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“Giving people Medicaid insurance is almost like giving them nothing”

Posted on May 15, 2015

“…Because it’s a fact. When you look at, yeah, you know why there’s more people insured? Because a lot more people are on Medicaid. And given, you know, we expanded Medicaid in a big way, and giving people Medicaid insurance is almost like giving them nothing, because you can’t find a doctor that will see Medicaid patients. And so where do they end up? The same place they used to end up, in the emergency room.” –Speaker John Boenher, Meet the Press, May 3, 2015

There are times in your life when you hold in your mind two conclusions, and you have to decide which one is true and which one is…well, absolute bullshit!

On one hand, you have the Speaker of the House speaking his “truth” to the American people. Stating clearly that those who were historically uninsured due to their inability to pay for medical insurance get nothing out of now having health insurance. That nothing has changed for those in poverty in Medicaid expansion states.

On the other hand, I travel the country presenting to primary care associations, medical providers, homeless service providers, educators, HIV providers, and many others. What I see in my work is a much different reality that Speaker Boenher stated. Here is the America I see:

• Several dozen documented cases in Arkansas where those people that got on Medicaid and went for a medical check-up were diagnosed with a disease that would have killed them if they had not engaged in care due to their inability to pay.
• World-class medical care being provided in beautiful clinics throughout this country.
• People in non-expansion states still struggling to work in an environment where their ability to pay determines whether or not they can access health services. This goes along with the personal stories of how health care bills and unequal access is impacting families and communities who are already struggling with poverty, addiction, and violence.

I’m left wondering about Speaker Boenher and those who seem to have wasted our tax dollars by voting 56 times to repeal a law that is documented as saving lives, not only in Arkansas, but around the country. I’m left with two possible conclusions. First, he is just terrible at his job. Boenher is so out of touch with what is going on in this country that he truly thinks that Medicaid expansion is not having a tremendous impact on those living in poverty. What scares me about this conclusion is that he seems to take every opportunity to spread his ignorance to others and, being one of the most powerful leaders in the country, people believe he knows what he is talking about.

The second conclusion is that he is so ego-invested in his ideology that he would hurt millions of people for his own political gain. If he does have knowledge of the impact and reality of Medicaid, then the only conclusion we can make is that he would rather people in poverty continue to get sick and die than provide them with adequate health care. I struggle in my heart to even think that someone could consciously hold this stance.

I like to believe the best of people and while ignorance in elected officials is a scary conclusion, it seems better than the alternative. While I have focused on Speaker Boenher, we also must struggle with the fact that around 20 state-level politicians have chosen not to expand Medicaid in their states, essentially denying those in poverty access to health care due to their inability to pay. One could make the excuse, though poorly in my opinion, that initially there was not enough information to feel confident moving forward on Expansion. However, today we have outcomes showing that Medicaid expansion works (economically and for health outcomes) and once again we are only left to struggle with whether those we have elected are ignorant or worse…intentionally harming the poor.

“…giving them nothing at all.” I think often about those documented lives saved in Arkansas and elsewhere around the country. What is the value of these lives to their families and communities? As the economic and health care Armageddon predicted by those that opposed Medicaid expansion start to seem silly and misinformed, we are left with one question: Are the lives of Americans living in poverty worth saving?

I hope this question transcends Speaker Boenher and likeminded politicians’ and voters’ political agendas and ideologies and makes its way to the soul of who they are as people. Are the lives of Americans living in poverty worth saving? This question should not require thought and debate, but should rally us as a country to see the unethical and inhumane situation still facing those in non-expansion states.

I know many of you, if not all, have a story. For those of us in expansion states, we need to find ways to communicate to our communities both the statistics and the personal stories of those impacted by finally getting access to health care. For those in non-expansion states, we must also share statistics and stories, but from the perspective of why those in poverty in Texas, Wisconsin, South Carolina, and other states have a right to affordable, preventative, and quality health care services. All lives have value and together let’s confront ignorance with knowledge and passion. “No justice, No peace.”