All of which brings us back to Medicaid and its effect on healthcare delivery (and possible reform of the delivery system). What started as a relatively small component of social reforms initiated by then-president Lyndon B. Johnson in the 1960s—when, initially, only 2% of Americans qualified for Medicaid—has become, effectively, the largest insurer in the United States, with more than 74 million people enrolled, according to Centers for Medicare and Medicaid Services data
. Part of this increase in Medicaid recipients can be attributed to the ACA, which, for states that opted in, expanded eligibility to include persons with incomes at 138% of the poverty level.
Notably, for the 31 states (and Washington, DC) that signed on for this component of the ACA, the federal government covers the costs for the bulk care provided these “new” Medicaid recipients—including addiction and mental health treatment. In fact, in announcing his “no” vote last week, Pennsylvania Republican Congressman Brian Fitzpatrick said he was basing his decision on “the impact on the single most important issue plaguing [his district], and the issue that I have made my priority in Congress: opioid abuse prevention, treatment and recovery,” according to The Times
And Fitzpatrick was, of course, hardly alone
. Which means, any future attempts to tear up the ACA will have to address the opioid epidemic and related issues or, as Young would put it, they will be “gone, gone, the damage done.”
Brian P. Duleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.
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