Wednesday, December 19, 2012

Medicaid expansion is a 'rural issue' and could save many lives, health expert says

"The big choices in health-care reform now rest with the state governors," Dr. Wayne Myers, former national rural-health director, writes for the Daily Yonder. "The biggest is whether to accept the federal offer of support for Medicaid expansion. This turns out to have a smaller price tag than a lot of people suppose, and a lot of lives depend on it."

Richer states would pay for half of Medicaid recipients' health care, and the federal government would pay the other half. Poorer states would pay less and the federal government would pay more. Myers says a lot of people will remain or become uninsured if states don't adopt the expansion deal. Between one-sixth and one-fifth of all Americans are on Medicaid, and it pays for more than 40 percent of all births and 70 percent of nursing home care in the country.

However, Republican governors are opposed to expansion for political reasons, stemming from their disapproval of "Obamacare," Myers writes. Some have promised to not implement any portion of it, which could create problems for millions of poor Americans, mostly living in rural areas, who can't afford health insurance and must rely on Medicaid. (Washington Post map)
"Medicaid is a rural issue because a higher percentage of low-income people live in rural communities, and rural families are less likely to have private health insurance," writes Myers, the first director of the federal Office of Rural Health Policy and former president of the National Rural Health Association. It's also "a major economic driver." According to the National Center for Rural Health Works at Oklahoma State University, Medicaid was responsible for 113,000 jobs and a total of $10.5 billion in economic activity in Oklahoma in 2010.

Medicaid also saves lives and expansion will be cheap for states, Myers writes. Studies have shown that patients with insurance that are hospitalized after accidents are 40 percent less likely to die than those without insurance because uninsured patients got less attention from medical staff. If all 50 states were to adopt expansion, they would spend a total of $8 billion over the next 10 years; but, if all 50 states opted out of expansion, they would spend $68 million over the next decade, according to a Harvard School of Public Health study.

With all of this in mind, opting out of the expansion "may get a governor a self-inflicted gunshot wound to the foot, some dead hospitals and a bunch of dead citizens who needn't have died," Myers writes. (Read more)

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