Monday, March 4, 2013
The upside of the Affordable Care Act
Posted by Linda Greene on Mon, Mar 4, 2013 at 3:55 PM
Hoosiers for a Commonsense Health Plan
The federal government is making the state of Indiana an offer that's too good to refuse: expanding Medicaid to cover more Hoosiers.
Medicaid is the national program that pays for the medical care of poor, elderly and disabled people. Under the new Affordable Care Act (ACA) (Obamacare), the program will be extended to people with incomes up to 138% of the federal poverty level. Indiana has threatened to opt out of the program even though the federal government would pay 100% of the cost during the first three years and at least 90% thereafter.
Currently in Indiana Medicaid covers a family of four only if it makes less than $11.50 per day (or about $4,200 per year). Clearly, Medicaid covers only those Hoosiers in dire poverty. But under the ACA, Medicaid would cover a family of four that earns $30,000 per year. That means a couple working 40 hours a week each would be covered by Medicaid. According to Bloomington physician Rob Stone, "This would be an incredible boon to working Hoosier families, lifting the threat of financial ruin caused by an accident or illness, and opening the door to preventive care."
Today, 800,000 Hoosiers have no health insurance, but if Medicaid is expanded in Indiana, 363,000 of those people would gain Medicaid coverage. A Harvard University study on deaths that result from a lack of health care has shown that 363 Hoosiers each year, or nearly one person per day, would escape a preventable death by being covered by Medicaid.
Here's how it would work. The federal government would donate $1.7 billion a year to Indiana to Indiana hospitals, physicians, nurses and the state's economy. The state would have to contribute anywhere from $50 to $150 million a year.
The state's contribution wouldn't be hard to come up with. The cigarette taxes collected from the Healthy Indiana Plan amount to some $121 million a year and by themselves would probably pay for Indiana's contribution to Medicaid. Expanded Medicaid would obviate the necessity for the Healthy Indiana Plan. According to Dr. Stone, the state's high-risk insurance pool currently costs $48 million annually but will end on January 1, 2014, freeing up the funds for expanded Medicaid.
The federal contribution would be more than $11 for every $1 of Indiana taxpayers' money. If our state doesn't accept the deal, the federal funds will accrue to states that do.
Jobs would benefit, too: a study in Missouri estimated that expanding Medicaid in that state would create 24,000 jobs.
If Indiana refuses Medicaid expansion, Hoosiers will be hurt. At least 340,000 people wouldn't be covered by Medicaid. The state treasury would lose millions in income taxes paid from the economic stiumulation that billions of dollars in federal funds would bring to hospitals, health care providers and the state economy. Further, Indiana hospitals would be deprived of miillions of dollars in future Medicaid compensation and probably would be forced to lay off workers.
According to state representative Matt Pierce (D-Bloomington), the state legislators are going to vote on Medicaid expansion before the end of the legislative session in April, and it's terribly important for them to hear from their constitutents on the topic. Contact your legislators to urge them to vote for Medicaid expansion. Pierce says an email will do; you needn't write more than a sentence or two. But it's essential that legislators hear something from their constituents on this topic, and the sooner, the better. You can find your senators' and representatives' email addresses at http://www.in.gov/cgi-bin/legislative/contact/contact.pl.
Hoosiers for a Commonsense Health Plan is a group of Indiana citizens who support a publicly financed, privately delivered (single payer) universal health plan at the state and national level.
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