With GOP’s Medicaid rollback, hard-working Pennsylvanians have the most to lose
By Olivia Golden
Expanding Medicaid to low-income adults is a win-win-win for workers, health care providers, and states. Recent reports about Pennsylvania and Ohio add to the already substantial evidence for each of these wins—and they add to the growing body of evidence that Medicaid expansion supports stable employment.
In Pennsylvania, a new report from the Pennsylvania Department of Human Services about the effects of expansion finds that more people than ever have health insurance, hospitals have less uncompensated care, an estimated 15,500 jobs have been created, and the state has received $53.4 million in additional tax revenue.
A detailed evaluation of Medicaid expansion in neighboring Ohio by that state’s Department of Medicaid provides rich data to explain just how it pays off for workers and taxpayers.
Besides just covering more people, the expansion increased their access to crucial health services, including treatment for mental health and substance abuse. Because people got help for their problems, the report found that they were able to work more steadily.
In fact, more than half of Medicaid expansion enrollees report that Medicaid has made it easier to maintain employment. For people looking for work, nearly three-quarters reported that Medicaid makes it easier.
And it’s not just Ohio. National evidence also suggests that access to health insurance helps people work more, because those who are unemployed and have significant health issues often find the lack of coverage inhibits their ability to search for or maintain employment.
Only once they are healthy will they be able to focus on employment.
A report from the conservative American Enterprise Institute (AEI) in July 2016 found that illness or disability are the top reasons why poor people, particularly adults without children, are not working.
Authors of the AEI report argue that policies must focus on improving the health of the poor in order to support employment. Medicaid expansion is exactly that type of policy.
So all the evidence suggests that Medicaid’s ability to support stable employment is very important in Pennsylvania as well. The majority of Pennsylvanians insured by Medicaid are working, but health concerns are a threat to the stability of that employment.
Without access to affordable health care through Medicaid, for example, those who become ill or have chronic conditions find it harder to maintain employment.
Medicaid expansion supports work in another way as well.
Some parents used to experience a so-called “cliff effect,” meaning that if they got a promotion or more hours, their earnings increased above the old Medicaid eligibility limit and they lost coverage—even though they still had no access to affordable health insurance.
With the expansion, that cliff is gone, because parents can get help from Medicaid all the way up to the point their income makes them eligible for subsidized coverage through the Affordable Care Act’s marketplace.
Removing the cliff effect means there’s no disincentive for parents to earn more, allowing them to move up and best provide for their families.
Many people get health insurance through their jobs, but for those who work in low-wage sectors like food service, retail, or child care, the chances are high that their jobs don’t offer health insurance.
Prior to Medicaid expansion, many of these workers simply went uninsured, and too often missed out on needed care. We know that poverty is a complex issue without crystal clear answers.
But, we also know that Medicaid offers a “hand up,” helping people stay in the workforce by getting needed care so they can provide for themselves and their families.
So it’s hard to argue with the economic success of Medicaid expansion in Pennsylvania. Medicaid expansion not only benefits the state’s economy and health care providers, but also allows hard-working Pennsylvanians to remain healthy so they can stay in the workforce.
Pennsylvania has come too far to consider taking dangerous steps backwards when it comes to access to affordable health care. Policymakers in Pennsylvania should embrace the success of Medicaid expansion and ensure that this vital hand up continues to be available to hard-working people across the state.