If the criticism of the Supreme Court’s ruling affirming the constitutionality of the Affordable Care Act (Obamacare) was rainfall, we would be facing rising rivers rather than drought. We have come to the bizarre place in which providing affordable coverage for working individuals who do not have affordable choices for health insurance is seen as a bad thing.
Critics condemn a plan that requires health insurance companies to cover people who are sick, allows young people an opportunity to remain on their parents’ insurance until they get on their feet, and that supports seniors by providing free preventive care and assistance with their prescription costs. While we generally accept across party lines the principle that individuals bear some responsibility for their own health, Obamacare critics now claim that requiring individuals who can afford insurance to assume that responsibility by purchasing one of a variety of affordable insurance plans is un-American.
I have too many friends and neighbors who lost their health insurance when they lost their job, faced a diagnosed illness and knew they could not afford treatment, or lived in fear that one accident or sickness would exhaust their life savings. I never want to purchase another raffle ticket, or attend another silent auction, barbeque or dance to raise money so someone can get medical care without losing their home.
The real question is how can we afford not to implement the Affordable Care Act?
A big piece of the ACA is expanding Medicaid to insure many more working families as well as working single adults. From a financial perspective, Missouri has much to gain. The federal government pays 100 percent of the cost for the first three years of implementation, and about 90 percent of the cost for the next 5 years, injecting an estimated $8.4 billion into Missouri’s economy. Current workers will be more productive since they will be healthier, new jobs in the health field will be created, and increased wages will pump money into the economy. Missouri gains a lot from a relatively small investment of its own.
From a human perspective, implementing the ACA is even more compelling.
A recent report from Families USA estimates that more than one Missourian has died each day from 2005 to 2010 because they were uninsured and did not get needed treatment. At least 100,000 working Missourians lost their insurance when Medicaid was cut in 2005. If Medicaid is not expanded, the Missourians who will lose are those with incomes under the federal poverty level ($1,595/mo for a family of three) who make too much to be insured by our current Medicaid program ( current eligibility level of $292/mo for a family of three), but too little to be eligible for insurance subsidies that will be available at 100 percent of the federal poverty level. It would be a tragic mistake for these most vulnerable working families to bear the brunt of politically motivated decisions.
Elected officials are jumping on the bandwagon to block the expansion of Medicaid in Missouri. They claim we can’t afford to insure people, and that other cuts in education will be needed if we expand Medicaid. Knee-jerk ideology is not a helpful response. Saying a blanket “no” to any new revenue defies common sense. There are taxes that should be raised – such as our tobacco tax that is lowest of any state. And there are plenty of loopholes to be closed that would create a more level playing field for local businesses and provide the resources needed to fund both education and health care.
Common sense, common decency and openness need to prevail when the next session begins in January 2013. Turning our backs on an opportunity to help working families who are uninsured is a mistake we cannot afford to make.
Ruth Ehresman is former director of Health and Budget Policy at the Missouri Budget Project and a candidate for Missouri House District 78.
