My Turn: Medicaid expansion is growing among red states, and that’s good

For the Monitor
Published: 8/11/2020 6:00:17 AM

I was happy to read the short Associated Press short ain the Aug. 7 Monitor by Ricardo Alonso-Zaldivar titled “Medicaid expansion keeps gaining.”

The article cites Missouri voters approving it last week and Oklahoma doing the same earlier this year.

Under President Donald Trump, seven states have done so, mostly by referendum.

All these states voted for the president who wants to get rid of not only the expansion but Obamacare completely.

Here in New Hampshire, prior to the COVID pan epidemic, we have had a dramatic 50% drop in uninsured patients evaluated in our emergency departments and admitted to our hospitals.

At first this improvement in uncompensated care was due to the Affordable Care Act’s exchange plans and then later grew even more due to Medicaid expansion.

This has meant less cost-shifting by hospitals to other insurances, saving the public money.

When Gov. Sununu and Sen. Jeb Bradley pushed for and won a work requirement on New Hampshire’s Medicaid expansion program, the federal courts rejected this concept as harmful to the purpose of Medicaid.

Also, prior to the rejection work-requirement monitoring here in New Hampshire was not working. If the work requirement had been in place now with the pandemic surging, it would be a disaster.

When Obamacare was passed, Congress removed a public option that would have provided millions of Americans a means to affordable health coverage. Medicaid expansion fortunately was left in the law and now provides health coverage to tens of thousands of Granite Staters during this COVID crisis.

One can argue that in the next few years most of the cost for Medicaid expansion will shift to the states. However, states are learning that with less cost-shifting from hospitals it will be more affordable now and in the future.

In addition, this newly insured population will be, with preventative care, healthier and less costly.

People are smart, and in hard times they need to be smarter than the politicians. They look at their options when the proverbial “bad stuff” hits the fan like the virus and jobs disappearing. They look at Obamacare versus no care. We have waited almost four years for a Republican health plan.

Three weeks ago, President Trump promised to deliver a health plan in two weeks. We’re still waiting. Don’t hold your breath.

The people in Missouri, Oklahoma and the other red states are looking at their options and acting. They’re smart.

(Dr. Nick Perencevich lives in Concord.)


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