I drove my mother to Midwest Eye Centers three times last July. Three months earlier, she suffered from partial posterior vitreous detachment. This isn’t life-threatening, but it requires regular screenings to avoid serious nerve breakage that would require costly surgery. Medicaid notified her on the first of July that this would be last month she was eligible for insurance, because of cuts to the Illinois healthcare budget. We made sure to take advantage of her coverage that month. I was afraid.
We’ve got a problem with healthcare. This is not just a problem for my mom, but for your moms too, and for your professor, and for the homeless men in Harvard Square. There are 49 million uninsured people in this country, and 25 percent of them are parents. The average premium for a family is $15,073 a year and rising. Some people, yes, even children with cancer, used to be denied coverage just a few years ago.
But beginning in 2010, when the Affordable Care Act was passed, many of these uninsured people began seeing expanded coverage. Three million previously-uninsured Americans under age 26 now have coverage, as well as thousands of children with pre-existing conditions. Beginning in 2014, no one can be denied coverage due to health problems. Other new benefits include free preventative services like vaccinations, check-ups for children, and blood pressure and cholesterol tests for people with insurance.
Perhaps most importantly, the ACA can expand coverage to 24 million Americans in 2014 through Medicaid expansion. This expansion will be covered by federal dollars until 2020, when the states will have to contribute 10 percent of the costs. However, several Republican governors have promised to reject federal dollars to expand their Medicaid programs. If only their constituents knew that their leaders were sacrificing their health to protect their political reputations, a few of these bleeding red states might turn blue.
Medicaid is a state-run program and each state has different eligibility rules. In Texas, working parents must make below 26 percent of the Federal poverty level ($23,050 for a family of four) to qualify for Medicaid. Even a single mother with three children who works as a waitress and makes $15,000 a year is not eligible. In Texas and 26 other states, mostly Republican voting, childless adults cannot receive Medicaid at all.
Other states, like Governor Romney’s home state of Massachusetts, offer Medicaid for adults earning up to 133 percent of the poverty level. As it happens, Massachusetts has the lowest uninsured rate in the country. The ACA makes every state like Massachusetts: Citizens earning less than 133 percent of the poverty line will qualify for Medicaid. (However, 23 million illegal immigrants will still not be eligible.)
To pay for this expansion of Medicaid, the Federal Government will pay 100 percent of the costs to expand care until 2019, when it will pay 90 percent. The Congressional Budget Office predicts that this expansion will cost $930 billion over the next 10 years. Some states that will benefit the most from this changed rule are Alabama, Nebraska, South Carolina, and Mississippi.
Ironically, all of these states sued to defeat the act.
As a result of the June Supreme Court ruling, these states have the right to accept or reject funds to expand Medicaid. Already, governors in Florida, South Carolina, and Louisiana have vowed to refuse them.
Their reasoning? Money. These states’ governors whistled the same old tired tune: that Obama is spending at the wrong time. What they fail to realize is that the expansion only accounts for 2 percent of the federal budget, and only 3 percent of the health budget. (On the other hand, 20 percent of the budget goes to defense spending.)
In fact, the ACA has measures in place to actually reduce the deficit, lower health care costs, and improve the economy. In 2014, the so-called “health care exchanges” will open. The exchanges are regulated, online mini-malls that allow customers to compare insurance plans easily. This transparency will increase competition and lower premiums. Customers between 133-400 percent of the poverty line can even obtain tax credits to help pay these premiums. Benefits of the ACA, including administrative savings, a sharp reduction in unpaid hospital bills, and increased taxes on drug companies and individuals making more than $250,000, are actually predicted to lower the federal deficit by $124 billion over the next 10 years.
The Affordable Care Act is effective, and the federal money for Medicaid expansion is too good to refuse. Republicans know this, but they will still be sure to call the law ineffective, socialistic, and economically suicidal in an attempt to convince their constituents that this antidote is poison. By doing so, these Republican politicians will stand between millions of middle-class patients and their doctors.
Michael F. Musharbash ’16 lives in Holworthy Hall.