Coalfield communities increasingly rely on federal health programs as the industry shrivels, Mason Adams and Dustin Bleizeffer report in the third installment of their "Transition in Coal Country" series for the Energy News Network and WyoFile, a Wyoming news nonprofit.
"Coal states that initially rejected Medicaid expansion now see it as a way to help stem some financial losses in healthcare and provide care to residents. Increasingly, the argument that expansion is vital to aiding coal communities’ transition to a sustainable post-coal economy is gaining traction," Adams and Bleizeffer write.
Some coal states, including No. 1 Wyoming, haven't used the Patient Protection and Affordable Care Act to expand Medicaid, the federal-state program for lower-income people. "Still, shrinking tax revenues, jobs and resources in the industry are forcing the issue in many parts of coal country, and communities are becoming more reliant on — and even warming to — federal health programs like Medicaid," the reporters write.
Wyoming legislative leaders asked members in May to consider Medicaid expansion "in light of the coronavirus pandemic and historic losses in coal," they report, but there was no action. “I’ve been very surprised at the continued resistance to Medicaid expansion,” said Adam Searing, a research professor at Georgetown University’s Center for Children and Families. “I thought surely this would be the catalyst. But it’s still an uphill battle to overcome this ideological resistance.”
"Coal states that initially rejected Medicaid expansion now see it as a way to help stem some financial losses in healthcare and provide care to residents. Increasingly, the argument that expansion is vital to aiding coal communities’ transition to a sustainable post-coal economy is gaining traction," Adams and Bleizeffer write.
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| Kaiser Family Foundation map, relabeled |
Wyoming legislative leaders asked members in May to consider Medicaid expansion "in light of the coronavirus pandemic and historic losses in coal," they report, but there was no action. “I’ve been very surprised at the continued resistance to Medicaid expansion,” said Adam Searing, a research professor at Georgetown University’s Center for Children and Families. “I thought surely this would be the catalyst. But it’s still an uphill battle to overcome this ideological resistance.”
Roanoke-based Adams reports, "Medicaid expansion has remained popular in Kentucky and West Virginia, to the point that no one’s talking about repeal any more. In 2018, incumbent U.S. Sen. Joe Manchin, D-West Virginia, who had famously shot the cap-and-trade bill in a campaign spot eight years earlier, reprised the ad — only now he was shooting a lawsuit to repeal the Affordable Care Act. The message helped carry the Democrat to victory in what had been Donald Trump’s second-best state just two years prior."
The same day, in referendums, voters in Idaho, Nebraska and Utah approved Medicaid expansion. The next year, a newly Democratic legislature in Virginia did likewise, and in June, do did Oklahoma voters. Missouri has a referendum Aug. 4, with business interests supportive.
Searing said, “One thing that’s struck me is how Medicaid in the last five years or so has become much more popular than it ever was. People are seeing it more like Social Security or Medicare — not so much welfare but a safety-net program.” In Kentucky, the pandemic prompted the state to enact "presumptive eligibility," which waives the usual screening process for two months. “Basically, if you’re uninsured and you’re under age 65, it will get you coverage,” Dustin Pugel, senior policy analyst at the Kentucky Center for Economic Policy, told the Lexington Herald-Leader.
Searing said, “One thing that’s struck me is how Medicaid in the last five years or so has become much more popular than it ever was. People are seeing it more like Social Security or Medicare — not so much welfare but a safety-net program.” In Kentucky, the pandemic prompted the state to enact "presumptive eligibility," which waives the usual screening process for two months. “Basically, if you’re uninsured and you’re under age 65, it will get you coverage,” Dustin Pugel, senior policy analyst at the Kentucky Center for Economic Policy, told the Lexington Herald-Leader.
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