Topic of the day: Medicaid

Published: Saturday, Jan. 4 2014 2:15 a.m. MST

In this July 12, 2012 photo, a man using two canes is helped in the waiting area at Nuestra Clinica Del Valle in San Juan, Texas. About 85 percent of those served at the clinic are uninsured. Texas already has one of the nationŐs most restrictive Medicaid programs, offering coverage only to the disabled, children and parents who earn less than $2,256 a year for a family of three. Without a Medicaid expansion, the stateŐs working poor will continue relying on emergency rooms _ the most costly treatment option _ instead of primary care doctors. The Texas Hospital Association estimates that care for uninsured patients cost hospitals in the state $4.5 billion in 2010. (AP Photo/Eric Gay)

Eric Gay, AP

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There have been several studies recently released on the effects of Medicaid expansion to low-income individuals and families. One result that has been gaining traction amongst various news outlets is that according to the research – done on test subjects from Oregon who were given Medicaid after winning a healthcare lottery back in 2008 – is that it appears that the expansion would end up costing more than it saved, because those with new access to Medicaid went to the ER 40 percent more than those without.

“The new Medicaid recipients used ERs more often for all kinds of health issues, including problems that could have been treated in doctors' offices during business hours,” says Melinda Beck at the Wall Street Journal. “On average, the Medicaid recipients visited ERs in 12 Portland-area hospitals 1.4 times during an 18-month period, compared with 1.02 visits for the control group without insurance. Using $435 as the average cost of an ER visit, the researchers calculated that Medicaid increased annual ER spending by $120 a covered person.”

“Critics of the health-care overhaul said the study's findings confirmed their view that Medicaid expansion would cost more, not less.”

But Julie Rovner at the NPR contacted those actually in charge in Medicaid for their response to the study. “’This is not something that is unexpected and not something that we're not prepared for,’ says Kathleen Nolan. She's director of state policy and programs for the National Association of Medicaid Directors.”

“Nolan says most states are already working to help Medicaid recipients get care in more appropriate settings. ‘Things like nurse-advice lines, trying to work with the community clinics and community providers to expand hours and make sure that people who are working two and three jobs can get access to primary care after hours and on the weekends,’ she said.”

Meanwhile, the overall debate on whether Mediciad expansion is federal overreach or a worthy goal goes on.

Ezra Klien writes for Bloomgerb that the Medicaid expansion is the true victory of the Affordable Care Act, despite the fact that it seems to be avoided by politicians on both sides. “It’s hard to say exactly how many of those Medicaid enrollments Obamacare is responsible for -- the government’s numbers don’t distinguish between people who signed up through Obamacare’s Medicaid expansion and those who entered the program through pre-existing channels. But the fact remains that Medicaid enrolled well over twice as many people as signed up for private insurance through the exchanges.”

Sandhya Somashekhar and Karen Tumulty at the Washington Post believe that the debate over the expansion of Medicaid hassplit the nation in half and has become a proxy for the broader debate over the role and responsibilities of government." According to an anylasis of which states have opted to expand the program vs those that refuse, “Today, the Medicaid expansion, more than any other aspect of Obamacare, demonstrates the nation’s red-blue divide.”

What are your thoughts and opinions on Mediciad?

Freeman Stevenson is a Snow College grad and a writer for the Deseretnews.com Opinion section and Brandview. Email Freeman at fstevenson@deseretdigital.com

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