Guest post written by Risa Lavizzo-Mourey
Ms. Lavizzo-Mourey is the president and CEO of the Robert Wood Johnson Foundation.
As a geriatrician who practiced for years in some of Philadelphia’s most disadvantaged communities, I have seen the profound impact that Medicare and Medicaid can have. These two programs help mothers, fathers, grandparents and children get the care they need, when they need it most, and I’ve seen the relief on patients’ faces when they know it’s going to be all right.
President Lyndon Johnson signed legislation creating these two ambitious national health programs on July 30, 1965. Fifty years later Medicare and Medicaid cover more than 100 million people and are an essential part of the nation’s safety net for elderly, disabled and poor citizens. Under the Affordable Care Act (ACA), states have the option of extending Medicaid eligibility to all non-elderly adults who make less than 138% of the poverty line ($16,242 a year for an individual). For the first three years the federal government pays 100% of the costs of new enrollees, declining to 90% by 2020. So far, 31 states have expanded their Medicaid program. It’s time for the other 19 to do the same—if for no other reason than it makes economic sense.
Medicaid expansion saves money
A study funded by Robert Wood Johnson Foundation (RWJF) looking at eight states that expanded Medicaid eligibility found that the resulting savings and revenues will total more than $1.8 billion by the end of fiscal 2015, just 1-1/2 years in. But the cost of caring for uninsured people in non-expansion states in the next 10 years is projected to reach $266 billion, according to a report from the Kaiser Family Foundation—and the residents of those states will more than likely end up paying higher taxes as a result.
Plus, another RWJF study from 2014 predicted that, for every $1 a state spends expanding Medicaid, $13.41 in federal funds will flow into the state. On the other hand, hospitals in states that don’t expand will forgo $167.8 billion in Medicaid reimbursements by 2022.
There are also long term gains to be had from expansion. A study by the National Bureau of Economic Research found that children that are Medicaid-eligible for more of their childhood are less likely to drop out of high school (one reason: fewer school days missed for illness), and likelier to earn a college bachelor’s degree—creating a higher-earning, more skilled workforce. Expanded Medicaid coverage also means expanded coverage for mental health issues, which can help reduce crime, addiction and homelessness.
Creating healthier communities
Then there are the states that are using Medicaid to create healthier communities. Medicaid agencies are working to reduce childhood obesity in several states, such as Arizona, New York and South Carolina, thus helping to prevent future adults from suffering from a lifetime of obesity-related chronic illnesses. And at least nine Medicaid programs have created coordinated care programs that team up hospitals and clinics that serve Medicaid populations with local agencies that address patients’ needs once they leave the hospital.
In Minneapolis, Hennepin Health identifies and addresses patients’ needs in the community, such as housing (some 50% of Hennepin’s high-needs patients are homeless). It also provides coordinated diabetes, heart disease and asthma care to chronically ill people. The strategy appears to be working: between 2012 and 2013, Hennepin’s emergency room visits decreased by 9.1%.
The evidence is piling up that Medicaid expansion saves money, helps build healthier communities, and creates all kinds of economic gains down the road. Surely everyone in the U.S. deserves to reap these benefits, not just those residing in the 31 states that have already expanded Medicaid. It’s time for the other 19 to do the same.
Medicaid Expansion Would Save Money And Create A Healthier Nation.