This blog post was written by Denise Nakiyaga Babirye, a Student in 2016 Fall Semester of Harvard Law School’s Public Health Law and Policy Seminar.
I originally wrote this in October, prior to the election. While President-elect Trump seems committed to the deconstruction of the Affordable Care Act and Medicaid expansion, I still believe in the importance of access to health care for all Americans, regardless of the state they live in.
Currently 22 states have not participated in Medicaid expansion. The article The Ryan White HIV/AIDS Program in the Age of Health Care Reform applauds the ACA for expansion of Medicaid that has allowed thousands of people living with HIV/AIDS to access healthcare. However, the article also notes the effects of the refusal by the 22 states to expand Medicaid. The resistance of these states, most of which are in the South, has limited the ability of their vulnerable populations to access improved and quality health care. The reasons for their defiance should be weighed against the cost that is paid by their citizens when these 22 states opt out.
Another article we read for class, Why States Should Not Expand Medicaid, provides twelve reasons for the state’s defiance. The authors argue that instead of improving healthcare, Medicaid will devour the states’ budgets due to the high costs, increase dependency, and harm the economy. All their arguments fail to convince me that Medicaid expansion should not happen.
Why have the states refused to learn from those that have expanded their Medicaid? There are a number of lessons to learn from Massachusetts, which was the first state that mandated health insurance for all residents. It now has the lowest number of uninsured population with the highest level of access to quality care. Not that this is a perfect example, but this should lure some states to expand their Medicaid. With the expansion of Medicaid, states get additional funds from the federal government to extend health care to their low-income population and increase the number of people who receive care. Despite the increase in federal control, I find no other reason that should keep these states away from the expansion. Medicaid expansion will help to harmonize the gap between the poor in the states and among states. It goes without saying that the poor are the most likely to be sick or get sick; therefore, ignoring this population is double jeopardy.
Health care should be rebranded from being a commodity to a human right. The community at large ought to be concerned about equal provision of healthcare for all and if takes Medicaid expansion that will bring this to life, every state should embrace it.
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