Covering Medicaid changes

The New York Times released an article, “Millions of poor are left uncovered by health law,” detailing the number of Americans that will be affected by the Medicaid expansion, or lack thereof, depending on how their states voted. According to analysis by the Times, the national effort to expand health coverage to the majority of Americans will actually exclude two-thirds of poor African-Americans and single mothers, as well as over half of low-wage workers that do not currently have health insurance. States controlled by Republicans that have rejected the Medicaid expansion will leave eight million Americans, already in poverty and uninsured, ineligible for Medicaid. Dr. H. Jack Geiger, a founder of the Community Health center Model, was quoted in the article saying: “The irony is that these states that are rejecting Medicaid expansion — many of them Southern — are the very places where the concentration of poverty and lack of health insurance are the most acute. It is their populations that have the highest burden of illness and costs to the entire health care system.” The Times analysis included those who are uninsured although they qualify for Medicaid in its current state, and excluded undocumented immigrants and residents born in foreign countries that would not be eligible for benefits in the Medicaid expansion. 

Other key findings include:

  • The New York Times found that 14 million eligible Americans are uninsured and living in poverty.
  • Every state in the South, except Arkansas, has rejected the Medicaid expansion. Economic and racial issues have been discussed as factors.
  • Twenty-six states have rejected the Medicaid expansion. The population of these states combined is almost half of the country’s population, and 68 percent of those are poor, uninsured single mothers and African-Americans. Sixty percent of the country’s working poor, who are also uninsured, are in those 26 states. It is estimated that about 435,000 cashiers, 341,000 cooks and 253,000 nurses’ aides will be excluded from Medicaid.
  • Mississippi has the largest percentage of uninsured, and poor, people in the country with 13 percent of its population. Republican leaders in Mississippi stated that if they opted for the expansion, almost one third of the state would be on Medicaid.
  • African-Americans are largely affected due to larger populations in Southern states. It is estimated that 6 out of 10 African-Americans live in the states not expanding Medicaid.
  • Half of uninsured and poor Latinos live in states that are expanding Medicaid, excluding Texas, which rejected the expansion and has a large Latino population.

To turn this into a story:

  • Use the Center for Medicaid and CHIP Services table “State Medicaid and CHIP Income Eligibility Standards Effective January 1, 2014” to see if your state chose to expand Medicaid or not and what the eligibility requirements are in your state. The Social Security website also offers a “List of Threshold Amounts for Calendar Year 2013.”
  • Use the New York Times’ interactive map “Where Poor and Uninsured Americans Live” to see how many uninsured people are in your state, as well as how many are eligible for Medicaid currently, as compared to after the expansion, or no expansion, depending on your state.
  • Small Area Health Insurance Estimates Interactive Data Tool that allows you to search by year, age, race, sex, income and insured or uninsured for each state. These statistics are presented in table format, an interactive map or as trends over time. The U.S. Census Bureau’s SAHIE page also features “Data” tab that includes reports on the number of uninsured people per county and regional areas. Use these resources to compare your county and state to others in your area, other regions and report on how many people, by age, race and sex have health insurance in your area. Compare this data to the New York Times’ interactive map.
  • Open the U.S. Census Bureau* website and select your state. Information is available on average family size, race statistics and average income in your state.
  • Use CNN’s Cost of Living Calculator to find out the average cost of living in your area and compare it to the Medicaid threshold for your state to see if many would qualify currently, and then after the expansion (depending on whether your state is expanding or not).
  • Interview state representatives on their reasoning behind expanding/rejecting Medicaid and if they are aware of statistics within your state for those who are uninsured. If possible, interview someone without health insurance who would qualify with the expansion to see how that would affect their quality of life.
  • For helpful tutorials and tips within the Covering Poverty blog, check out the tutorial on Covering Poverty and Health, as well as multiple case studies on income divide and health.
    *Certain federal websites are currently shut down. Information typically displayed on these sites will be available when the government shutdown is over.

Other reporting and commentary from across the web:

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