Without Medicaid Expansion, Poor Forego Health Care

Jets

Former Staff
Feb 2011
22,138
11,762
New York
#12
Not for anything, but it’s up to the voters of those red states to push their elected reps to expand Medicaid. Protest and make sure they hear you!!!
 
Likes: EnigmaO01
Jul 2015
2,691
1,605
Maryland USA
#13
Mr. B,

and those with Medicaid are worse off than those with no health insurance at all:

Medicaid Is Worse Than No Coverage at All

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I'm not sure how logically one could say that Medicaid coverage is worse than no coverage. I have often stated that I think the ACA formed the basis for a reasonable workable solution to our health concerns, but needed major improvements. Along with a public option, it should have mandated Medicaid expansion as opposed to optional. The problem with that is that the current mandated State funding of Medicaid is bankrupting State treasuries. So additional federal funding would be needed.

The population of those covered by Medicaid needs to be examined to address ancillary problems or concerns. Many of those, if not a majority, do not use the primary care coverage available to them. They still tend to use the ER as a source of primary care. Medicaid eligibility was a major result of the ACA exchanges, many did not even know that they were eligible in the past. I served on the voluntary board of a 501 organization operating inner city clinics. Much too often, the clinic personnel had to help the patients apply for Medicaid coverage. An apparent problem for many Medicaid recipients is actual transport to the primary care sources. In large urban areas, perhaps, they could use public transportation, but in less populated locales just getting to a doctor or clinic is difficult, they just can't call Uber.
 
Mar 2012
51,146
33,787
New Hampshire
#14
I'm not sure how logically one could say that Medicaid coverage is worse than no coverage. I have often stated that I think the ACA formed the basis for a reasonable workable solution to our health concerns, but needed major improvements. Along with a public option, it should have mandated Medicaid expansion as opposed to optional. The problem with that is that the current mandated State funding of Medicaid is bankrupting State treasuries. So additional federal funding would be needed.

The population of those covered by Medicaid needs to be examined to address ancillary problems or concerns. Many of those, if not a majority, do not use the primary care coverage available to them. They still tend to use the ER as a source of primary care. Medicaid eligibility was a major result of the ACA exchanges, many did not even know that they were eligible in the past. I served on the voluntary board of a 501 organization operating inner city clinics. Much too often, the clinic personnel had to help the patients apply for Medicaid coverage. An apparent problem for many Medicaid recipients is actual transport to the primary care sources. In large urban areas, perhaps, they could use public transportation, but in less populated locales just getting to a doctor or clinic is difficult, they just can't call Uber.
Around here a lot of doctors wont take Medicaid so they have no choice but to go to the ER. Its starting to get that way with Medicare as doctors are being overwhelmed with the amount of new patients beginning Medicare. We really need to figure out how to get more doctors where they are needed or we will always have a huge fight over healthcare. People in rural and poor areas will never want these healthcare solutions if they have no access. Its kind of why the ACA had more problems, sure you got insurance but either had no doctor or had to travel long distances.
 
Jan 2014
15,277
3,872
California
#15
I'm not sure how logically one could say that Medicaid coverage is worse than no coverage. I have often stated that I think the ACA formed the basis for a reasonable workable solution to our health concerns, but needed major improvements. Along with a public option, it should have mandated Medicaid expansion as opposed to optional. The problem with that is that the current mandated State funding of Medicaid is bankrupting State treasuries. So additional federal funding would be needed.

The population of those covered by Medicaid needs to be examined to address ancillary problems or concerns. Many of those, if not a majority, do not use the primary care coverage available to them. They still tend to use the ER as a source of primary care. Medicaid eligibility was a major result of the ACA exchanges, many did not even know that they were eligible in the past. I served on the voluntary board of a 501 organization operating inner city clinics. Much too often, the clinic personnel had to help the patients apply for Medicaid coverage. An apparent problem for many Medicaid recipients is actual transport to the primary care sources. In large urban areas, perhaps, they could use public transportation, but in less populated locales just getting to a doctor or clinic is difficult, they just can't call Uber.
Mr. Wahoo,

because the University of Oregon did a study and that was the conclusions they came up with.

