July 29, 2015

Ahead Of 50th Anniversary Of Medicare And Medicaid, Kaine & Brown Lead Colleagues In Urging States To Expand Medicaid

In States That Opted Out of Expansion, Uninsured Rate Remains Near 40 Percent for Americans With Incomes Below 138 Percent of the Federal Poverty Level

Failure of Alabama, Florida, Georgia, Idaho, Kansas, Louisiana, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Virginia, Wisconsin, and Wyoming to Expand Medicaid Has Left Four Million Eligible Americans Without Medicaid Coverage

WASHINGTON, D.C. – Ahead of the 50th anniversary of Medicare and Medicaid, U.S. Senators Tim Kaine, Sherrod Brown and 29 of their Senate colleagues are urging the 19 states that have not yet decided to expand Medicaid to do so in order to give more than four million additional Americans access to affordable, comprehensive health care.

“The 50th anniversary of Medicare and Medicaid is a chance to celebrate one of the greatest public health accomplishments in our nation's history,” Kaine said. “It’s also a time to encourage those states who haven’t expanded Medicaid, including Virginia, to take advantage of the opportunity to provide affordable health care to millions of additional Americans. It’s time we give the most vulnerable in our country – including hundreds of thousands in Virginia - the peace of mind affordable, comprehensive health insurance coverage brings.”

“The creation of Medicare and Medicaid enhanced the lives of millions of Americans. And through the Affordable Care Act, we built on that public health achievement,” said Brown. “Unfortunately, four million Americans living in states that failed to expand their Medicaid program under the health law have yet to see its benefits. This is most true for low-income Americans and communities of color. It’s time for state legislatures and governors in these states to expand Medicaid so millions more Americans can realize the promise of health care coverage.” 

The Affordable Care Act (ACA) put an end to insurance coverage denials for those with pre-existing conditions, halted unjustifiable premium rate hikes, and capped annual and lifetime insurance coverage limits. Because of the ACA, more than 16 million previously uninsured Americans now have health coverage – some for the first time in their lives. However, these gains in health insurance have not been uniform. This is chiefly due to the Supreme Court’s holding that states could not be compelled to expand their Medicaid programs and the ensuing willingness of some states not to expand Medicaid.

According to the Journal of the American Medical Association (JAMA), the rate of uninsured among residents eligible for Medicaid as expanded under the health law has dropped to 26.5 percent in states that have expanded their Medicaid program. The rate remains near 40 percent in the same population in non-expansion states. Failure of states to expand Medicaid disproportionately affects low-income individuals and communities of color. The uninsured rate remains about 1.5 times higher for African-Americans and more than three times higher for Latinos than for white Americans living in states that did not expand Medicaid. If every state that did not expand Medicaid chose to do so, the insurance gap between white and black Americans could be cut in half.

In 19 unique letters to governors and legislators in states without expanded Medicaid programs, Kaine and Brown, along with 29 of their Senate colleagues, cited the potential impact expanding Medicaid could have in their states and urged them to take action.

The letters were cosigned by U.S. Senators Tammy Baldwin, Richard Blumenthal, Barbara Boxer, Maria Cantwell, Ben Cardin, Bob Casey, Dick Durbin, Dianne Feinstein, Al Franken, Martin Heinrich, Heidi Heitkamp, Mazie Hirono, Amy Klobuchar, Patrick Leahy, Ed Markey, Jeff Merkley, Barbara Mikulski, Chris Murphy, Patty Murray, Gary Peters, Bernie Sanders, Brian Schatz, Chuck Schumer, Jeanne Shaheen, Debbie Stabenow, Tom Udall, Mark Warner, Elizabeth Warren and Sheldon Whitehouse. 

A version of the letter below was sent to the governor and state legislators in Alabama, Florida, Georgia, Idaho, Kansas, Louisiana, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Virginia, Wisconsin and Wyoming.

