In 2013, our state lawmakers announced that West Virginia would make the quality health care provided through Medicaid available to thousands more, particularly low-income adults who previously had no other option for health insurance.
This program, known as Medicaid expansion under the Affordable Care Act, has been great for West Virginians — including our doctors, hospitals, employers, and especially our population at large who relies on affordable and accessible health care.
It is not hard to understand why the program is good for the previously uninsured. Without health insurance to cover the cost of their treatments, the uninsured community was often limited to seeking care through a visit to the hospital emergency room.
Most in this situation cannot afford to pay the hospital for their care — a trip to the hospital either bankrupted the person or the hospital charged off the bill and passed the cost of care on to other customers.
Medicaid has allowed folks who previously could not seek basic primary care services to receive quality and comprehensive care, including preventive benefits that reduce the risk of major illness through screenings, early treatment and disease management.
The cost of many of these preventive services is covered under Medicaid, so families and individuals who previously may have avoided hospital trips whenever possible can now access screenings and counseling services that ensure longer, healthier lives.
The availability of these preventive services — a key feature of Medicaid — will greatly benefit the long-term health of our state’s entire population while keeping costs lower throughout the health care system. A healthy population is both physically and financially fit.
With the cost of insurance for a middle-aged male in excess of approximately $1,200 a month, there is no way a person with a salary below the poverty line could afford the continually rising costs of health care and strictly private insurance.
Thanks to Medicaid, our state’s workforce is healthier than ever as individuals remain at their jobs as a result of affordable care. Previously, many of these same individuals could not afford to work and receive health care.
Another benefit of Medicaid is that it allows health care providers to collect for care that may have never been paid for by lower-income families and individuals who can’t afford the services they need. Now, these families and individuals can receive quality care without worrying about their bills, and without medical facilities worried about whether or not they will be reimbursed. It’s a win-win.
Medicaid also allows the medical community to better manage care as opposed to the pre-expansion health insurance environment. For providers of substance abuse services, for example, there is now a stable source to pay for treatment and counseling. These providers also benefit from the care coordination encouraged and implemented by Medicaid, benefiting health care professionals and patients, alike.
The economic impact of Medicaid’s mark on West Virginia must also be considered. For businesses whose employees cannot afford employer-based health insurance and those who employ seasonal workers, Medicaid is essential. This program reduces the cost of providing health insurance for employers and individuals who buy health insurance — yet another mutually beneficial characteristic of the program.
When health care providers deliver care to individuals who do not have health insurance or the means to pay for their care, the cost of the uncompensated care is passed on to individuals who do pay for health insurance, such as families and small businesses. In turn, health care costs are passed on and prices throughout the system grow. Medicaid helps to reduce this cost shift by providing a stable source of payment for care that may otherwise have been left uncompensated.
A recent study reported in the journal Health Affairs cited several noteworthy data points regarding Medicaid points that reinforce the impact of the program on the cost shift in particular. Since our Legislature’s decision, out-of-pocket spending has decreased, and the spending burden of our state has been significantly reduced.
With or without Medicaid expansion, the low-income labor force of our state will incur medical costs that will eventually be borne by the public. This can either happen in an organized fashion or it will be as it was before expansion: unorganized, and reliant on the emergency room and cost shifting models for payments.
Either way, society has to pay for the cost of care. But with Medicaid, families and individuals across the state have been able to receive quality health care without breaking the bank.