In each edition, we'll feature an action, victory, campaign, or interesting tactic shared by a state advocate. Send us your updates.

In This Issue:

• Advocacy Tip: Attend Health Action 2013!
  
• States in Focus
  
• Michigan: Medicaid Expansion Makes Sense for Michigan
  
• Nebraska: New Medicaid Program Gaining Momentum as States Recognize Benefits
  
• North Carolina: Healthier North Carolina Rests in the Hands of Pat McCrory
  
• Meme of the Month
  
• New Resources from Families USA and Stand Up for Health Care

Advocacy Tip

Advocacy Tip: Attend Health Action 2013!

We hope to see you all at Health Action 2013, our annual conference, from January 31 through February 2. We’ve gone green this year, so attendees will be able to enjoy our online toolkit with resources from Families USA and others about policy issues and advocacy strategies. Also, be sure to use your smartphone to check out our Health Action 2013 Mobile Conference Center at www.swankmmm.com/HealthAction/. The Conference Center will give you all sorts of conference information, such as the program schedule, a floor plan of the hotel, and more, right in the palm of your hand!

And for those of you unable to make it this year, keep your eyes peeled for video footage of plenaries to be posted following the conclusion of Health Action 2013.

States in Focus

Medicaid Expansion Makes Sense for Michigan

Expanding Medicaid benefits not only the uninsured, but it also benefits employers and individuals who purchase private health insurance, hospitals and Michigan's economy as a whole. The Affordable Care Act (health reform) gives states the opportunity to expand Medicaid eligibility to cover all non-elderly citizens and eligible immigrants up to 138 percent of the Federal Poverty Line.

Governor Snyder has the power and obligation to decide whether Michigan should participate in Medicaid expansion. Now is the time for Governor Snyder to join other governors across the country by deciding, and publicly announcing, that Michigan will do the right thing and take advantage of this rare opportunity.

Medicaid expansion benefits Michigan's economy. The Affordable Care Act provides that the federal government will pay for 100 percent of Medicaid expansion's costs between 2014 and 2017 and ultimately pay for 90 percent of its costs in the following years. Analysts at the Center for Healthcare Research and Transformation project that Michigan can reap up to $1 billion in savings in the next 10 years due to expansion. They also project that Medicaid expansion will bring more than $30 billion of federal dollars into Michigan's economy over the next 10 years.

Medicaid expansion benefits those who need health insurance, particularly low-income adults. According to the Center for Budget and Policy Priorities, there are about 676,000 total uninsured Michiganders who would be eligible for Medicaid if Michigan participates in expansion. Many of these uninsured are low-income adults. Low-income adults often struggle especially hard to get health insurance, and many times go without, for several reasons: the individual health insurance market is often inaccessible and too expensive; if they have jobs, those jobs often don't provide health insurance benefits; and, they are currently largely ineligible for Medicaid. Medicaid expansion gives these low-income adults a chance to get the health insurance coverage that they need and deserve.

Medicaid expansion benefits employers and individuals with private health insurance. If you're an employer or individual who purchases private health insurance, part of your costs come from uncompensated care that hospitals provide to the uninsured by law. If we reduce the number of uninsured, we reduce the amount of uncompensated care expenses that get passed onto those with private health insurance. The Center for Healthcare Research and Transformation projects a savings between $640 and $985 million over the next 10 years statewide to those who purchase private health insurance because of Medicaid expansion.

Medicaid expansion benefits hospitals. Hospitals, especially those that treat a lot of uninsured patients, get extra compensation from the federal government called Disproportionate Share Payments (DSH payments). As the law stands now, the federal government will reduce DSH payments to hospitals across the nation, including hospitals in Michigan, between 2014 and 2020 because it expects that fewer people will be uninsured. If we fail to expand Medicaid, Michigan hospitals will most likely be in a nasty bind that could jeopardize their ability to provide quality care -- their DSH payments will go down and they may face an increase in, or at least steady, levels of uncompensated care expenses.

Governor Snyder believes that "to build a stronger Michigan, we must build a healthier Michigan." I agree wholeheartedly, but we've got a long road ahead of us. Let's get the ball rolling by expanding Medicaid.

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New Medicaid Program Gaining Momentum as States Recognize Benefits

As state Legislatures come back into session this month and budget discussions begin, the new Medicaid option under the Affordable Care Act is gaining momentum.

In the past week alone, the governors of Arizona and North Dakota, who both had previously spoken out against the ACA, included the new Medicaid plan in their budgets because of the economic benefits that would come to their states in the form of federal dollars.