And one of the other things the study said is emergency room visit went up, not down, as a result of Medicaid expansion.
 
Jul 2013
48,623
51,392
Nashville, TN
#16
Around here a lot of doctors wont take Medicaid so they have no choice but to go to the ER. Its starting to get that way with Medicare as doctors are being overwhelmed with the amount of new patients beginning Medicare. We really need to figure out how to get more doctors where they are needed or we will always have a huge fight over healthcare. People in rural and poor areas will never want these healthcare solutions if they have no access. Its kind of why the ACA had more problems, sure you got insurance but either had no doctor or had to travel long distances.
And the advantage of having no insurance at all is...…??
 
Jul 2013
48,623
51,392
Nashville, TN
#17
Mr. Wahoo,

because the University of Oregon did a study and that was the conclusions they came up with.

And one of the other things the study said is emergency room visit went up, not down, as a result of Medicaid expansion.
And the hospital is worse off getting Medicaid funding than getting nothing at all, how?
 
Jul 2013
48,623
51,392
Nashville, TN
#19
Depends on the variables. If you are paying half your income for premiums and have a 12K deductible and you lose your job its still the same result. Bankruptcy is bankruptcy whether its millions of dollars or 20K.
I was talking about Medicaid and Medicare....for your private insurance pain, I suggest a dose of single payer.
 
Jul 2016
4,173
3,395
DS9
#20
Mr. Wahoo,

because the University of Oregon did a study and that was the conclusions they came up with.

And one of the other things the study said is emergency room visit went up, not down, as a result of Medicaid expansion.
Are you ever right? (No)

The Oregon study didn't say that having no insurance was better than Medicaid. So quit lying.

Try reading these links that explain why ER use has gone up. If you're able, read the whole thing. I'll just post a few snippets below:

More evidence expanding Medicaid increases emergency room visits

"People covered by Medicaid were more likely to both see a physician at a regular office visit and also go to the emergency room "
"Making something nearly free -- in this case, emergency room visits -- often means people will use more of it. "

THIS IS IMPORTANT TO NOTE:

"A Health Affairs study published in August found that expanding Medicaid did not increase emergency room visits overall, but who paid for them did shift. In 2014, visits by Medicaid patients increased while uninsured visits decreased, according to the study."

HHS chief mostly correct that ER use is up since Obamacare

NOTE THE LAST PARAGRAPH, WHEREIN YOUR AUTHORS OF THE OREGON STUDY TELL US THE WHYS OF INCREASED MEDICAID COVERAGE:

Why isn’t emergency room use going down?

Experts cite a mix of reasons.

Medicaid reimbursement rates are lower than those for private insurance, so appointments at doctors’ offices may be hard to obtain for those who received Medicaid coverage under the Affordable Care Act. In addition, "two-thirds of emergency visits occur on weekends and when doctors’ offices are closed," said Laura Gore, a spokeswoman for the American College of Emergency Physicians.

Demographics may play a role, too. Senior citizens are growing as a percentage of the population, and older Americans are likelier to have chronic health problems that require an emergency room visit, Gore said.

In fact, the trend of growing emergency room use predates the enactment of the Affordable Care Act.

"Emergency department use has been rising since they were popularized after World War II," said Scott M. Dresden, a physician and assistant professor at Northwestern University who co-wrote the Illinois study. "Research on health services use since the 1970s has shown that providing patients with assistance for health care costs, such as insurance, leads to increased health services use. So it's not particularly surprising that providing patients with insurance didn't decrease emergency department use."

But the biggest factor may be force of habit.

"Old habits are hard to break," said Gail Wilensky, who headed Medicare and Medicaid under President George H.W. Bush. "People who were used to seeking care in ERs may continue to go there for a while. When Kaiser first started taking Medicaid patients, many continued their use of the ER for routine care like they had always done. It took a while to wean them away."

Katherine Baicker, a professor of health economics at Harvard University’s T.H. Chan School of Public Health and co-author of the Oregon study, agreed.

"Expanding health insurance coverage leads to greater use of care across many settings, including the doctor's office, the pharmacy, the hospital, and the emergency room," she said. "This is what one might expect from the basic economics: Medicaid took health care that was expensive and made it free, so people used more of it."