Federal spending on Medicaid is expected to decrease by $880 billion over approximately the next 10 years. We all know someone, or are related to someone, who works in a profession that may be adversely affected by this change. With decreased access to care, there will be less preventative health exams, less prenatal services and less treatment of acute and chronic illness. It is projected that 14 million Americans will lose or drop health insurance in 2018 under the ACHA. Our most vulnerable patients will be denied care because it is not affordable. This is not a step forward.
A study from Cornell and Harvard showed that children with access to healthcare (Medicaid and CHIP) had more success in school than kids that had no healthcare. The Medicaid expansion helped decrease income and race-based coverage disparities. Ultimately, the Medicaid expansion saves Medicare money down the road. The states that had the expansion under Obamacare offered coverage to people who were then able to get care for chronic conditions. Conditions such as hypertension, high cholesterol and diabetes are often untreated in patients who can’t afford health care, making the complications of these diseases more severe as the patient ages.
As with any free program, there will always be scoundrels to take advantage. But certainly not everyone who received coverage under the expansion was a bum. Most of the patients that I took care of at a free clinic who were able to get Medicaid with the expansion in Pennsylvania were hard working laborers. Some were addicts or alcoholics and thereby unable to hold down full-time work and did not make enough money to buy insurance on the exchange. Others had physical disabilities, such as chronic back pain, that prohibited full-time employment, and these patients qualified for health insurance under the expansion. This segment of the population needs and deserves medical care.
The current battle over Obamacare’s overhaul is off the back burner and in the news again. We await the Senate’s input on Trumpcare. Let’s hope that the offered replacement includes a humane proposal that includes ongoing Medicaid for our most vulnerable patients. Let’s protect those that need it. As a society, those that have need to help those that have-not when it comes to healthcare. Period.