Column: Medicaid: the Untold Obamacare Success
The untold success story in the health-care rollout is that the working poor are enrolling in Medicaid.
Sadly, this fact is largely ignored. Positive statistics are crowded out by incessant Republican distracters who prefer obsessing over glitches on the Healthcare.gov website than highlighting the thousands of families already benefiting from the safety and security that come with finally having medical insurance.
The Obama administration is not blameless here. Until only recently, the White House and congressional Democrats had silently acquiesced to the media meme that somehow 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 those younger Americans would pay premiums that are cost-effective and contribute to lower insurance rates overall by bringing more people into the insurance market, which is true. But there are two problems with that narrative: First, it ignores the fact that many of those same healthy young Americans are working in minimum-wage jobs, and so they qualify for Medicaid. Second, it implies a hierarchy of sorts, 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 Barack Obama himself finally acknowledged the disparity in the underreporting of the success of the Medicaid expansion during a news conference last Thursday, 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.
“That’s been less reported on, but it shouldn’t be,” said the president. “Americans who are having a difficult time, who are poor — many of them working — may have a disability. They’re Americans like everybody else.”
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. The GOP and their operatives have created a separate and unequal perception of Medicaid beneficiaries. But why should the poor be shamed for needing Medicaid? Especially when they are hard-working, taxpaying citizens?
Beginning with Nixon’s Southern strategy, which was perfected by Ronald Reagan’s “welfare queen” analogies in the 1980s, the GOP has cruelly crafted an image of poor people — black and brown in particular — who are living high off government. It’s a false narrative of someone receiving Medicaid, food stamps and housing assistance and who therefore has no incentive to work.
But that is the warped fantasy of misguided Fox News pundits and conservative talk radio hosts. America’s poor are mostly working people who simply don’t make enough to live, support their families and also pay for health insurance.
According to research by the Kaiser Family Foundation, there were 47 million Americans without 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. Many were self-employed or worked for small firms that are less likely to offer health benefits. Low-wage workers were sometimes offered coverage, but the premiums were too costly, given their low wages. More than 60 percent of uninsured Americans had at least one full-time worker in the home, and 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, “There is so much heated rhetoric about the Medicaid expansion in the political arena, but I think the average person believes it’s a good thing. We have about one-fourth of our population on Medicaid already, and I don’t think anyone would not want those people to have health care.”
Bond continued, “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 proverbial war on the poor.
These tactics leave the GOP out of sync with the broader electorate. A record 49.7 million Americans were poor in 2012, and this was alongside more than 97.3 million who are considered low income. That means nearly half of the entire U.S. population — roughly 148 million people — may need Medicaid coverage or subsidies. And yes, they’re not only our neighbors, friends and family — in many cases they’re ourselves.
By shaming those living in poverty, Republicans betray the nation’s foundational principles. It’s time to applaud the fact that health-care reform is boldly embracing the need to protect and serve the poor.
Edward Wyckoff Williams is a contributing editor at The Root. He is a columnist and political analyst, appearing on Al-Jazeera, MSNBC, ABC, CBS Washington, Arise America and national syndicated radio.