The Medicaid expansion that the governor announced today means more Kentuckians will get the treatments they need to stay healthy while avoiding the risk of financial catastrophe should they get sick.
Given our state’s health status, the help is needed. According to the United Health Foundation, Kentucky ranks 7th from the bottom among the states in overall health. Kentucky has the highest rates of cancer deaths and preventable hospitalizations in the U.S.—and also ranks among the ten worst states in obesity, diabetes and cardiovascular deaths.
Many of the state’s health problems can be improved by increasing the number of people with health coverage. Research shows that those who are uninsured have worse health outcomes than those with insurance—particularly for those with chronic conditions like diabetes that Kentuckians suffer from at high rates. According to a survey of both insured and uninsured Kentuckians, those who are uninsured are more likely to refrain from seeking medical care because of cost—delaying medical attention; skipping medical tests, treatments or follow-ups; not filling prescriptions for medicine; and not seeking out needed treatment from a specialist.
Expanding Medicaid will qualify about half of Kentucky’s uninsured for coverage, enabling them to receive preventive care and timely medical treatment (many of the remaining uninsured will gain coverage through the health insurance exchange that will be launched in 2014). New findings from the ongoing Oregon Health Study show that Medicaid beneficiaries were less likely than those without insurance to suffer from depression and more likely to be diagnosed with and treated for diabetes. Those with Medicaid were also far more likely to access preventive care such as mammograms for women.
In addition, the Medicaid expansion will protect more Kentuckians from the risk of financial hardship. The Oregon study indicated that Medicaid very nearly eliminated catastrophic out-of-pocket health care costs, which are the cause of the majority of personal bankruptcies in the United States.
While the Oregon Health Study did not find significant changes in diagnoses or treatment of high blood pressure or high cholesterol during an average of 17 months on Medicaid, recipients’ increased use of preventive care could take years or even decades to show its full effect on health. Another recent study found that five years after three states expanded Medicaid, expansion was associated with a 6.1 percent reduction in mortality. Recipients were also more likely to report that their health was “excellent” or “very good” and less likely to report delaying care due to costs.
The Medicaid expansion will allow 308,000 Kentuckians to access the care they need to stay healthy. And it will give them the peace of mind of knowing that financial disaster is no longer an illness away.