Medicaid Expansion Under the Affordable Care Act is the Best Long-term Choice for All States

Abstract

A study run by the Center on Budget and Policy Priorities found that 19,200 lives were saved by Medicaid expansion under the Affordable Care Act. The same study estimates 15,600 lives were needlessly lost in states that did not expand. Healthcare for uninsured individuals can be cost-prohibitive. This is especially true with preventative care. Chronic illnesses are more easily treated if caught early. In fact, some illnesses, like some types of diabetes, can be prevented with proper early interventions. Other chronic illnesses, like asthma, can end in acute complications if not properly monitored. Access to healthcare for early detection, intervention, and monitoring saves lives. Kenneth King of Birmingham, Alabama is a great example of those losing out because he lives in a state that has not passed a Medicaid expansion bill. At 57 years old, he makes enough money to get by and rent an apartment but not enough for insurance premium expenses. After having emergency heart surgery, he found himself buried in bills he could not pay. He also must decide which of his two prescriptions to take because he cannot afford both that his doctor prescribed him. King makes too much money for traditional Medicaid but lives in a state unlikely to expand, so he is unsure when or if he will get coverage. Not taking his heart medicine can lead to any number of problems for him down the line.

Following doctor's orders and protecting one's life should not be a financial decision. All states should expand Medicaid under the Affordable Care Act because they can take advantage of higher matching funds from the federal government. This expansion population will obtain better access to preventative care, allowing for lower costs and higher quality of care to those state residents in the long term.

This paper will discuss the background of the ACA. The legislation was difficult to pass in any form but by focusing on access to healthcare over cost, an agreement was struck. There are several provisions driving toward greater access, but the Medicaid expansion is a very important part of the goal. To make sure the expansion works, Congress offered a great deal of financial incentives to states willing to expand Medicaid. As this paper will discuss, research shows that state decisions regarding Medicaid expansion (positive and negative) tracks along political party lines. Those states that have expanded, despite politics, have not spent extra money in their budgets. The paper will then discuss the need for preventative care and the lack of overall healthcare coverage on future illness burden. It will also acknowledge the counterpoints to expansion. Among the most cited counterpoint, that state healthcare budgets will soar when the federal matching funds revert to current Medicaid matching levels. While this is a valid concern, the risks can be mitigated. The paper will show that state residents will be better off if Medicaid expansion becomes universal.