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For all its many faults, Illinois did do something right

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Patricia Powers went a few years without health insurance and was unable to afford regular doctor visits. So the Missouri resident, who lives near St. Louis, had no idea that cancerous tumors were silently growing in both of her breasts.

If Powers lived just across the Mississippi River in neighboring Illinois, she would have qualified for Medicaid, the federal-state health insurance program for low-income residents that 36 states and the District of Columbia decided to expand under the Affordable Care Act. But Missouri politicians chose not to expand it — a decision some groups are trying to reverse by getting signatures to put the option on the 2020 ballot.

Powers’ predicament reflects an odd twist in the way the health care law has played out: State borders have become arbitrary dividing lines between Medicaid’s haves and have-nots, with Americans in similar financial straits facing vastly different health care fortunes. This affects everything from whether diseases are caught early to whether people can stay well enough to work. […]

A recent University of Michigan study found Medicaid expansion substantially reduced mortality rates from 2014 to 2017. The researchers said Illinois averted 345 deaths annually while Missouri had 194 additional deaths each year. The same trends held for other side-by-side states such as Kentucky (did expand) and Tennessee (did not), New Mexico (did) and Texas (did not).

And it’s not just the averted deaths. It’s also the averted debilitating impacts of untreated or partially treated illnesses and injuries and the crushing debts which often lead to bankruptcies and the inability to work or be productive citizens…

In neighboring Illinois, getting Medicaid through the expansion helped Matt Bednarowicz avoid debilitating medical debt after a motorcycle crash.

The wreck crushed his left foot, requiring doctors to insert pins. Without Medicaid, he would have faced thousands of dollars in medical bills.

“The debt would have been greater than I could comprehend overcoming,” says Bednarowicz, who is now 29.

His Medicaid kicked in “just in the nick of time” to cover the surgery, Bednarowicz says. It also allowed him to get psychiatric help for depression. More than a year later, he’s able to get around well — even jog — and works as a caregiver for an elderly man.

Having insurance helps people like Bednarowicz stay productive, says Riopedre.

posted by Rich Miller
Tuesday, Oct 1, 19 @ 12:12 pm

Comments

Illinois did something right. I disagree with Medicaid expansion

Comment by Blue Dog Dem Tuesday, Oct 1, 19 @ 12:16 pm
State borders have become arbitrary dividing lines between paying higher taxes and lower taxes which enable many people to afford more things, using NPR’s logic.

Comment by Steve Tuesday, Oct 1, 19 @ 12:17 pm
Lower deductibles for insurance should be legislated. Politicians seem to be more concerned about protecting the insurance and medical people than the real people.

The people in these stories are better off but ask them about their deductibles.

It makes no sense that you qualify for a premium subsidy but can’t find any affordable insurance with deductible below $7000 per year. Who can afford to go to the doctor with that guaranteed expense?

Comment by still hurting Tuesday, Oct 1, 19 @ 12:20 pm
Steve - it’s not NPR’s logic. Just yours.

Comment by Ike Tuesday, Oct 1, 19 @ 12:22 pm
Illinois also participates in the Medicaid Buy-In program (HBWD). People with disabilities can continue to get Medicaid as they increase their earnings from work by paying for it. This is important because Medicaid pays for a lot of the supports to enable people to work so is needed while the person gains self-sufficiency.

Comment by Earnest Tuesday, Oct 1, 19 @ 12:24 pm
- Earnest -

I wouldn’t say correlation and causality are the same thing but ever notice that before Medicaid, the New York Times wasn’t running front page stories of people dying in the streets for lack of medical care?

Comment by Steve Tuesday, Oct 1, 19 @ 12:30 pm
States that didn’t expand Medicaid under the ACA are also loosing rural hospitals. Always amazing when people vote against their own interests.

Comment by Anotheretiree Tuesday, Oct 1, 19 @ 12:33 pm
Anotherretiree. Come down to the real southern Illinois.

Comment by Blue Dog Dem Tuesday, Oct 1, 19 @ 12:36 pm
Poor woman.

