Can we patch the umbrella?: The fight for Medicaid expansion

Advocates like Heidi Sinclair of Doctors for America are working hard to encourage Medicaid expansion in all states because when it comes to health coverage, “we have an umbrella with a hole in it,” she said during this morning’s session on Louisiana’s fight for Medicaid expansion.

Her group has active campaigns in 13 states that have yet to expand Medicaid to cover people with incomes up to 133 percent of the federal poverty level. For example, in Texas, which has the nation’s highest rate of uninsured residents at 24 percent, nearly 785,000 people fall into the “coverage gap” left by not expanding Medicaid. In Florida, the number is nearly 1 million.

But the group’s advocacy has helped turn the tide in Arizona, Ohio and Pennsylvania, three states that initially opted not to expand coverage but then changed course.

“Nothing could save more lives in terms of health policy in the United States in this decade than following up with Medicaid expansion,” said session moderator Ramon Castellblanch of San Francisco State University.

Alma Stewart, a leader for Medicaid expansion in Louisiana who organized Saturday’s rally near the convention center, stressed that the fight for expansion is about improving health. Louisiana consistently ranks low in the yearly America’s Health Rankings report, most recently coming in 48th on measures such as obesity, physical inactivity and percentage of children living in poverty.

“That’s the reason why it’s important for us to really advocate and do the work,” said Stewart, president and founder of the Louisiana Center for Health Equity.

The coalition Healthcare For Everyone In Louisiana has held “Dying for Coverage” vigils and reached out to lawmakers to stress the need for change, Sinclair told session attendees. She estimated that up to 260,000 people in the state fall in the coverage gap. In many of the states where doctors are pushing for expansion, the focus is no longer on changing the opinions of state policymakers but on getting the public into the fight.

“Probably our best bet at this point is an emphasis on advocacy in the community rather than trying to sway the legislature,” she said.

Everyone can play a role in helping bring health coverage to more Americans, the presenters said. Check out APHA’s action alert on protecting the Affordable Care Act for starters.

— D.C.