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The Blue & Gray Press | May 26, 2018

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Virginians would benefit from Medicaid expansion


Last semester, I attended a City Council meeting to speak on behalf of Medicaid expansion in the Commonwealth of Virginia. It is rather unfortunate that I even needed to take time to encourage my local government to lobby on behalf of Medicaid expansion, but it is even more unfortunate that our state legislature has not already opted for this crucial aspect of the Patient Protection and Affordable Care Act.

The United States is the only country in the industrialized world that does not provide some sort of universal health coverage for all of its citizens. Instead, we have private health insurance corporations that are motivated by profit. We are controlled by a cartel. As Merriam-Webster defines it, a cartel is “a group of businesses that agree to fix prices so they all will make more money.”

They pour billions into lobbying Congress, padding their CEO’s pockets and paying legal fees to fight against providing medical coverage at all. Before the ACA, only about 50 percent of the money citizens paid in monthly premiums went to providing actual care.

The real snub is the cost. This system costs more than any other system in the world. As taxpayers, citizens pay the most and get the least amount of care. The U.S. system consumes 18 percent of our GDP because it is subsidized.

In order to keep the system affordable, the government pays insurance companies to keep premiums low for those who have insurance. The motivation for profit provides no incentive for private health insurance companies to keep at-risk patients insured, which would then cause pools of insured people to shrink and premiums to skyrocket.

In order to combat this tremendous problem, President Barack Obama worked with Congress to pass the ACA in 2010. Among other things, the ACA created health insurance exchanges for people to keep premiums low and forced the private insurance companies to provide coverage equally, regardless of sex or pre-existing conditions. In addition it could actually provide coverage –80 percent of premiums would go toward care, rather than 50 percent.

However, the real teeth in the ACA is the provision for Medicaid expansion, which would cover a huge swath of Americans who live just above the poverty line, around $25,000 for a family of four, but do not make enough to be able to afford private insurance. The ACA expands Medicaid to cover all Americans even those that fall into that gap.

I am one of those Americans. My parents are uninsured, so my only access to health insurance is through Medicaid, but because the Virginia state government opted not to expand Medicaid, I remain uninsured, along with 55 percent of other Virginians.

This is mind-boggling, because Medicaid expansion is fully funded by the federal government for three years, and 90 percent is funded by the federal government until 2022. If every state expanded Medicaid under the ACA, 48 percent of Americans who are currently uninsured would have insurance.

Of the 23 states that opted out of Medicaid expansion, 11 would see a reduction in the total number of uninsured. States already spend about 20 percent of their budgets on Medicaid, and this expansion would only add about 2 percent, while saving states billions of dollars in unpaid hospital bills every year. There is no logical argument for why we should not expand Medicaid. So what is our state government waiting for? We need to stop allowing ourselves to be bullied by the health insurance cartel that controls almost one-fifth of the U.S. economy and begin claiming a system that works for us – all of us.