The untold success story in the health care rollout is that the working poor are enrolling in Medicaid.
Sadly, this fact is largely ignored, crowded out by incessant Republican obsessing over glitches on the HealthCare.gov website. But many thousands of families already are benefiting from the security that come with medical insurance.
The Obama administration is not blameless. Until recently, the White House and congressional Democrats had acquiesced to the media meme that enrolling young healthy people in the private insurance exchanges was more important than expanding government health services for those in poverty.
The rationale, of course, was that younger Americans would pay premiums that contribute to lower insurance rates overall, which is true. But there are two problems with that narrative: First, many of those healthy young Americans are working in minimum-wage jobs, and so they qualify for Medicaid. Second, it implies a hierarchy — in which those who can pay for private insurance are more worthy of the benefits attached to the Affordable Care Act.
Not so. Those who qualify for Medicaid deserve it and should not be shamed for needing it.
President Obama himself finally acknowledged the underreporting of the success of the Medicaid expansion during a Thursday news conference, when he explained that in the first month alone, 396,261 Americans qualified for Medicaid benefits. This was in contrast with the 106,185 people who have enrolled in a marketplace private insurance plan.
Noting that those who have already qualified for Medicaid are poor but also working, Obama highlighted a fact often lost on Republicans, who have consistently marginalized the poor, portraying them as unworthy leeches on society.
According to research by the Kaiser Family Foundation, 47 million Americans lacked health insurance coverage in 2012. Sixty-one percent of adults said that the main reason they were uninsured was that the cost was too high or they had lost their job. More than 60 percent of uninsured Americans had at least one full-time worker in their home, and another 16 percent had a part-time worker in the home.
Medicaid has become a necessity for an increasing number of Americans, as essential as Social Security and Medicare for the elderly.
Kentucky, led by Democratic Gov. Steve Beshear, is largely white and extremely poor. It has also become the poster child for the successful Medicaid expansion, despite being a “red” state. Beshear’s team has enrolled more than 33,561 of the state’s 636,000 uninsured in Medicaid in the first few weeks of the ACA open enrollment. And that is only the beginning.
Gwenda Bond, Beshear’s assistant communications director, said, “The vast majority of people who qualify for Medicaid are not on welfare — they are working. And it’s why the Medicaid expansion was a part of the original design of the ACA. These are people who don’t make enough money to afford insurance in the private market — even with a subsidy. And we have a moral responsibility to cover them. These are our neighbors and friends, not people who are living off the system.”
Many of the states that have refused the Medicaid expansion are the poorest and most Republican, including Texas, Louisiana, Florida, South Carolina, Mississippi and Georgia — all of which have uninsured rates that are among the highest in the country.
The 2012 Supreme Court ruling that upheld the constitutionality of the ACA’s individual mandate also permitted states to refuse to expand Medicaid, and Republicans have used this as a tool to subvert and obstruct Obama’s efforts to successfully implement the ACA — as well as to continue their war on the poor.
A record 49.7 million Americans were poor in 2012, alongside more than 97 million who are considered low income. That means nearly half of the entire U.S. population may need Medicaid coverage or subsidies. And, yes, they’re not only our neighbors, friends and family — in many cases, they’re us.
It’s time to applaud the fact that health care reform is boldly embracing the need to protect and serve the poor.