Medicaid Expansion: A Grave Matter

Tom Dwyer
dwyert@wittenberg.edu

For many, these midterm elections contain nothing of note. In fact, many pundits and observers have noted this election cycle for its increasing apathy. The election is, for lack of a better term, boring for many. But for those in 27 states living under 138 percent of the federal poverty line, the upcoming state legislature elections are nothing short of a matter of life and death.
Before 2010, states’ requirements to qualify for Medicaid — the federal health insurance program designed for low-income individuals — varied greatly. This posed the federal government with a large problem, both in terms of program administration and basic issues of justice. The Affordable Care Act sought to alleviate this problem through expanding Medicaid to cover all persons living under the 138 percent of the federal poverty line. The Federal Government decided to make all Medicaid funding contingent on adopting the new program qualifications. However, in 2010, the Supreme Court ruled that such practice violates states’ sovereignty, and states became able to choose whether or not they would accept the new funding for the expanded Medicaid program.
Ostensibly, the decision for the states should be a no-brainer. First, it is a simple matter of justice. Even in the hyper-polarized, modern political environment, Americans across the spectrum adopt the principle enshrined in our Declaration of Independence: governments are established to protect the rights of life, liberty and the pursuit of happiness. Integral to all three of these ideas in modern life is access to quality health care. One’s lack of material wealth should not come at the punishment of death. A study conducted by four health-care economists showed that failure to expand Medicaid caused between 7,000-17,004 deaths. Or, put another way, the failure to expand Medicaid has caused 5.6 more deaths than the terrorist attacks on Sept. 11, 2001. Medical care is not something anyone should have to earn. Denying people health insurance prevents them from receiving primary care, limits the medical procedures they can receive and kills them.
Even when forced to operate in the narrow view of self-interest, opponents’ failure to expand Medicaid is still a terrible decision. Taxpayers in the states that refused to expand Medicaid pay into the Medicaid fund, only to see their tax dollars shipped to other states. Taking money out of the pockets of one’s own constituents only to ship to other states is no way for a government to behave.
Even if the basic issues of fairness and justice do not appeal to the cynics that are preventing the expansion, one can still point to the one issue in American politics that has gained widespread support across both parties: shrinking the U.S. debt. Health care spending represents one-fifth of the U.S. economy and remains the single largest driver of the long-term budget deficit. On its face, expanding a government program does not seem to reduce expenditures, but expanding Medicaid will increase its buying power, allowing it to set prices at a lower rate and, furthermore, grant people access to preventive care, which will slow the growth of raising health care costs.
While this issue may seem mute to many — as Ohio Governor John Kasich unilaterally expanded the state’s program — it is important in this upcoming election to hold those in legislature who refused to make the obvious decision. More importantly, as Wittenberg students across the country contemplate their absentee decision-making, I implore them to vote on the side of Medicaid expansion in their home state, as states across the country are still contemplating the program’s expansion.

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