A recent study found that Medicaid expansion slowed the rate of self-reported health decline, helped increase Medicaid coverage, and boosted the likelihood of maintaining one’s health in Southern states.
The Southern Community Cohort Study conducted the research by recruiting participants from a total of 12 states: Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia. Of these 12, Kentucky, West Virginia, Louisiana and Virginia have expanded Medicaid while the remaining eight have not. Some notable characteristics of the cohort of participants are that overall, the participants were lower-income, older, had considerably higher mortality, morbidity, and uninsured rates than the low-income population in general. The study found that overall, individuals in expansion states experienced less of a decline in overall health status and a greater ability to maintain their baseline health status than individuals in non-expansion states.
These findings contribute to the wealth of evidence that tells us time and time again that expanding Medicaid has the potential to positively impact the health of thousands of Americans (and it’s cost-effective too!). This study has significant implications for people in the South, where a majority of those remaining in the coverage gap live. It is important to remember that of the 14 states that have yet to expand Medicaid, nine are in the South. That the participants of this study are all from Southern states as well as primarily rural areas, where large health disparities and lack of access to care exist, simply goes to show just how much the South has to benefit from expansion. Furthermore, expanding Medicaid has the potential to address disparities in the health outcomes of people of color, who make up a greater proportion of the population in non-expansion states.
Despite the growing proof of the overwhelming benefits of Medicaid, too many state policymakers continue their attempts to prevent expansion or to attach harmful stipulations such as work reporting requirements to undermine expansion efforts. Disguised as the push needed to help get low-income and unemployed Americans “back on their feet,” work reporting requirements actually pose a significant barrier to Medicaid coverage and can even cause eligible people to lose their coverage. What good does expanding Medicaid do if the people who can benefit most from the program are prevented access with harmful barriers like work requirements?
Unfortunately work requirements are not the only threat to Medicaid. Recent guidance released by CMS invited states to submit 1115 demonstration waivers to alter how they receive program funding. Known as “Healthy Adult Opportunity,” these waivers could change Medicaid’s current funding from an as-needed basis to a capped amount (also known as a block grant), ultimately limiting how much a state can receive for its residents. Limits on Medicaid funding mean limits on Medicaid beneficiaries. States would be pressured to cut benefits, which would inevitably be at the expense of Medicaid recipients. (Stay tuned for a deeper dive on the impact of Medicaid block grants next week.)
As we enter the new decade, there is no doubt that new research will continue to demonstrate the positive impacts of Medicaid expansion. And as the evidence rolls in, we must continue urging our policymakers not to turn a blind eye to the value of Medicaid. If you are feeling stuck on where to start, take a look at past resources for useful tactics that our advocates have used to uplift Medicaid expansion as a priority to their state policymakers.