While proponents of Medicaid expansion point to increased health care coverage as the ultimate goal, critics of such programs on the state level say the practical costs are too high.
Dozens of states expanded their coverage of the government-funded Medicaid system as part of their implementation of Obamacare.
As The Associated Press recently reported, Virginia Gov. Ralph Northam promised to once again call for such a measure in his state ahead of next month’s budget special session.
“My goal has never changed,” he said. “I want every Virginian to have access to good, affordable health care, and I want us to help those who need help the most. No family should be one illness or accident away from financial ruin.”
Opponents in his state and elsewhere across the country, however, have a different take on the outcome of Medicaid expansion.
The American Spectator, for example, pointed to a study suggesting expanded coverage on its own does not lead to health care for all.
In fact, the Foundation for Government Accountability found that simply declaring more people are covered under Medicaid creates sometimes deadly wait times that disproportionately affect the very low-income and disabled citizens the program was designed to assist.
Across all 33 states, including Washington, D.C., that have expanded Medicaid, the study found nearly 250,000 patients remained on waiting lists for certain services.
“Nationwide, there are more than 650,000 individuals on Medicaid waiting lists for needed home- and community-based services,” the report states. “These are individuals with severe intellectual disabilities, spinal cord injuries, traumatic brain injuries, severe developmental disabilities, and more.”
Research linking Medicaid expansion to waiting lists has been disputed by a number of groups, including the Kaiser Family Foundation, which argues there is no discernible connection between the two factors.
The data do not support a relationship between a state’s #Medicaid expansion status and changes in its #HCBS waiver waiting list. Most expansion states (18 of 32) had no HCBS waiver waiting list or had a decrease in the waiting list from 2015 to 2016. https://t.co/KrzkS72K6Y pic.twitter.com/a4IZpUiPqQ
— Kaiser Family Foundation (@KFF) March 22, 2018
At the same time many poor patients saw diminished care in expansion states, however, FGA researchers argued that government spending increased rapidly in the same states for coverage among the often able-bodied and higher-income patients introduced into the system.
Spending on this group has doubled in a 3-year span, the foundation reported.
The study found that not only are hundreds of thousands of Americans finding necessary medical care postponed or entirely out of reach, a significant number of them have already died while waiting.
“At least 21,904 individuals on Medicaid waiting lists have died in expansion states since Obamacare began,” the researchers wrote.
Researchers looked at several individual states, including Maryland, which saw 8,495 deaths among patients on Medicaid waiting lists and an average statewide wait time of 7 years and 6 months before approval for services.
“While Maryland’s expansion continues to spiral out of control, the truly needy are being left behind,” the study found.
The actual number of deaths caused by waiting lists across Medicaid expansion states, however, is unknown and certainly higher, the researchers wrote.
“Alarmingly, multiple states claimed to have to knowledge of deaths that have occurred amongst their waiting list members,” the study found. “Some states provided only partial death totals. As a result, the findings do not reflect the full magnitude of the crisis.”
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