In the first year under expansion, the state's uninsured population was effectively halved, from 22.5% to 11.4%, according to a 2015 Gallup report.
Six years later,
A proposed constitutional amendment on the
According to research by the nonpartisan
"Studies show that Medicaid expansions result in reductions in uncompensated care costs for hospitals and clinics, and a growing number of studies show an association between expansion and gains in employment as well as growth in the labor market," the Kaiser analysis concluded.
Uncompensated care, or care for the uninsured, has been a significant strain on struggling rural hospitals -- 10 of which have closed in
Still, conservatives argue that expansion will cost the state money, likely necessitating cuts to education and other state programs
"When you have a program that's run as inefficiently and poorly as our current Medicaid program, the last thing you want to do is make it bigger," Eigel said.
The federal government initially paid 100% of states' expansion costs, and now pays 90%. A
A 2019 study from the
Advocates are selling expansion not just as a lifeline for low-income residents but as an economic development opportunity.
But Eigel was critical of these sunny economic projections.
"You can't advocate for economic growth through government expansion. That's the antithesis of what this country was founded on," he said.
Earlier this month,
The coverage gap
It's a misconception that the only the poorest of the poor stand to benefit from Medicaid expansion. It would provide coverage for those who find themselves in an economic gap -- unable to afford healthcare or qualify for Medicaid benefits.
One such person is
After earning her law degree from the
"When I left the classroom, of course that means I lost insurance coverage," Taylor said.
She looked into a government healthcare plan, but couldn't afford it. As an adult with no dependent children, she didn't qualify for Medicaid either.
And just like that, Taylor fell into the coverage gap.
"I think that people have an idea or a thought when we talk about Medicaid expansion that it's the most poor among us or the most destitute," Taylor said. "They don't see a person who has a law degree. They don't see an entrepreneur like me who has worked since I was 15 years old, and here I am."
"We're already covering the folks that are the most needy in the state," Eigel said.
"Government has a responsibility to help those less fortunate, but at the same time, we can't expand unlimited amounts of dollars [for people] that quite frankly don't need the help in the first place."
Taylor said she's only had one medical emergency over the last five years, but the unexpected ambulance trip to the emergency room set her back
"You think about all of the associated bills with that, and now I have them and I'm in debt, so I'm trying to claw my way out of that as an uninsured person," Taylor said.
Tension over work requirements
Some states have pushed in recent years to make work compulsory for many Medicaid recipients. Like Taylor, 65% of people who fall into the coverage gap are already working, according to the
In February, a court threw out
"This amendment prohibits placing greater or additional burdens on eligibility or enrollment standards, methodologies or practices on persons covered under Medicaid Expansion than on any other population eligible for Medicaid," a portion of the measure reads.
"The advocates for expansion, perhaps because of what happened in
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