Movement challeges states’ deadly decision to opt out of Medicaid expansion

A January posting on the Health Affairs Blog estimates that thousands of people will die because political leaders in 25 states have decided not to expand Medicaid coverage to more people. In Florida, that decision has already taken the life of one hard working woman.

Think Progress reports that Charlene Dill, who lived and worked in Florida, died on the job as a result of a known and untreated heart condition.

Dill couldn’t afford health insurance even though she worked three part-time jobs.

She also could not afford to pay for the treatment herself.

Had Florida officials decided to expand Medicaid eligibility, Dill would have been eligible for coverage and could have received medical treatment before her heart condition killed her.

But political leaders in Florida and 24 other states have decided to opt out of expanding Medicaid eligibility even though the federal government will pay 100 percent of the cost of the expansion for three years and then 90 percent of the cost.

As a result, health care coverage will not be expanded to nearly 8 million hard-working, low-wage workers like Dill.

Because state leaders in these opt out states, chose not to expand Medicaid eligibility, reports Health Affairs, an estimated 422,000 people with diabetes will not receive medicine to treat their illness, 195,500 women ages 50-64 will not receive mammograms, and 443,600 will not have pap smears taken.

The lack of access to treatment for diabetes and other chronic illnesses and the lack of access to preventive measures to stave off deadly illnesses, according to Health Affairs, will kill between 7,100 and 17,100 low-income workers in these opt out states.

The decision not to expand Medicaid eligibility will affect many more than the workers who can’t get health care coverage.

According to a study by the Commonwealth Fund, states that opt out of Medicaid expansion will lose tens of billions of dollars in federal funds between 2014 and 2022.

This is money that would have been spent locally and created thousands of jobs.

The biggest loser will be Texas, which stands to lose $9.2 billion. Other states that will take big hits are Florida, $5 billion; Georgia, $2.9 billion; and Virginia, $2.8 billion.

“The Medicaid expansion presents an opportunity for states to bring in new federal dollars, in addition to providing critical health coverage for their low-income residents,” said Sherry Glied, one of the Commonwealth study’s authors. “No state that declines to expand the program is going to be fiscally better off because of it. Their tax dollars will be used to support a program from which nobody in their state will benefit.”

Because the benefits of expanding Medicaid are so obvious, grassroots movements to expand Medicaid coverage have sprouted up in several states including North Carolina, Florida, Tennessee, Mississippi, and Georgia.

In Texas, a coalition of more than 40 groups has launched the Texas Left Me Out campaign to build support for expanding Medicaid eligibility in the state.

The coalition, Cover Texas Now, includes health care providers and advocates, disability advocates, community groups such as the Texas Organizing Project, public policy advocacy groups such as the Center for Public Policy Priorities, religious groups such as Impact Texas, and the Texas AFL-CIO.

In a February letter to lawmakers, organizers of the campaign said that Texas has more than 6 million residents who lack health insurance, the highest in the US.

Most uninsured Texans are low-income workers who can’t afford health insurance premiums.

The letter goes to explain that the federal Affordable Care Act (ACA) provides a vehicle for insuring many Texans who otherwise couldn’t afford health care.

Under ACA, some low-income workers are eligible for federal subsidies that will make health insurance affordable for them.

But other low-income workers like Irma Aguilar of San Antonio won’t qualify for the subsidies.

Aguilar, a 28-year old mother of four, works as an assistant manager for a local Pizza Hut. Her pay is too low to qualify for federal subsidies.

She would have been eligible for Medicaid had Texas taken the federal money to expand Medicaid, but for now she remains uninsured and cannot afford treatment for a bulging disk in her neck or her high blood pressure.

The February letter asks lawmakers who hear from constituents like Aguilar who have been left out of health care coverage because of the state’s decision to forgo Medicaid expansion to refer them to the Texas Left Me Out website where they can tell their individual stories about how the state’s decision has affected them.

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