July 29, 2015

Dear Governor McAuliffe, Lieutenant Governor Northam, Speaker Howell, Senate Minority Leader Saslaw, and House Minority Leader Toscano:

July 30, 2015, marks the 50th Anniversary of Medicare and Medicaid. In the past half century, these programs have prolonged and enhanced the lives of millions of Americans. Extending access to health care for America’s most vulnerable ranks among the greatest public health accomplishments in our nation’s history. However, when it comes to improving the health of our nation, much more must be done. Medicaid expansion – which represents the greatest single opportunity to extend comprehensive, affordable health coverage and reduce health disparities for low-income residents across your state – can only be accomplished with your leadership. 

Of all the ways that the passage of Medicare and Medicaid improved our nation, one deserves significant attention: in 1966, more than 1,000 hospitals desegregated in less than four months. Historians note that prior to the integration of segregated hospitals, ambulances in the South would not pick up emergency calls “until the race of the person needing help had been determined.” African-American patients were segregated to “‘old sections’” of hospitals, where facilities were poor, and the limited number of beds made available for African-American patients too often meant death for those who couldn’t be treated in time. President Lyndon B. Johnson – showing his legislative mastery – used provisions of the Civil Rights Act of 1964 to require that all hospitals must serve white and African-American patients equally. President Johnson threatened to refuse Medicare payments to those hospitals that refused. As a result, Medicare and the Civil Rights Act led to more equitable access to care for all Americans.

Since that time, our nation has continued to improve access to health care. The enactment of the Affordable Care Act (ACA) was the most significant reform to our nation’s health care system since Medicare and Medicaid’s creation. The ACA ends insurance coverage denials for those with pre-existing conditions, halts unjustifiable premium rate hikes, and caps annual and lifetime insurance coverage limits. Because of the ACA, more than 16 million previously uninsured Americans now have health coverage. However, these gains in health insurance have not been uniform. This is chiefly due to the Supreme Court’s holding that states could not be compelled to expand their Medicaid programs and the ensuing willingness of some states not to expand Medicaid.

As a result, nearly four million low-income uninsured Americans have been left without access to affordable health care in states that have not expanded Medicaid. While the majority of Americans who both benefit from Medicaid and fall into the coverage gap are white, similar to the characteristics of low-income uninsured adults generally, racial and ethnic minorities are disproportionally impacted by state decisions not to expand Medicaid. In states that have not expanded Medicaid, like Virginia, the effect is even more poignant. Nearly forty percent of African-Americans who would otherwise be eligible for Medicaid reside in states that have chosen not to expand the program. Absent steps to increase the rates of insurance for the uninsured, access to affordable, comprehensive health care in America will continue to disproportionally impact low-income Americans and communities of color.

It is time for states to take action. Adopting the ACA’s expansion of Medicaid to individuals making less than approximately $16,000 a year would significantly expand insurance to 179,000 Virginians. Health insurance policy experts have concluded that, “states’ decisions to accept or reject Medicaid expansion was the single most important factor in whether residents in low-income communities and communities of color were able to obtain health insurance.” In fact, if all the states that did not expand Medicaid chose to do so, more than four million Americans would gain access to affordable, comprehensive health care, including millions of low-income racial and ethnic minorities.

Virginia also stands to receive direct economic benefit from expanding Medicaid. Medicaid expansion in Virginia would mean a $2.1 billion dollar boost to the state’s economy.

Medicare and Medicaid were created based on the principle that our nation has a duty to provide for the health care needs of its citizens, especially the elderly and the poor. The Civil Rights Act and President Johnson’s leadership ensured that race would be no barrier to that principle. Today, however, cost prevents millions of Americans from accessing the care that should otherwise be available to them. By expanding Medicaid, you can help ensure more equitable access to health care, regardless of race or income. On this 50th Anniversary of Medicare and Medicaid, we encourage you to take this important step toward health equity for all.

Sincerely,

 

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