ActivePaper Archive Medicaid expansion working - American Press, 2017-06-25

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Medicaid expansion working

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Americans who have qualified for Medicaid expansion that serves lowincome citizens will be the big losers if the House or Senate health care bills replace Obamacare.

The 2017 federal poverty level is $24,600 annually for a family of four and $12,060 for an individual. Expansion of Medicaid under Obamacare opened the federal-state health care program to adults who make less than 138 percent of the federal poverty level — about $33,500 a year for a family of four and $16,200 for a single adult.

Louisiana was late expanding its coverage. Former Republican Gov. Bobby Jindal opposed expansion, calling Medicaid a poorly run and costly program. Democratic Gov. John Bel Edwards made expansion one of his campaign promises, and he delivered quickly after taking office.

The expansion has added about 428,000 low-income Louisianans to the Medicaid rolls, and they could lose their coverage by 2020 or 2024, depending on which of the two Republican plans, if either, becomes law.

Republican conservatives like U.S. Sen. Ted Cruz of Texas favor curbing Medicaid expansion because of its costs, so they don’t like the Senate bill. Five moderate GOP senators like Sen. Dean Heller of Nevada don’t like it either, but for different reasons.

Heller said Friday, “I’m telling you right now, I cannot support a piece of legislation that takes insurance away from tens of millions of Americans and hundreds of thousands of Nevadans.”

U.S. Sen. Bill Cassidy, Louisiana’s senior senator and a physician who has done work at charity hospitals, wants to be sure lower income citizens will still be able to afford health care insurance.

Republicans and Democrats accept the fact that Obamacare isn’t working, but they can’t agree to work together to fix it. So the GOP is going it alone, which means it can’t afford to lose more than two Republican senators when trying to pass a Senate health care bill.

Some Republican and Democratic governors, on the other hand, are working together to try and save Medicaid expansion in their states. Seven of them, including Edwards, asked both major political parties in a joint letter to work together in fixing the program rather than phasing it out.

Yes, there are problems with any program that serves some 72 million people. However, fixing them is the better solution. Critics mention Medicaid fraud often, but the federal government and the states have adopted steps designed to combat fraud, waste and abuse. They aren’t completely successful, but trying.

The Kaiser Family Foundation in a February report said nearly 8 in 10 Medicaid parents and childless adults live in working families and a majority are working themselves. It added that most of those not working have “major impediments to their ability to work.”

Many members of Congress and state legislatures fail to accept the realities of life in America. The Louisiana Association of United Ways in April issued a report saying 42 percent of state households, over 723,000, are struggling to afford housing, transportation, food and other basic needs. Only 16 percent had investments like savings accounts, retirement plans or rental property that produced income. The figures are from 2014, the latest available.

The federal poverty level of $24,600 annually is one thing, but the United Ways report said a family of four in Louisiana needs at least $46,240 to cover the most basic costs of living. If only one of those four is working, they would have to make $23.12 an hour at a full-time job to make enough just to scrape by on.

Unfortunately, jobs paying that well are hard to find, the report said. Low-wage jobs dominate Louisiana’s economy with 68 percent of all jobs in the state paying under $20 an hour.

The situation in Calcasieu and surrounding parishes isn’t much different. In Calcasieu, 43 percent of the nearly 74,000 households were either living in poverty (18 percent) or were just above the poverty line (25 percent) but had trouble paying for basic expenses.

Conditions may improve in Calcasieu because of the growing job numbers created by billions of dollars of industrial expansion in Southwest Louisiana, but only time will tell if things change.

Cassidy, like those governors mentioned earlier, has demonstrated he has a good grasp of what will happen if Medicaid expansion eventually ends. He said back in March the uninsured are paid for only in part by U.S. government funds.

If Medicaid expansion ends, the uninsured will go back to hospital emergency rooms for their health care. Cassidy said that means society pays the rest of the bill for the uninsured because the hospitals will shift the remaining costs to the privately insured who end up paying higher health care premiums.

Medicaid expansion has given millions of Americans the first real health care they have ever enjoyed in their lives. There has to be a better way than ending it now, or later.

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Jim Beam, the retired editor of the American Press, has covered people and politics for more than five decades. Contact him at 337-515-8871 or jbeam@americanpress.com.