Last week the Congressional Budget Office produced a report saying that the decision of the Supreme Court to uphold the ACA but let states opt out of the Medicaid expansion could save the federal government money.
The projections show that 30 million people will be eligible for some type of coverage but the opt out by states could leave 3 million uncovered. Those 3 million uncovered will save the government $84 billion over the next 10 years.
What the government saves will be shifted onto those with private insurance through higher premiums and elimination of that cost shift was one of the goals of the ACA. The savings come at a price and beyond the monetary price there is an access to care and health care price. Most of the uncovered will seek care in hospital emergency rooms and we all know primary care services are not very efficient when delivered in the emergency setting and tend to cost a whole lot more than needed.
The other cost is even more costly. The New England Journal of Medicine reported that for each 500,000 adults who fail to gain access to Medicaid, 2,840 more deaths can be expected to occur each year. Eliminating access to Medicaid for 3 million adults can be expected to contribute to 17,000 unnecessary deaths each year.
I try to stay away from politics but it’s impossible for me to stay away from compassion. Our health care system is broken and I don’t know if the ACA is the right answer but it’s the answer we have to deal with at this time and it’s at least an attempt at a solution until something better comes along. You’re going to hear a lot about the ACA as politicians banter back and forth over the coming months.
States will need to decide if they are going to participate in the Medicaid expansion and the decision is difficult from a dollars and cents perspective but it seems to me that the decision is simple from a life and death perspective.