Medicaid Expansion (Or Not)

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A Good Day To Advocate for Better Healthcare

If there are subjects you’d like to see or improvements made, please let me know using the comment button below. One item in work is how some medical networks are choosing to not accept patients from Medicare Advantage plans because these commercial insurers are driving down what they will pay providers to keep their profits up. More on this later.

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Medicaid Expansion

Medicaid is a joint federal/state project to provide health insurance to the nation’s poor. Right now (Oct 2023) there are about 87,289,666 people on Medicaid. That’s about 25% of us. Originally, it applied to those whose incomes were at the Federal Poverty Limit (FPL). Here is a link to the US government’s overview of Medicaid for reference.

If you’re interested in how each state and D.C. implement Medicaid, you can check this interactive map at the Medicaid website. I recommend this for my friends at OnePayerStates.

The amount that states pay for Medicaid varies greatly. It is never more than half and for many patients it can be as low as 10%. States are allowed to tax certain medical services to help recover their portion so as not to disturb their general budgets and many do.

Under the affordable Care Act States were allowed to provide Medicaid to more people by increasing the income limit up to 1.38 x the Federal Poverty Limit. That’s $34,307 for a family of three. However, states administer the program and can add additional requirements, like employment. States also can also decide not to cover certain prescriptions, thus sentencing some to death. Check the introduction to T.R. Reid’s book, The Healing of America.

States worried that they could not afford to pay for those extra people who would be added in the expansion but have found that it is well within their capability. The expansion of Medicaid moved certain patients into new categories for which the federal government paid 90% of the cost thus saving the states significant money. Additionally, having more people needing health services helps to keep facilities open and increases the tax base since more people are needed to care for those new patients. It is complicated but the Commonwealth Foundation found that states that expanded Medicaid were covering far more people at no additional impact to their states budget. Here is that report.

Some states are really proactive because they know a healthy population is good for the whole population. I’ve seen state prison systems signing up those scheduled for release with Medicaid so there is no gap in medications or treatments. Good choice.

The most recent state to expand Medicaid is North Carolina. It was a 10 year battle. The Medicaid expansion went into effect in North Carolina on December 1, 2023, making approximately 600,000 North Carolinians between the ages of 19-64 eligible for full Medicaid coverage. As of February 1, 2024, more than 346,000 North Carolina residents have enrolled in expanded Medicaid. 

Georgia began a partial Medicaid expansion in July 2023 called Georgia Pathways to Coverage. This program covers adults with household incomes below the poverty level who work at least 80 hours per month. Coverage takes effect the month after enrollment is approved.  As of October 2023, Georgia has 2,297,930 Georgians covered by Medicaid/CHIP. If the state fully expanded Medicaid, 434,000 additional Georgians would be covered. According to National Public Radio today, they have added 2,300. Shande.

We can speculate why some states don’t want to expand. It isn’t the money because they can look to the other 40 and examine the effect or the Commonwealth Fund report. It could be economic or racial eugenics (ugh). It could be a complete misunderstanding of how economies work. Increased demand will bring an increase in supply to meet the demand. If you think resources are fixed and do not grow, then you do everything possible to protect what you have instead of planning to provide healthcare to everyone.

The answer, of course, is universal healthcare that covers all of us and does it for far less than we pay now, according to the Congressional Budget Office - check the chart on page 12).

It’s not that Medicaid is bad but it is a complicated band-aid serving 25% of Americans and isn’t a solution. It is more than 50 different ways to provide coverage and is different state to state. We need a plan that works for all of us wherever we are.

ACTION

Let’s remind our representatives and senators in Congress that we want Universal Healthcare. Their contact info is in the RESOURCES section. or you can use RESISTBOT to send the email below. Just text SIGN PUURGR to 50409.

“I am your constituent and I want you to know that Medicaid serves 25% of Americans. But not all the same way. Drug formularies and coverages can vary from place to place. The expansion of Medicaid should have helped but there are still 10 states that won’t cover the additional people. Even though Commonwealth Fund analysis shows that expansion does not affect state budgets. You can read that report here, https://www.commonwealthfund.org/publications/issue-briefs/2020/may/impact-medicaid-expansion-states-budgets.

All of this and we still have at least 25,000,000 with no health insurance at all.

There is a solution and it is in your hands. It is Universal Healthcare, like HR 3421, the vastly improved Medicare for All Act. I want you to make the effort to make sure no American is without healthcare. Enact it for your constituents.”

COVID-19

We discussed a South Korean study a few weeks ago that found those who were well vaccinated were better able to fend off new variants of the disease even when those variants were not present when their vaccines were developed. Now a new study based on 4,605 participants in the Michigan COVID-19 Recovery Surveillance Study shows that the prevalence of long COVID symptoms at 30 and 90 days post-infection was 43% to 58% lower among adults who were fully vaccinated before infection. The study appeared yesterday in the Annals of Epidemiology. The 30- and 90-day time frames were meant to compare two different definitions of long COVID.

Please keep your vaccinations up to date.

RESOURCES

Healthcare Advocacy (Us)

Website

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Find My Elected Officials

Contact the White House  https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

• By phone: (202) 224-3121

• By email: democracy.io

• https://www.usa.gov/elected-officials

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Organizations to Contact

National Nurses United Medicare4All

Physicians for a National Health Program

One Payer States

Healthcare Now

Reproductive Health

NARAL - Pro Choice America

Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion

Planned Parenthood

Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.

United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.

Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.

If you need financial help with an abortion try abortionfunds.org

Claims Denials and Appeals & What to Do

Appeal a Healthcare Decision

Appeal/Negotiate a Hospital Bill

Disinformation Management

Cybersecurity Infrastructure Security Agency

Library of Advice

Specific Advice

Save Democracy

Chop Wood, Carry Water by Jessica Cravens

RESISTBOT

Link to the RESISTBOT site to learn more

Link to Chop Wood, Carry Water RESISTBOT write up

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