New York Times Offers a Preview of Who Might Benefit Under the ACA

By Martha Heberlein

As we await the ruling from the Supreme Court, a recent article in the New York Times reminds us of just how important the Medicaid expansion will be. The article tells the stories of a number of adults who have benefited (or didn’t) from a lottery in Oregon in 2008 that randomly selected 10,000 adults to enroll in the state’s Medicaid program.

One of the lucky ones was Wendy Paris who got surgery on a foot she had broken four years earlier back when she was uninsured. She was able to receive other services, including treatment for depression. Her response to the coverage –  “It saved my life,” she said.

Another, John Bell, reports, “I feel like a different person.” Before the lottery gave him coverage, he had filed for bankruptcy after emergency kidney stone surgery left him with a $6,000 bill.

For those who aren’t lucky enough to win the lottery, the lack of coverage is huge barrier to care and piece of mind.

Take Christine Toman who reports that not having insurance “affects your whole life.” She suffers from chronic pulmonary condition and hepatitis C and typically skips care.

Or Samantha Kious, who at just 24 is living with untreated cervical cancer. “It’s scary for me, having cancer and knowing I can’t do anything about it.”

Under the ACA, Medicaid will be extended to most adults up to 133% of the FPL. This is a huge sea change, ending the historic exclusion of adults without dependent children from the program and possibly ending uninsurance for 4.9 million parents. The NYT piece puts some faces on these numbers and reminds us that you shouldn’t have to win the lottery (money or otherwise) to get covered.

Editor’s Note: The NYT article builds on a unique and ongoing study of the impact that Medicaid coverage has on the health and health care experiences of those enrolled. The first results of the study, released last July, found that those on Medicaid were much more likely to receive recommended preventive care and more likely to receive services such as outpatient visits, prescription drugs, and hospital admissions. The study also found that having Medicaid coverage was an important contributor to more stable economic circumstances. And as seen in the interviews in the NYT article, Medicaid beneficiaries also self-reported better physical and mental health status, lower rates of depression, and other positive outcomes.