Now is a particularly perilous time in the COVID-19 pandemic. Winter is here and we will all be forced to spend more time indoors due to cold temperatures, further fueling the spread of COVID-19. Before the vaccine is more widely distributed, we are holding out hope that our frontline workers can keep running on fumes while the number of ICU beds shrink. California is seeing a spike in COVID-19 cases and in some parts of the state, ICU availability is at zero percent. Meanwhile, low-income Californians are disproportionately contracting COVID-19 while simultaneously facing food insecurity, housing insecurity, and job loss. These are uncertain times and everyone is ready for 2020 to be over.
Despite the uncertainty of the COVID-19 pandemic, one thing we can have faith in is that the benefits of Medicaid are far reaching. A growing body of research shows that Medicaid expansion has improved access to preventive care and chronic condition management, and improved physical and mental health outcomes, with at least 19,000 lives saved. The passage of the Affordable Care Act (ACA), and in particular the Medicaid expansion, helped narrow racial disparities in coverage and access to care. Blacks and Hispanics had the highest uninsured rate prior to the ACA and have made the largest gains, and experienced the largest improvements in access to care.
One less well known benefit of the Medicaid expansion is that it indirectly contributes to the financial security of low-income individuals and families. On average, individuals who gained coverage through the expansion spent less on health-related costs and had a $1,140 reduction in medical debt sent to third party collection agencies. The ACA’s Medicaid expansion also resulted in a 55 percent drop in hospital uncompensated care costs compared to 18 percent in non-expansion states.
Since individuals had less medical debt,Medicaid expansion also indirectly contributed to increased financial opportunities, by creating better access to credit, including lower-interest mortgages and auto loans. Medicaid expansion was one factor that helped lead to a 20 percent drop in evictions. Individuals in recent studies from Ohio and Michigan also reported that gaining health coverage improved their physical, mental or dental health after coverage, which allowed them to look for work or remain employed. Overall, Medicaid helps keep more money in the pockets of low-income families, helping them avoid catastrophic medical spending and more precarious financial situations.
While Californians grapple with the COVID-19 pandemic and the economic fallout over the years to come, Medi-Cal will continue to be a key element to the economic stability of low-income families. The highest poverty neighborhoods in California are bearing the brunt of COVID-19 cases. In fact, a recent California Healthline review of data found that communities with high poverty rates are experiencing confirmed COVID-19 infection rates two to three times as high as rates in wealthier areas.
This highlights the fact that low-income wage workers like grocery store workers, home health aides, farmworkers, hospital janitors, and other service workers are shouldering the greatest risk of COVID-19. Medi-Cal will not only help us tackle the spread of COVID-19, but it will also help low-income families stay out of debt and keep food on the table by shoring up their limit funds that would otherwise go to health care for other basic needs.
While we collectively navigate the economic fall out of the COVID-19 pandemic, it is abundantly clear that one of the best things we can do for low-income Californians is help them get on Medi-Cal, and keep them on. NHeLP will continue to work with California’s Department of Health Care Services and our partner organizations to ensure everyone eligible is enrolled in Medi-Cal and remains enrolled during the pandemic and after the public health emergency ends.