WASHINGTON -- Medicaid expansion generated jobs and increased the number of people receiving preventive care in Arkansas and 25 other states that took part in the program, President Barack Obama's administration says.
A White House report released today focuses heavily on the 24 states that declined to participate.
The expansion is funded under the 2010 Patient Protection and Affordable Care Act. A Supreme Court decision left it to individual states to decide whether to accept funds and expand access to residents.
Some states that rejected the expansion have cited concerns that the federal government will not pay as much as it promised for the program, leaving state governments on the hook when they begin paying a portion of the cost. Others are divided politically on the issue. The federal government will pay the full cost until 2017, when states will begin paying 5 percent. The states' shares will then rise each year until they reach 10 percent in 2020.
The Obama administration is still urging the other 24 states to embrace the expansion, saying 5.7 million Americans in those states stand to benefit between now and 2016.
In a statement, Obama said he applauds states that have expanded Medicaid.
"I urge the governors and state legislatures who have not yet expanded Medicaid to put their constituents' health over partisan politics and give millions more Americans the access to affordable health care they deserve," he said.
In 2013, the Arkansas Legislature extended eligibility for Medicaid to adults with incomes of up to 138 percent of the poverty level: $16,105 for an individual, for instance, or $32,913 for a family of four.
Under the so-called private option, most people who qualify can sign up for a plan on the state's health insurance exchange, with the Medicaid program paying the premium. Those who don't qualify for Medicaid but have incomes of less than 400 percent of the poverty level may qualify for federal tax-credit subsidies to help pay their premiums.
As of May 31, more than 187,000 newly eligible adults had been approved for Medicaid coverage, according to the Arkansas Department of Human Services, while more than 40,000 who did not qualify for Medicaid were enrolled in plans on the exchange.
The White House report includes several state-specific estimates of how residents might benefit from a service through the Medicaid expansion.
It estimates that 20,800 more Arkansans will receive a cholesterol level screening because of the private option, that 5,600 more will receive a mammogram and 8,500 will under go a Papanicolaou Smear or "pap smear." It also estimates that in Arkansas, there will be 386,000 more doctor visits each year and 12,000 fewer people will suffer from depression because of treatment.
The report estimates that the federal government will spend nearly $2.7 billion more in Arkansas by 2016 because of the expansion and that 11,500 jobs will be created by 2017.
Little Rock resident Mara D'Amico, 26, who was diagnosed with Type 1 diabetes at age 7, said the expansion was a lifesaver.
"I can't emphasize enough how much of an impact I know this has had on my life," she said Tuesday. "It's kept me alive, it's kept me healthy and it's made my life better."
D'Amico became too old to be on her parents' health insurance in October while attending the University of Arkansas Clinton School of Public Service. When her parents' plan ended at the end of the year, she was uninsured for a month and a half before getting covered by Medicaid and then a subsidized insurance plan under the private option.
She said she made it through the time without insurance by using medical supplies she had stockpiled but feared getting a cold or influenza.
Her insulin supply ran out the day Medicaid kicked in, she said.
"It was the difference between $600 and $12 [per month for her insulin]," D'Amico said. "It's not an option to take the medicine. I'll die if I don't take it."
She praised state legislators for approving the expansion, but its future is uncertain in Arkansas.
Private option supporters narrowly secured appropriation for another year of funding during the 2014 fiscal session, and it has been an issue in many 2014 legislative campaigns.
Arkansas Rep. Bob Ballinger, R-Hindsville, voted against the appropriation and said Tuesday that his position hasn't changed.
"In general, we are a nation that is 17 and a half trillion [dollars] in debt," he said. "We cannot afford to continue to expand entitlements."
He said it isn't clear to him how the state will pay for its 10 percent share of the Medicaid expansion cost in 2020.
"Unless you can say how you will pay for this program ... then I think it's a bad idea. I think it's money that we shouldn't be spending," he said.
Metro on 07/02/2014