What's Really at Stake with Healthcare

Karen Dove, a former apartment manager living in Texas, lost her job when she could no longer manage to walk up and down the stairs in the buildings she managed. She had pulmonary disease. When she lost her job, she also lost her insurance. When she started to have severe stomach pains, the doctor she went to see wouldn't send her for tests because she didn't have insurance. Eventually, she wound up in a hospital emergency room. She later learned she had stage three ovarian cancer. $24,000 later, with both of her ovaries removed, bills piling up and her husband's dreams of owning a home dead, she struggled to survive. Tragically, she succumbed to her cancer in 2008.

On Wednesday, July 11th, Congresswoman Michelle Bachmann helped lead a largely symbolic House vote to repeal the Affordable Care Act, proclaiming her allegiance to the taxpayer who, in her view, would be oppressed by the law. After the nation's highest Court upheld the Affordable Care Act, Texas Governor Rick Perry threatened to reject Medicaid expansion, a key part of the Affordable Care Act. Although the Supreme Court upheld the law, they ruled that States could not be required to expand Medicaid, creating the potential for 50 fights across the country. Most states will willingly expand Medicaid to cover anyone earning up to 133% of the Federal poverty level, or $31,000 for a family of four. But some states aren't budging. Alongside Governor Perry is Florida Governor Rick Scott who is also threatening to reject Medicaid expansion on the grounds that it would cost Floridians $1.9 billion.

Where does this leave the millions of people whose stories are similar to Karen's? And what's really at stake?

Let's be clear - we are talking about the lives of hard-working Americans - our friends, family and neighbors. In Texas, 78% of the uninsured have a working adult in their family. That means employers are not providing health insurance to their employees or their employees' family members. Medicaid expansion as it is would cover virtually everyone earning up to 133% of the federal poverty level. Currently, that figure is $31,000 for a family of four. You can bet that families earning that much are struggling to make ends meet. In fact, the cities and towns ranked among the most affordable still have average household expenses of at least $40,000 a year. Clifton, NJ has average household expenses of $66,000. In Overland Park, Kansas it's $51,000. And in Montgomery, Alabama it's $44,000. At these rates, who could afford to shell out $24,000 in hospital bills even at higher salaries?

The reality is that people can't live without insurance. Karen Dove couldn't. Our leaders must look their constituents in the eye and explain why they could possibly refuse the federal government's generous offer to foot the entire bill for Medicaid expansion for the first few years. Would the stories of millions without insurance be different if they could benefit from this expansion today? Would Karen Dove's story have been different?

Governors Perry and Scott complain that their states will have added costs. That's misleading. Taxpayers are paying for care for the uninsured now. When people are not insured, they wait to get care because they can't afford it. They get sicker and sicker. Finally, they end up in the emergency room. Those hospitals that treat the uninsured pass the costs of care to those with insurance. The insurers then raise premiums for employees and employees pay. Families USA showed that in 2005 the cost of uninsured care in Florida cost $2.9 billion which was substantially paid for by higher premiums for people with insurance. That was in 2005. Imagine what the figure is in 2012! Given these facts, is Governor Scott's complaint about $1.9 billion to expand Medicaid coverage plausible?

Here is the difference between those of us who support the Affordable Care Act and those of us who don't:

We supporters think we should all pay for long and healthy lives. Opponents believe we should pay for sicker, sadder lives that result in earlier deaths. Either way, we pay. I say let's pay for life!