SHOT/CHASER: Yes, Mitt (47%) Romney, The People Understand The Benefits of Medicaid Expansion Just Fine

“Mitt Romney, it’s actually not that complicated. Medicaid Expansion is a good thing. That’s why it’s popular and that’s why the people will vote for it — and not for you — in November,” said Brad Woodhouse, executive director of Protect Our Care

SHOT: Mitt Romney opposes Medicaid expansion, and believes that the issue is too complicated for the people to decide in an initiative to appear on November’s ballot. “Medicaid expansion is a very complex issue. It requires extensive research and analysis and I think is generally done best by elected representatives of the people.”

CHASER: Medicaid expansion has been studied, and it’s been found to provide numerous benefits for Americans. That’s why Utah’s proposed initiative to enact the Medicaid Expansion is enjoying support from 60 percent of residents.

Here are a few of the studies Mitt Romney must have willfully ignored:

• Research From Georgetown University Center For Children And Families Confirms That Rural Populations Are Especially Hurt When States Do Not Expand Medicaid. “The uninsured rate for low-income adult citizens (below 138 percent FPL) has come down since 2008/09 in nearly all states, but small towns and rural areas of states that have expanded Medicaid have seen the sharpest declines. The uninsured rate for this population dropped sharply from 35 percent to 16 percent in rural areas and small towns of Medicaid expansion states compared to a decline from 38 percent to 32 percent in non-expansion states between 2008/09 and 2015/16.” [Georgetown University Center for Children and Families, 9/25/18]
• Rural, Low-Income Voters Less Likely To Have Health Insurance In Than Urban Poor States That Did Not Expand Medicaid. “Rural, low-income voters who helped propel President Trump to victory in 2016 are less likely to have health insurance than the urban poor in states that didn’t expand Medicaid under the Affordable Care Act. A new study compared uninsured rates from 2008-2009 and 2015-2016 by the the Georgetown University Center for Children and Families and the University of North Carolina Rural Health Research Program. It examined insurance coverage in 46 states with significant rural populations and found a disparity between low-income adults living in rural areas and small towns versus those living in metropolitan areas.” [Washington Post, 9/25/18]
• Georgetown Report Emphasizes That Medicaid Expansion Plays Significant Role In Coverage Gains Given Difficulty Getting Insurance Companies To Cover Rural Communities. “There are several reasons cited in the Georgetown/University of North Carolina report that Medicaid expansion could be part of the solution:  It’s difficult to get insurance company to offer plans in sparsely populated rural towns; areas with more insured residents draw clinics and providers to operate there; and rural hospitals are less likely to close in places where they can depend on Medicaid payments.” [Washington Post, 9/25/18]
• University of Michigan Study Finds Medicaid Expansion Improves Access To Family Planning. “Among 1,166 reproductive-age women who enrolled in the Healthy Michigan Plan, Michigan’s expansion of the Medicaid program for low-income adults, 1 in 3 said the expanded coverage improved access to birth control and family planning services…’Our findings suggest that the expansion provided an important service for populations with a high unmet need for family planning care,’ says lead author Michelle Moniz, M.D., M.Sc., an assistant professor of obstetrics and gynecology at Michigan Medicine. ‘Insurance coverage also means that women have access to more options if they do not want to become pregnant at the current time.’…Each dollar spent on contraception is estimated to save the health care system more than $7 in return, according to a recent study from the Guttmacher Institute. About 40 to 50 percent of the 4 million live births in the U.S. every year are paid for by Medicaid.” [University of Michigan, 8/31/18, JAMA Publication]
• Northwestern University Research Heart Attack Patients Had Higher Rates Of Health Coverage In Medicaid Expansion States.“In a boost for cardiovascular care in the U.S., new research shows those suffering heart attacks and strokes were less likely to be uninsured for their hospital stays after states expanded Medicaid under the Affordable Care Act…Research led by Dr. Ehimare Akhabue from Northwestern University’s Feinberg School of Medicine showed Medicaid expansion states had a ‘significant reduction in the proportion of uninsured hospitalizations for major cardiovascular events within 1 year of Affordable Care Act Medicaid expansion compared with nonexpansion states.’ Researchers looked at more than 3 million ‘non-Medicare’ hospitalizations from hospital databases from 30 states.” [Forbes, 8/26/18]
• Ohio Medicaid Expansion Study Found That People Continuously Enrolled Through Medicaid Were Less Likely To Have Medical Debt. “People continuously covered by Medicaid were substantially less likely to have medical debt than eligible people who were still uninsured or people who churned on and off of Medicaid.That aligns with prior studies published in Health Affairs and elsewhere. If the purpose of Medicaid is to provide people with health care and a certain level of basic economic security, it seems to be succeeding.” [Vox, 8/24/18]
• Following Medicaid Expansion, The Percentage Of Uninsured Ohioans With Income At Or Below 138 Percent Of FPL Dropped Drastically. See chart below. [Vox, 8/24/18]

• Researched Published In JAMA Confirms That Medicaid Expansion Increased Access To Opioid Treatment. “Medicaid expansion significantly increased buprenorphine with naloxone prescriptions per 100 000 county residents in expansion counties, suggesting that expansion improved access to opioid use disorder treatment. Expansion did not significantly increase the overall rate per 100 000 county residents of OPR prescriptions, but increased the population with OPRs paid for by Medicaid. This finding therefore suggests the growing importance of Medicaid in pain management and addiction prevention.” [JAMA, Saloner et. al, 8/17/18]
• Health Affairs Study Finds Low-Income People More Able To Afford Diabetes Medications And Manage Disease In Expansion States. “Low-income people with diabetes are better able to afford their medications and manage their disease in states that expanded Medicaid under the Affordable Care Act, a new study suggests. The Health Affairs study, released Monday afternoon, found a roughly 40 percent increase in the number of prescriptions filled for diabetes drugs in Medicaid programs of the 30 states (including Washington, D.C.) that expanded eligibility in 2014 and 2015, compared with prior years.By contrast, states that didn’t embrace the Medicaid expansion saw no notable increase.” [Kaiser Health News, 8/6/18]
• University Of Kansas Research Finds Medicaid Boosts Employment For People With Disabilities. “People with disabilities are much more likely to be employed in states that have expanded Medicaid coverage as part of the Affordable Care Act, new research from the University of Kansas has found. Similarly, the number of those who report not working because of a disability has greatly declined in expansion states. Neither trend happened in states that chose not to expand Medicaid.” [Healthcare Finance News, 7/23/18]