Industry Voices—COVID-19 all the impetus needed to expand Medicaid

Medicaid
By providing more comprehensive health coverage to lower-income families, people who contract COVID-19 can be assured of treatment. (Getty/designer491)

Millions of uninsured Americans stay up at night wondering what they will do if a member of their family contracts COVID-19. It doesn’t have to be this way. Coverage for these individuals is within reach, through the expansion of Medicaid in states that have not yet opted in.

The list of states that have not yet enacted the Medicaid expansion afforded under the Affordable Care Act (ACA) is growing smaller as voters across the nation—including red states like Oklahoma and Missouri—have supported expansion to cover more low-income workers who lack access to private health insurance.

The ACA gave states the option to expand Medicaid coverage for non-elderly adults earning up to 138% of the poverty line. States that do this get enhanced federal matching funds, in some cases covering the state’s cost in the early years of the expansion.

By providing more comprehensive health coverage to lower-income families, people who contract the illness can be assured of treatment. The benefits, though, go far beyond that. Medicaid coverage will also ensure access to treatment for people suffering from anxiety, depression and other mental health conditions that result from the economic devastation that has ensued from the pandemic.

It is simply unfair that, for low-income people, your access to coverage depends on where the leaders of your state stand on the Medicaid expansion.

Increasingly, voters are overruling their leaders on this topic, with referenda clearing the way for Medicaid expansion. Even when the people speak, there have been leaders who tried to refuse to implement it. In the end, the people’s will always wins.

RELATED: States face looming crisis over Medicaid growth, which could trigger changes for providers and payers

Medicaid, unlike Medicare, was designed as a joint federal-state program to give states flexibility over the design of the program. For instance, some states cover dental and chiropractic services and others do not. It was not meant to be all-or-none for states.

When healthcare is handled in a patchwork way—much like the Trump administration’s response to COVID-19—it becomes disjointed and uncoordinated, and people at the lower end of the income scale, who often have the greatest healthcare challenges, are the ones who suffer the most.

For the father of a child with multiple disabilities to an individual battling substance use disorder to a mother who can no longer return to work because the pain from a chronic illness is debilitating, health coverage is simply vital to ease suffering and provide stability.

It is understandable that a person’s state of residence will have a financial and human impact on them. If someone lives in New Hampshire they pay no income tax, but across the border in Massachusetts they do. If someone lives in Oregon they pay no sales tax, but over the border in California, they do.

But why should where you live—especially in the U.S., with its broad system of health and human services programs—have such a dramatic impact on your well-being? If you work and are low-income in Louisiana and develop cancer, you can qualify for coverage and beat it; if you live in the neighboring state—Mississippi—you may very well die for lack of comprehensive care.

People are clamoring for Medicaid, even in places that are generally fiscally and socially conservative. A pandemic is exactly the right time to provide that coverage—when people need it the most. Expanding access to Medicaid will be a healthcare game changer in many of the dozen states that have not done so, in some cases covering as many as a third of the people who presently have no coverage.

RELATED: Urban Institute: Medicaid expansion will be a critical safety net as COVID-19 job losses continue nationwide

The COVID-19 pandemic has led to economic devastation, and that means many of the Americans who historically got their coverage through the workplace no longer have that option available to them. Unemployed people often lack the funds to pay for replacement healthcare coverage. COVID-19 has hit low-income communities, and their hard-working Black, brown and immigrant inhabitants, particularly hard. These people—often the same ones stocking the supermarket aisles and working in healthcare facilities—deserve a measure of fairness.

We may not yet have a proven therapy to treat COVID-19 or a vaccine to stop its spread, but we do have a tool at our disposal that can help ensure our readiness as a nation for those who continue to contract COVID-19 and who have no or limited healthcare coverage: an expansion of Medicaid in the states that haven’t done it, many of which—such as Florida and Texas—are in fact the current hot spots.

Red state governors must seize the opportunity. It will not compromise their conservative values, because voters in the deepest red states have already voted overwhelmingly to enact it. 

COVID-19 deaths are ticking up, and time is ticking away.

Gerard A. Vitti is the founder and CEO of Healthcare Financial Inc., a Boston-area company that assists individuals in obtaining healthcare benefits.