Most people would agree that the Affordable Care Act or ACA is not a perfect piece of legislation. However, I believe that the risks of eliminating the benefits of Medicaid expansion, which is part of ACA, deserve more attention.
Access to healthcare is the primary intended purpose for expanding Medicaid. If low income, uninsured individuals become insured, they would no longer have to use the emergency room for their primary health care — a very expensive and inefficient delivery for basic general health care needs. Research has shown that health care delivered in a primary health care setting produces better health outcomes.
The primary benefit for anyone who has health insurance is access to primary care without incurring huge costs to themselves. It is no different for people who enroll in the expanded Medicaid program. These individuals can now go to a doctor if they are sick.
There is more opportunity for being proactive about one’s health. Fifteen percent of the total population of Colorado is now signed up for Medicaid expansion. Uninsured rates dropped from 12 percent to 9 percent. Typically, these individuals are the working poor, disabled, elderly, homeless and children.
Through expanded Medicaid, eligibility has been revised to include individuals at 138 percent of the Federal Poverty Level, which translates to $16,000 for a single adult or $24,000 for a family of four. This year, because Colorado (one of 31 states) signed up for this expansion, 100 percent of the federal dollars allocated to our state is designated to pay for healthcare for this population
The second benefit of expanded Medicaid is the increase of wellness and prevention programs. The main focus of these programs is to prevent disease and minimize costs associated with chronic disease. Areas of these programs include:
• Basic dental health that includes screening and cleaning
• Screenings for cardio vascular disease, diabetes and breast cancer
• Reproductive health including long term birth control
• Mental health counseling now includes treatment for addiction.
Other positives consequences of the Medicaid expansion program include insurance standards for basic care and requiring no exclusions for individuals with pre-existing conditions. Clients are now protected during their policy coverage period from changes to their policies by insurance companies.
Medicaid expansion is not a panacea. Premiums and the cost of care are still too high. The program hasn’t attracted enough of our younger population. Insurance companies have withdrawn from the marketplace exchanges, limiting an individual’s choice of different insurance plans.
However, a full repeal of the ACA without replacing these benefits mentioned above is a mistake. As Senator Gardner and Representative Tipton and our other elected officials begin to change this program, I hope they will differentiate between what is working, from what isn’t, and will craft a better program that retains and builds rather than repeals and starts over.