Medicaid Expansion

Medicaid Expansion

"The obligation to care for the health of the poor, universally recognized by religious organizations, is among this country’s fundamental values and is furthered by the Affordable Care Act’s expansion of Medicaid."

Medicaid is the only option for many low-income Americans

Created by Congress in 1965, Medicaid is a public insurance program that provides health coverage to low-income families and individuals, including children, parents, pregnant women, seniors, and people with disabilities. Medicaid is funded jointly by the federal government and the states. Each state operates its own Medicaid program within federal guidelines.   

Congress expanded Medicaid through the Affordable Care Act (ACA) in response to the fifty million uninsured Americans, many of whom are too poor to afford health insurance.  Medicaid Expansion represents a shift in federal policy regarding eligibility in this program.

Prior to the ACA, Medicaid expansions and the creation of the Children’s Health Insurance Program (CHIP) decreased the percentage of uninsured American children, but the number of uninsured American adults continued to grow.  The law previously required states to cover their poorest or lose federal funding to Medicaid (federal funding covers 90-100% of state costs). On June 28, 2012, the Supreme Court upheld the constitutionality of the Affordable Care Act but allowed States to opt-out of Medicaid Expansion leaving millions of poor working families without coverage.

Medicaid Expansion in the States

As of August 31, 2014, 29 states have implemented Medicaid expansion while 19 states (most located in the south and the mid-west have stated that they will not expand Medicaid at this time. (They include AL, AK, FL, GA, ID, KS, LA, ME, MS, MO, MT, NE, NC, OK, SC, SD, TX, VA, WI.) Regardless of whether they expand Medicaid or not, all states are required to establish streamlined, coordinated, and automated Medicaid eligibility and enrollment systems to facilitate enrollment in Medicaid and promote continuity of coverage.

Four states are expected to soon join the Common-Wealth of Pennsylvania in the expansion – TN, Indiana, Utah and Wyoming. Of the states who opt-ed, most out have the highest uninsured rates and are the states where expansion could help the most. It is projected that in these states health insurance will increase for everyone, including those with private insurance.

There are many costs to being uninsured. Poor working families will go without proper health care creating a less healthy society, chronic medical problems become acute, and medical bills become a disincentive to going to the doctor. In the worst cases, medical debt leads to bankruptcy, major depression and possibly suicide. Medical providers will have to raise rates on insured people to deal with the large numbers of uninsured. States who refuse to expand Medicaid will have to make up the difference from state or local taxes or else see vital health institutions go out of business. There is a big economic ripple effect. Medicaid expansion will help to break this vicious cycle – but only if states decide to expand it. Many who could have obtained financial assistance through Medicaid expansion will remain outside its reach. The problem is that this will likely raise everyone's health insurance, including those with private insurance.

Why The Medicaid Expansion Matters to Faith Communities

In 2012 the United Church of Christ joined 60 national, state, and regional faith organizations in working together as coalition partners thorough Faithful Reform in Health Care and the Washington Interreligious Staff Community (WISC) Health Care Community is signing an Amicus Brief to inform the Court about the moral imperatives that impel faith communities to support the Medicaid expansions and improves in the Affordable Care Act (ACA). The brief was delivered to the President and Members of Congress in 2011.

Why Medicaid Expansion matters to the faith community:

  1. Faith communities understand that state legislators are subject to a greater law than the ACA – a moral imperative to care for the poor and the sick.,
  2. Faith communities are guided by the teachings of Matthew 25:37-40 – “whatever you did for the least of these my brothers and sisters of mine, you did for me.” 
  3. Faith communities agree that our government has a role in bringing justice and protection to the poor and the sick.
  4. Faith communities are grounded in values that inspire them to work on behalf of the common good.
  5. Faith communities embrace the vision of a society where each person is afforded health, wholeness, and human dignity.” [taken from “A Faith-Inspired Vision of Health Care.]
  6. Faith communities want to see comfort and healing to those who suffer, in particular the poor and vulnerable who are served by Medicaid and for whom the ACA’s Medicaid provisions are significant.

How faith Communities Can Advocate for Medicaid Expansion Uncommitted States

Across this nation citizens are raising their voices and "speaking truth to power" the importance of expanding Medicaid for low-income Americans in their state.  The UCC has a history of standing up for justice.  Here are some tips to support Medicaid Expansion in those states that have decided NOT to accept Medicaid Expansion funding:

  1. Organize a rally such as the “People! Not Politics Rally (Ohio) that resulted in that Governor changing his mind.
  2. Organize a forum to tell your state legislators and Governor to accept federal funds designated for Medicaid expansion.  Tell them “please put people before politics by keeping Medicaid Expansion in the budget”.
  3. Organize a story bank and invite persons to send in stories of how Medicaid has helped them.  Collect the stories and send to governor and legislators.
  4. 10 Advocacy Steps to Support a Medicaid Expansion in Your State
  5. Medicaid Expansion Messaging for State Advocates
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