Hank Sanders: Reasons to expand Medicaid
by Hank Sanders
Special to The Star
May 12, 2013 | 3106 views |  0 comments | 14 14 recommendations | email to a friend | print
One phrase captures a critical reason why Alabama should agree to bring more people under the umbrella of Medicaid: the economy, the economy, the economy.

If Alabama’s Medicaid program is expanded under the Affordable Care Act, it will bring billions of new dollars to the state. It will infuse our health care industry with money to expand services and create even more jobs.  It will benefit the whole state as the investment spills over into other realms of the economy.

These are great reasons to expand Medicaid. However, I believe there are 250,000 better reasons to expand Medicaid.

I’m talking about 250,000 people, a quarter-million citizens, who go to work every day and do the best they can — but literally cannot afford to get sick.

Without health insurance, they can’t get the preventive care that many of us take for granted. They can’t get routine screenings, which is just as well because they are terrified to find out what those tests might show. Because they don’t have health insurance, they know they are one illness away from economic ruin.

The Medicaid expansion proposed in the national health law won’t eliminate the problem entirely. But it would eliminate the problem for many.

Specifically, it would extend Medicaid coverage to people whose incomes reach up to 138 percent of the federal poverty line. For 2013, the income cutoff would be $15,856 for a single person and $32,499 for a family of four.

Medicaid already covers more than 900,000 Alabamians who qualify because of their age, disability or income.

The proposed expansion would make 500,000 additional people eligible for Medicaid coverage.

They could include the teacher’s aide who helps your child, the fast-food cook who makes your favorite hamburger, the janitor who cleans up your office, or the sales clerk who rings up your purchases. They might be your relative, your neighbor or your friend.

If history is a guide, some of these Alabamians won’t sign up for Medicaid even if they do become eligible. But experts predict that close to 300,000 of them would sign up if given the opportunity.

A UAB study predicted that, with Medicaid expansion, enrollment would grow by 292,000 people, many of them currently among the ranks of the uninsured. Expanding Medicaid, the study estimated, would reduce the number of uninsured Alabamians by 232,000. That’s a decrease of 34 percent.

Republicans who now control Alabama’s state government are standing in the door of Medicaid expansion. Some of them said the state must first reform Medicaid to make it less costly. For better or worse — I hope for the better — state legislators have  passed the reforms championed by the Republicans.

Now, Gov. Robert Bentley should do the right thing and expand the program to serve more Alabamians. The federal government will pay all of the cost initially and will continue to pay at least 90 percent of the cost going forward.

Those who have studied the cost vs. the benefits have concluded that Alabama will overwhelmingly come out a winner in an expansion of Medicaid.

Certainly, giving so many more people access to health care would be good for those in the business of providing medical services. Among other things, it would do wonders for hospitals that are crucial not only to the physical health but also the fiscal health of communities across Alabama.

If you think of the new jobs and growth that could be on the horizon for these communities, you discover Medicaid expansion really is about the economy.

But it is so much more than that.

It is a way to ensure that hundreds of thousands of Alabamians can get routine and preventive care through regular doctor visits and cost-effective drugs. It is way to keep people from seeking routine medical help in emergency rooms, where the cost is the highest and must be absorbed to some degree by those of us with insurance.

It is a way to give Alabamians access to real health care — and the security of knowing if they do get sick, they won’t become sicker worrying about medical bills.

Expanding Medicaid under the Affordable Care Act won’t help every Alabamian who is in this predicament. But if the experts are right, it would help between 250,000 and 300,000 of them.

And in my view, they are the best reasons for Alabama to expand Medicaid.

State Sen. Hank Sanders, D-Selma, represents the 23rd District in the Alabama Senate. He is serving his eighth term.
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Special to The Star

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