Ideology kills

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Republican-led states have for years refused to expand Medicaid eligibility to many of their poorest residents, and now, in the midst of the coronavirus pandemic and an unprecedented economic crisis, thousands upon thousands of Americans will fall through that hole in the safety net and end up uninsured.

This was completely avoidable.
The Affordable Care Act was designed to extend Medicaid coverage to everybody living in or near poverty. But Republican resistance to the health care law, enabled by a 2012 ruling from the US Supreme Court, prevented that vision from becoming a reality. Today, 14 states have not expanded Medicaid access. Poor people — particularly black Americans living in the South — have already been paying the price for that obstruction for years.
But today, in the middle of the coronavirus outbreak, many thousands more are going to discover the harsh reality that the United States has failed to adequately protect its poorest citizens from financial ruin in a medical emergency.

New estimates from the Urban Institute provide a fuller understanding of the cost of those decisions during the Covid-19 crisis. With record unemployment upon us, the institute’s researchers anticipate that between 25 million and 43 million Americans will lose their employer-sponsored health coverage along with their job. In the 36 states (plus Washington, DC) that have expanded Medicaid through the ACA, less than a quarter of those people are expected to become uninsured. Most of them are expected to end up on Medicaid, as intended.

But in the 14 states that still refuse to expand Medicaid, a full decade after Obamacare became law, about 40 percent of the people who lose their jobs and their health insurance will end up with no coverage at all.
Urban Institute/Robert Wood Johnson Foundation

Those newly uninsured people will be less likely to seek necessary medical care, the available research tells us, and more likely to face financial catastrophe if they do have a medical emergency — coronavirus-related or otherwise. The price tag for treating Covid-19 if a patient ends up hospitalized is anywhere from about $10,000 to north of $20,000. And these will be people who just lost their job and therefore their income. Enhanced benefits for unemployment aren’t going to cover a $15,000 hospital bill.

It gets worse. Rural hospitals in states that refused to expand Medicaid were already more vulnerable to closure than hospitals in states that did expand. Now they have been forced to cancel elective surgeries, a fiscal lifeblood for any hospital, pushing them even closer to closing.
Tens of thousands uninsured, hospitals on the brink of bankruptcy, all amid a devastating pandemic. It didn’t have to be this way..

Coronavirus: Rejecting Medicaid expansion hurt newly unemployed workers - Vox