Republicans want to limit Medicaid, kill Obamacare… and hurt people like me
For most of my adult life I was taking the same gamble as so many young Americans before the Affordable Care Act: I was uninsured. As my 40thbirthday crept up on me a few years back, I figured that, if you are only going to have health insurance for one half of your life, it should be the second half and not the first. It just so happened that my generation was in exactly the right age demographic to benefit greatly from the onset of Obamacare.
Like millions of others, I braved the initially faulty website and eventually got directed to my New York state exchange. I typed in my name, address, social security number and all the other relevant personal information. And I discovered to my pleasant – though sobering – surprise that I was eligible for Medicaid, so low is my income as a freelance journalist and photographer. So I signed up immediately and received my card in the mail a few weeks later.
Governor Rick Scott of Florida announced on 16 April that he is going to sue the Obama administration for trying to expand Medicaid in his state, despite up to 800,000 people being potentially eligible. Florida is behind only Texas leading the nation in the number of uninsured. In both states, without either voluntary state-run health insurance exchanges or proposed Medicaid expansion, the Affordable Care Act has failed to make enough of an impact. Where you live now determines how you will or won’t get health care, every bit as much or more as your profession and income.
The US supreme court will soon decide in the King vs Burwell case if the federal government can run its national subsidized exchange in states without their own exchanges. If the upshot is that it cannot, up to 8 million people in the 36 states without exchanges could lose their insurance. In the short term, I would still have Medicaid in New York. But the entire edifice of healthcare would be at risk of collapse throughout the country.
When it comes to healthcare, two unequal Americas are emerging. It may soon not be an exaggeration to encourage people to flee states that opt out. Ironically, that would hurt the economies of states like Florida, while states like New York would gain. The increase in funding for Medicaid would be more than offset by the increase in productivity and healthy tax-paying workers.
The money people like me save in out of pocket expenses is a measurable resource that we are spending into the larger economy. By paying attention to preventive care and routine visits, I hope to catch future ailments early rather than defer trips to the doctor, as I had done before for decades. Not only will I probably have a lower life time medical bill than if I had received care only in catastrophic circumstances, but I will also have more years as a healthier and more productive worker.
But this is only the case because I am the resident of a state that has set up its own exchange, accepted the Medicaid expansion and implemented the spirit as well as the letter of the law. If I were living in Florida, I would fall into the coverage gap and still be uninsured. Or, since my aging hasn’t stopped of course, I would have to make the difficult choice of spending scarce dollars on healthcare and consequently have much less for anything else. Those choices that people in poverty or close to poverty have to make are excruciating. Paying for insurance might mean not being able to afford transportation or a place to live. Faced with this grim reality, health insurance is often sacrificed – until, inevitably, it is too late.
Governors like Rick Scott wilfully turning down coverage for their citizens and Republican litigants continuing to pursue lawsuits up to the US supreme court are doing so without any serious proposals on the table to replace the Affordable Care Act if it is struck down. Their only alternative would be a return to what we had before, which was nothing – and failing. That’s not only disingenuous, but would also be disastrous for us all.
Photo: The progress made with the Affordable Healthcare Act could be undone by the US supreme court.
(From: The Guardian)
