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Medical debt is way down thanks to Obamacare

Good news! Thanks to Obamacare, medical debt is way down. But not everywhere:

This is from a study published in JAMA a few months ago. In states that expanded Medicaid, serious medical debt (i.e. debt in collections) has been cut in half. In states that didn't, medical debt has stayed about the same. And needless to say, this debt is mainly a problem for those with low incomes.

18 thoughts on “Medical debt is way down thanks to Obamacare

    1. Salamander

      Yeah, and why should he empathize? As a US Senator, he's got free medical care for the rest of his life. If other people gripe about their medical bills, all they need to do is get elected to Congress! Eazy peazy!

        1. Jasper_in_Boston

          No, he doesn't have free medical care.

          When he's in metro DC, he does. Members of Congress get free access to outpatient medical services at military facilities.

          And he's got US taxpayers picking up 72% of the cost of ACA gold coverage.

          He's also got unlimited access to the Capitol's own on-site physician (small annual enrollment fee).

          So, a senator's healthcare coverage options aren't literally "free"—that's true!— rather, they're merely the gold-plated arrangements we typically associate with Fortune 500 CEOs.

  1. SC-Dem

    South Carolina didn't expand Medicaid because it would cost too much. (Probably most of the State's small share of the cost would have been recovered from increased tax revenues.) Now with a $2B surplus, are we going to expand Medicaid or work on climate change issues? No, the politicians have been falling all over themselves to cut taxes in a way where most of the cuts will go to high income people and companies. Boy, I hate them.

  2. akapneogy

    Unfortunately, they'll still fall for "Death Panels" next time a major reform measure comes up. Gullibility and innumeracy are the twin scourges of our society.

  3. Brett

    We should make Medicaid the default secondary insurance for everyone. If you're not on a health insurance plan, they bill Medicaid for it. Couple that with some rules to prevent double-billing Medicaid on covered people and private insurance from dropping people who become too expensive, and you're good.

      1. Jasper_in_Boston

        Alas, still requires a buy in by the state...

        Not if we change the law. The <iSebellius decision cited the critical importance of federal revenue to state budgets: it said (not completely unreasonably) that withholding such large quantities of funds amounted to holding a gun to the temples of state governments, and so treated them as mere appendages of Washington (thus a violation of federalism).

        The change in the law I have in mind is simply a complete federal takeover: 100% removal of the burden of Medicaid funding from state governments. Too many of the latter simply cannot be relied on to work to improve the lives of the millions of Americans who live in such places.

        Fully federalize it!

    1. Jasper_in_Boston

      We should make Medicaid the default secondary insurance for everyone. If you're not on a health insurance plan, they bill Medicaid for it.

      Agreed. I'd throw in all federal healthcare spending (Medicaid, CHIPs, Obamacare subsidies, etc) outside of Medicare/VA (for political purposes) into one big program. Call it "Universal Coverage for America" (or something snappy like that). You'd be automatically enrolled when you're born or obtain legal residence. Payroll tax would replace (at roughly equivalent amounts) premiums for both employers and individuals. Opt-out in favor of private insurance would be possible (again, politics) but lack of coverage would essentially be made legally impossible. And the state component would be taken over by the Feds. So the states would be free to cut taxes or increase spending in other areas with the cash they previously were spending on Medicaid. Taking over the state portion of Medicaid funding ($300 billion) would be the biggest cost involved with such a plan.

      Basically, what I'd like to see is something like Buttigieg's "Medicare for all who want it" but with automatic enrollment to make it truly universal, BUT A) I think politically, Democrats would be better off separating it from Medicare. I know "Medicare for All" polls well with progressive voters, but my recollection from the ACA struggles is that the elderly as a voting block are super protective of this program, B) The name "Medicaid" is associated with poverty (for good reason) and shouldn't be part of any expansion to achieve universal coverage.

  4. rick_jones

    In states that didn't, medical debt has stayed about the same.

    Applying one of your (in)famous trendlines using the Mk I eyeball suggests down perhaps 10%.

  5. Wonder Dog

    Point well made, Mr. Drum. This really is the crux of everything, isn't it? At least as far as the overlords, er, Republicans are concerned. From Wikipedia:

    "...a condition of debt bondage and indentured servitude with similarities to and differences from slavery..."

    It's the raison of 'conservatism,' from Reagan onward. No wonder they hate democracy so much.

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