MONTGOMERY, Ala. - States that have expanded Medicaid have seen dramatic decreases in their numbers of uninsured, low-income adults, especially in rural areas, according to a new report that notes Alabama has gone in the opposite direction. Wisconsin did not accept expanded Medicaid funds.
According to the report from the Georgetown University Center for Children and Families, the percentage of low-income adults without insurance who live outside of metropolitan areas dropped by almost 20 percentage points in states that have expanded Medicaid.
However, Jim Carnes, policy director for the group Alabama Arise, said that without that expansion, the number of uninsured Alabamans in rural areas has increased from 35 percent to 36 percent. "And we're paying the price," he said, "in terms of health coverage for low-income workers, in worker productivity because of unnecessary sick days, and in our state budget and larger economy."
Opponents of Medicaid expansion have said it would strain the state's general fund, but Carnes said it would bring in 90 cents from the federal government for every 10 cents of state money.
Joan Alker, the Georgetown center's executive director and co-author of the report, said caring for uninsured patients puts a huge strain on hospitals, especially in rural areas where health care already is harder to access. "A lot of these hospitals are facing pretty tough times if a lot of their patients are uninsured," she said. "So, not only is a hospital critical for rural communities, but they're also employers, often one of the largest employers in these small towns."
More than 10 Alabama hospitals have been forced to close in recent years. Carnes predicted that more hospitals will close unless Alabama joins other states in expanding Medicaid. It's an idea he believes may be starting to gain some traction. "The Hospital Association has recently launched a Medicaid expansion campaign. There are some business leaders starting to talk about that option," he said. "So, I think some stars are aligning and we may be able to push it forward." He said expanding Medicaid in Alabama would give an estimated 300,000 people access to health insurance.
More information is online at georgetown.edu.
