AUSTIN, Texas -- As states grapple with financial shortfalls due to the coronavirus pandemic, a new study shows just how much Texas could benefit by expanding Medicaid under the Affordable Care Act.
Study lead Laura Dague, associate professor in the Bush School of Government and Public Service at Texas A&M, said at current funding rates, Medicaid expansion in Texas could bring in $5.4 billion in new federal spending and provide health coverage to nearly 1 million Texans, with little cost to the state.
Dague said the unexpected health crisis illustrates how expanding Medicaid could help lower-income Texans.
"Medicaid is the kind of program that can make a big difference in a pandemic - especially as, going forward, where hopefully we'll develop better treatments, and thinking about how people are going to pay for those things," Dague said.
Without health insurance, people typically forgo preventive care, and head to an emergency room when they're sick, creating a financial burden for the state and taxpayers. Research for the study was compiled by the Bush School of Government and Public Service and sponsored by the Episcopal Health Foundation.
Texas is one of 12 states that hasn't expanded Medicaid since becoming eligible to do so with passage of the Affordable Care Act in 2010. As a result, Texas has the nation's highest rate and total number of uninsured individuals.
Dauge said many Texans earning minimum wage are too poor to qualify for an ACA tax credit, but earn too much to qualify for Medicaid under the state's strict eligibility criteria.
"So, we have a really big eligibility gap in Texas that a lot of people in working families can fall into," she said. "And that's one of the reasons we have a high uninsured rate relative to other states."
Dague worries when the COVID-19 vaccine is available, the cost will be out of reach for some Texans.
In 2019, a federal judge in Texas invalidated the Affordable Care Act, although the law remains in effect awaiting a U.S. Supreme Court ruling.
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A Pennsylvania nurse is sounding the alarm about proposed cuts to Medicaid funding now in Congress, cuts she said could jeopardize care for her son as well as millions of Americans.
The House version of the budget reconciliation bill would slash federal Medicaid spending by at least $700 billion to fund a tax-cut extension and other Trump administration priorities.
Jennifer K. Graham Partyka, a registered nurse in Northeast Pennsylvania, joined the "Fair Share for Americans" bus tour in Scranton this week. She said Medicaid is a lifeline for her 28-year-old son living with Crohn's disease.
"We were lucky, because when he was very sick, he qualified for Medicaid," Partyka recounted. "He was fully disabled until he started getting the treatments and started getting better. There's a version of that Medicaid called, like, 'Medicaid for working disabled people.'"
Medicaid covers about one in four Pennsylvanians, including 750,000 with disabilities. Partyka pointed out her son, who works full-time, would not be affected by the work requirements Congress wants to add for Medicaid eligibility. It would mean adults without children would need to work or volunteer 80 hours a month to keep their coverage. Republicans are pushing to pass the reconciliation bill by July 4 but debate could delay it.
Partyka emphasized Medicaid is one of the top five sources of payment to every hospital in the nation. With many already struggling to stay open and fully staffed, she thinks cutting Medicaid would also be disastrous for people's access to care.
"My professional experience with Medicaid is that most of the recipients of Medicaid are children," Partyka stressed. "I'm also going to share that 60% of people in nursing homes list Medicaid as their primary payer."
She added voters ultimately have the power to hold lawmakers accountable for the fallout from major budget decisions, noting many congressional seats will be up for grabs in 2026.
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Diabetes diagnoses are climbing, with about 37,000 adults diagnosed in Indiana every year, and doctors caution they are seeing more cases in younger patients.
Diabetes means the body is unable to maintain a healthy blood glucose or blood sugar level. Type 1 is caused by an autoimmune process affecting the pancreatic cells which make insulin. Type 2 diabetes means the body has reduced sensitivity to the insulin it naturally produces.
Dr. Tamara Hannon, pediatric endocrinologist at Indiana University's Riley Hospital for Children, explained why the body's response function changes.
"The pancreas can stop making enough insulin for a number of reasons," Hannon noted. "Could be genetic, the cells get damaged over time by having to work too hard, an infection, high blood fat levels, or just getting exhausted over time."
The Centers for Disease Control and Prevention predicts if the rate of new diagnoses in kids and teens continues to climb, Type 1 diabetes cases would increase by about 65 % and Type 2 by about 700% by the year 2060.
There is no cure for Type 1 diabetes but its progression can be delayed with medication. For the more common Type 2, cell damage can be delayed or even reversed through weight loss, exercise, lifestyle changes and medication.
Hannon pointed out with the epidemic of childhood obesity, younger people are developing diseases traditionally diagnosed in adults, in part because of their food and beverage choices and other environmental factors. She added research shows sugary drinks in particular increase the risk for not only Type 2 diabetes, but liver disease and cardiovascular disorders.
"If you think about when you drink sugar versus when you eat foods that contain sugar, there's a different way that is absorbed and metabolized," Hannon observed. "If you drink something that's sugary, the sugar goes into your bloodstream quite quickly."
Hannon stressed the body has to mount a quick metabolic response to a rapid sugar download but the natural sugars in whole foods, like fresh produce and certain vegetables, are not absorbed by the body as quickly. According to the American Diabetes Association, 12%, or about 666,000 Hoosiers, are diabetic.
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The Missouri Foundation for Health has named the first five winners of its new "Spark Prize," an award backing Missourians who are working to promote health equity.
Each winner gets $200,000 in no-strings-attached funding to fuel their vision. Awardees were chosen for their potential to create meaningful, lasting change in the Show-Me State.
Evonnia Woods, a community organizer and movement builder, was one recipient, chosen for her progress and vision to advance racial, reproductive and economic justice across Missouri. She shared why the award from the foundation is unique.
"A lot of foundations, they want to see evidence that you're already doing what you're asking for funds to continue doing," Woods explained. "In this regard, it's like, 'Oh, you believe in me. This is good because I believe in me.'"
Unlike traditional grants, the Spark Prize is flexible and trust-based, given directly to individuals and not organizations. The recipients were selected from more than 170 nominations from diverse backgrounds, regions and sectors across Missouri.
Ciearra "CJ" Walker, founder and CEO of the Community Health Worker Coalition, which has trained more than 300 community health workers in St. Louis and supported more than 600 statewide, was a recipient. Walker, a Detroit transplant, shared the motivation behind starting her organization and her vision for the future.
"What we are hoping to do is to replicate across the country what's possible when we position ourselves," Walker noted. "Not just to extract from our community leaders, but to truly allow them to be architects of the system that they participate in and benefit from them accordingly."
Walker added her coalition also reinvested $30,000 dollars into its members through pay, training and growth support.
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