From the story ”Powers kept thinking she could have found the cancer earlier, if only she had insurance. That would have meant less treatment and lower costs for taxpayers, who ended up footing the bill anyway. Research shows breast cancer in its earliest stage can cost half as much to treat as in later stages.”

So Missouri has Medicaid for breast cancer patients who already know they have breast cancer but not Medicaid to diagnose breast cancer at its earliest stages. And this is done in the name of cost savings? Bizarro world.

Comment by Da Big Bad Wolf Tuesday, Oct 1, 19 @ 12:39 pm
==ever notice that before Medicaid, the New York Times wasn’t running front page stories of people dying in the streets for lack of medical care?==
I rarely notice New York Times articles printed before 1965, the first year of Medicaid, no matter the subject.

Comment by Da Big Bad Wolf Tuesday, Oct 1, 19 @ 12:43 pm
“The people in these stories are better off but ask them about their deductibles.“

The people in this story are Medicaid recipients and not subjected to deductibles.

There’s probably not another country on this planet that fights against health insurance expansion or tries to gut it like we do. How can people even begin to call themselves religious, or worse, politically force their religion on others, while slashing and denying help to the poorest and sickest among us? This is done while the richest are benefiting the most from huge tax cuts.

Comment by Grandson of Man Tuesday, Oct 1, 19 @ 12:51 pm
I thought the right-to-life movement was strong in Missouri. What is it doing to get Medicaid expansion ? Isn’t it concerned about the deaths of the uninsured, or is it just the unborn it cares about?

Comment by Truthteller Tuesday, Oct 1, 19 @ 1:10 pm
=Come down to the real southern Illinois.=

Why? For another easternbloc rally?

Comment by JS Mill Tuesday, Oct 1, 19 @ 1:14 pm
=The researchers said Illinois averted 345 deaths annually while Missouri had 194 additional deaths each year.==
Right to life is stronger in Illinois than Missouri.

Comment by Da Big Bad Wolf Tuesday, Oct 1, 19 @ 1:16 pm
Let’s get off the ‘right to life’ issue and stick to the basic story.

Comment by CentralIllinoisan Tuesday, Oct 1, 19 @ 1:34 pm
For too many right to life begins at conception and ends at birth.

And yea, this is a big deal. States with Medicaid expansion save the lives of hundreds of their citizens. Those who declined for political reasons chose to kill hundreds of their citizens instead. And lest you call that hyperbole, it was predictable and predicted that this would be the outcome. But right wing politicians chose to ignore what happens to poor folk constituents of theirs.

Comment by Chicago Cynic Tuesday, Oct 1, 19 @ 1:42 pm
-Steve

I don’t read the New York Times much either now or prior to my birth so am unfamiliar with any stories or lack thereof you are noticing. I’m not strong on history, but imagine there were some kind of news stories or public sentiment driving the creation of such a massive humanitarian program. The most I have time to search for was this page of speeches by President Johnson, bookmarked to this one: https://www.cms.gov/About-CMS/Agency-Information/History/Downloads/CMSPresidentsSpeeches.pdf#page=32&zoom=100,0,0

Comment by Earnest Tuesday, Oct 1, 19 @ 1:47 pm
Steve - before Medicaid the NYT ran stories about people robbing banks to pay for their mother or children’s medical care. They also ran stories about how black folks could not be admitted to Hospitals.

Comment by Al Tuesday, Oct 1, 19 @ 3:12 pm
Medicaid expansion also helps prevent child neglect. This study got a lot of attention earlier in the year.

https://www.forbes.com/sites/brucejapsen/2019/06/14/how-medicaid-expansion-prevents-child-neglect/#75c868953cbf

Comment by Andrea Durbin Tuesday, Oct 1, 19 @ 3:36 pm
Thanks Ms. Durban for that article. There is some evidence that Medicaid expansion caused the US abortion rates to go down too.
https://www.register-herald.com/news/health-care-increased-abortion-rates-declined/article_1b58a48a-b787-506d-84d3-d154eb977eba.html

Comment by Da Big Bad Wolf Tuesday, Oct 1, 19 @ 6:38 pm
Sorry, Durbin. I hate misspelling names.

Comment by Da Big Bad Wolf Tuesday, Oct 1, 19 @ 6:39 pm