Who Suffers When Medicaid Is Cut?

Each spring we who plant vegetable gardens look forward to getting things a little bit better than the year before; we have a another chance to start fresh and get it right.  The expectation of sharing the bountiful crop nourishes our sense of generosity and caring, nourishes our feeling for others.  With each tiny Burpee seedling that is planted the seed of altruism is also planted, and then fed and watered to get it started.  As the early weeks pass I carefully inspect the garden daily, looking deeply to find and support what is working, and to try to fix what is not.  This concentrated effort causes time to slow down.  In the beginning, walking through the neatly planted rows there is order, no chaos. 

But by mid-summer the prickly cucumber vines twist and punish my fingertips.  But the canopy

Cucumber Vine from "Mother Nature Network"

leaves protect the cucumbers hanging underneath.  Following the vine to the very end there's a surprise.  Some of the cucumbers are straight, as expected, while others have curled up into crooked shapes, not how they are supposed to look at all, impossible to peel.  Transporting these cukes and the few Early-Girl tomatoes that have begun to ripen back to the house cradled and cocooned safely in the bottom of my too-big tee-shirt I feel full, and connected firmly to the Earth.  I sense that this gardening strengthens my compassion for life, for life in all its forms.

As I empty my shirt onto the kitchen counter and marvel at the freshly picked (and still living) vegetables I glance over at "The New York Times" and think to myself, Now what?  What is Congress up to?  Why, it's healthcare insurance again, the latest version.  Cuts in Medicaid.  Who are the people who will be hurt, I wonder?

It didn't take much digging to find out.  Over the next ten years it had been estimated by the non-partisan Congressional Budget Office that 22 million Americans will likely lose coverage but the newest figure is 32 million, as many as 17 million in the next year alone.  Most of these have been relying on Medicaid and the Medicaid Expansion under the Affordable Care Act (ACA).  Who are they?  Let's see. 

According to the "Business Insider" (July 14, 2017 ) Medicaid currently covers 20% all adults 19-65, 30% of all adults with disabilities, 39% of all children, 40% of all poor adults, 60% of all children with disabilities, 64% of all nursing home residents, 76% of all poor children, and 49% of all births.  These are the people in the cross-hairs of the new version of the Senate healthcare proposal. 

Especially to be affected are those in states with high rates of poverty and the working poor who benefited from the Medicaid expansion.  (While Medicaid is far from perfect and does not solve the problems of timely access to affordable medical care-a subject for later-at least it aims to try to address the inequalities in health insurance coverage that have been based solely on income.)

On the other hand, provisions contained in the so-called Better Care Reconciliation Act (wow!) as originaly proposed by the Senate's long-awaited (eight years in the making) plan to "repeal and replace" what they still refer to as "Obamacare" (the ACA) have been designed to help other groups of Americans.  Help them quite a lot.  The big winners were to be households making more than $250,000 a year as two ACA taxes targeting them would be repealed; those whose "passive" income is mostly from investments would have come out particularly well.  But the wrangling continues as factions within the controlling party writing the plan search for agreement, and the details of what finally emerges will certainly be changed (at least a little bit).  We will stay tuned and we will be listening.

Manel Blanco: "Coming Out of the Cocoon"

After writing these few paragraphs and sensing the pain and suffering hidden in the cold calculations I take a deep breath and let it out slowly.  The unborn, young children, new mothers, disabled fathers, and grandparents living their lives out in nursing homes, among others, will be without protection. 
This feels like the direct opposite of a cocoon, the direct opposite of a cocoon of caring.  Is this what we really want?