Arizona Gov. Jan Brewer said the new Medicaid plan would bring $2 billion to her state.
Last week, North Dakota Gov. Jack Dalrymple told the Grand Forks (N.D.) Herald, “We try to leave the politics out in the hallway when we make these decisions. In the end, it comes down to are you going to allow your people to have additional Medicaid money that comes at no cost to us, or aren’t you?” he said. “We’re thinking, yes, we should.”

And yesterday, the CEOs of the four hospital systems in Columbus, Ohio, joined together to call for their state to adopt the program because it would stabilize increasing medical costs.

According to a story today in Columbus Business First, the four CEOs “agree that having more people covered will result in more predictable costs because of better coordination instead of episodic ER visits.”

Likewise, Nebraska would see all of these benefits if the Legislature decides to take up the new Medicaid option, which would be fully funded by the federal government for the first two years, and would never be less than 90 percent federally funded.

The new Medicaid plan could return at least $2.3 billion to Nebraska through 2020 and sustain 10,000 new jobs.

Many states have already come to the realization the ACA’s new Medicaid option is a deal too good to pass up. The same is true right here in Nebraska.

Healthier North Carolina Rests in the Hands of Pat McCrory

We have an opportunity to care for more North Carolinians than ever before—to be healthier than ever before.

If, that is, Governor Pat McCrory chooses to act on behalf of North Carolinians rather than play politics with our health. It’s up to Gov. McCrory—as executive of our state—to decide to expand Medicaid and provide health insurance to hundreds of thousands of uninsured North Carolinians.

A key component of the Affordable Care Act helps states expand their Medicaid programs. In its current form, Medicaid provides health insurance for the lowest-income Americans, but because of current restrictions in the program, millions of low-income adults are not eligible for coverage. But through health care reform, states may expand the eligibility requirements so that almost all adults earning below 138% of the federal poverty level (or about $25,000 per year for a family of three) will gain Medicaid coverage. If, that is, Governor McCrory opts to expand the program.

There is every incentive for Governor McCrory to choose to expand Medicaid. The price tag for North Carolinians will be extremely small—under the ACA, the federal government will finance 100 percent of the cost for the Medicaid expansion through 2016. Starting in 2017, the federal government will slightly decrease its share but still cover 90 percent of the costs in 2020 and beyond. The end results? Five hundred and seventy thousand newly insured North Carolinians.

The small price that our state will have to pay is worth the sweeping benefits to North Carolinians. No longer will some of our poorest neighbors have to worry about how they’ll pay for their basic care; no longer will they have to put off doctors visits because of fear of how much they’ll cost. Even better, North Carolina’s small investment in expanding Medicaid will help save the state money in long-term health care costs because more residents will be seeking preventive care that staves off more costly long-term medical care.

Gov. McCrory has the potential to fundamentally change the health care system in our state. If low-income North Carolinians suddenly have health insurance, there is a potential to undo the profound health disparities in our state. As it stands, North Carolinians who are uninsured are likelier to develop serious health complications or even die younger from diseases that are all too often preventable. But by gaining health insurance through Medicaid, this population of North Carolinians will be able to prevent diseases like diabetes and will be able to detect and treat diseases like cancer. Gov. McCrory can make North Carolina healthier than it has ever been.

I write this as someone who sees the empowerment of health insurance every day. At Planned Parenthood, seventy percent of the patients we treat are uninsured or underinsured. And no matter what, we help all of these men and women access the care they need.

But there’s a huge gulf between how our patients approach their care—and it is too often tied to their insurance status. If we see a woman who has a lump on her breast, we always refer her to a breast specialist and help cover as much of her care as we can. But how she chooses her medical care options is far too frequently dictated by her insurance status.

This is not right—and speaks to the importance of insuring as many North Carolinians as possible. No one in our state should ever have to think twice about treating cancer or coming in for a routine preventive care visit. This will mean affordable birth control—no longer will North Carolina women have to choose between putting food on the table and purchasing contraceptives. This is something we see every day at Planned Parenthood—and something that flies in the face of effective family planning. Medicaid expansion could change this choice, and allow more women to take control of their family size.

It’s now up to Gov. McCrory to make sure that North Carolina expands its Medicaid program. By doing so, he has the potential to transform our state. With his executive blessing, McCrory can save lives—improve lives—and create the healthiest North Carolina yet.

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Take me to back issues of the Beat!

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