This week Beth and Kelly celebrate the one year anniversary of the non-repeal of Obamacare (aka, the Patient Protection and Affordable Care Act). There have been many years worth of fake news surrounding the ACA, but it's lack of clarity around certain aspects of Obamacare that continue to put the plan in jeopardy.
Let’s Talk about the New Report
The recent study from George Mason University found that Bernie Sanders Medicare for All plan would cost the US government 32.6 trillion over the next 10 years; however, the Mercatus report also found the total amount spent on healthcare in the US by the federal government, states, businesses, and individuals — would come in below current projections under this plan. This means that while the federal costs would increase, the overall costs of healthcare would decrease by $2 trillion over the same decade. On top of this decrease in costs, the new proposal would also cover an additional 30 million citizens.
Time it would take you to count to:
1 Million - 11 days, 13 hours, 46 minutes, and 40 seconds
1 Billion - 31 years
1 Trillion - 31,709.79 years
So, not an insignificant amount.
One challenge of the ACA is that many states (presently 17) have not accepted Medicaid expansion in their state, which places an undue burden on the population that does need insurance but cannot afford it.
Before we talk about that, here's a handy chart to show you what Medicaid and Medicare are and how they are different:
To break it down in the simplest of terms, Medicare is a federal program that provides health coverage if you are 65 and older or have a severe disability, no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income.
Kellyanne doesn't seem to understand that many Americans who are covered by Medicaid ARE already working, often in lower-paying jobs that may not have health insurance benefits, according to a report by the Kaiser Family Foundation, cited by CNBC. According to the foundation, “Among Medicaid adults (including parents and childless adults — the group targeted by the Medicaid expansion [under Obamacare]) nearly 8 in 10 live in working families, and a majority are working themselves.”
So, what is the Medicaid expansion?
Medicaid expansion under the ACA extended eligibility to nearly all low-income individuals with incomes at or below 138 percent of poverty ($28,676 for a family of three in 2018). Medicaid eligibility for adults in states that did not expand their programs is very limited: the median income limit for parents in these states is just 43% of poverty rate, or an annual income of $8,935 a year for a family of three in 2018! In nearly all states without expansion childless adults remain ineligible.
According to the Kaiser Family Foundation, a non-profit organization focusing on national health issues, "About 2.2 million uninsured people nationally fall into the “coverage gap” – too poor to qualify for tax credits but ineligible for Medicaid because their state did not expand under #ACA."
Medicaid expansion has been adopted in 34 states. 3 more are considering expansion and 14 are left with no expansion.
A 2017 study published in the American Journal on Health Economics found:
“Medicaid expansion is associated with statistically significant lower premiums for gold plans (17 percent) and the second-lowest-priced silver plans (25 percent). I also find evidence that Medicaid expansion decreases average premiums for other silver and bronze plans by about 16 and 13 percent, respectively. Overall, these findings are consistent with lower expected medical cost after Medicaid expansion removed certain low-income individuals from the marketplace risk pools.”
This refusal to expand Medicaid also affects hospitals who rely on Disproportionate Share Hospital program to partially reimburse them for people who cannot afford to pay for health care. These federal funds were cut during the ACA process, because more people were meant to be insured through the ACA marketplace. Those states that did not expand have left these hospitals without relief from unpaid bills, thus insuring the cost of care goes up for everyone else to compensate for losses.
These 10 essential health benefits (EHBs) were the foundation of the ACA, but of course the right's loudest banshee, Ann Coulter takes issue with insurance covering things that will never affect her - meaning she literally doesn't understand how insurance works. While this green eyed monster hates the idea of providing pre and post-natal care, a recent study from the American Journal on Public Health say:
"Our study findings suggest that Medicaid expansion by 31 states and Washington, DC, was associated with a greater decline in infant mortality rate, particularly in African American infants, than was seen in non–Medicaid expansion states."
So, while it is often the right wing states that refuse expansion, this very contrarian gesture goes against their core pro-life ideals. What a conundrum, if only there was a way to fix that!
Beth’s Jam of the Week: A Little Honey by Nathaniel Rateliff & The Night Sweats
Spread jam, not lies.