here in North Carolina. Mission Health System alone will lose about $15 million. We can’t sustain that for very long.

Some will blame it on “Obamacare” when hospitals and clinics close, but the real blame rests with the legislatures that voted not to accept Medicaid.

So who are the real “death panels?” The legislators who oppose health reform. When they vote to reject money for health care for everyone, they vote to allow people to die unnecessarily. That is not “pro-life.” That is the very definition of a death panel in my book.

Leslie Boyd is president of the nonprofit WNC Health Advocates.