It is estimated that nearly 2,800 Grand Island residents — 8 percent of the city’s population — have no way to afford health insurance. They’ve fallen into what’s called the “coverage gap.”
And, according to Jeff Sheldon from Nebraska Appleseed, statewide it’s estimated that there are as many as 100,000 Nebraskans who are in that coverage gap.
Sheldon, along with other members of Nebraska Appleseed, was in Grand Island and Hastings today to talk with the public and community leaders about the increasing number of area people falling into the coverage gap.
“It is a significant problem in the Grand Island area,” Sheldon said.
What being in the “coverage gap” means, Sheldon said, is that those individuals aren’t eligible for Medicaid currently, and they don’t make enough money to get tax credits to afford private insurance.
“These are folks who don’t make enough money to afford private insurance, but earn too much to qualify for Medicaid since Nebraska hasn’t expanded Medicaid,” Sheldon said. “This hurts their families, but also isn’t great for local businesses and local health care providers, who often have to write off uncompensated care costs to provide these people with services.”
According to Sheldon, currently, children, pregnant women, seniors, people with disabilities and some very low-income parents are eligible for Medicaid in Nebraska. But because Nebraska hasn’t expanded Medicaid, that leaves an estimated 100,000 people in Nebraska not able to afford private insurance.
Nebraska has the option to expand Medicaid coverage for adults between the ages of 18-64 up to 133 percent of the Federal Poverty Level, Sheldon said. Expanding Medicaid coverage would allow more hard-working, low-income people who can’t qualify for federal Marketplace credits to afford health insurance. If Nebraska was to expand Medicaid coverage, he said low-income parents over the current income limit and working adults without children would have a way to afford health insurance.
Sheldon said Medicaid expansion would benefit Grand Island’s economy, as increased insured rates are good for both consumers and providers.
Sheldon provides some examples:
- Nebraska non-metro counties have a 15.5 percent uninsured rate, higher than any county type in the state. As a county’s population decreases, its uninsured rate grows.
- Counties with high uninsured rates (21 percent or greater) exist only in non-metropolitan Nebraska. Sheldon said it is estimated that Medicaid expansion could potentially cut the rural uninsured rate in the state by half.
- Currently, nearly one-third of rural physicians derive 25 percent or more of their patient revenue from Medicaid, as compared to 19.9 percent of urban physicians. Nationally, 56 percent of all rural physician income and 60 percent of all rural physician income and 60 percent of all rural hospital cash flow is tied to Medicare and Medicaid.
Sheldon said one economic benefit of Medicaid expansion in Nebraska is that it could avert bankruptcies and allow more money to be spent in local communities.
- A study of 2007 bankruptcy data found that 62.1 percent of all U.S. bankruptcies were because of medical debt.
- Medicaid expansion in Nebraska could avert a projected $142.7 million in bankruptcies over a five-year period.
Sheldon said bankruptcy hurts a family’s ability to get credit and leaves local businesses unpaid. When these families are not paying off a crippling amount of medical debt or filing bankruptcy, they could spend more money in their communities, which would also help to create more jobs.
The stops in Hastings and Grand Island Wednesday are part of a statewide tour to generate public awareness.
He said when the Affordable Care Act was passed, it had a way for everyone from all income levels to afford health insurance. But the U.S. Supreme Court ruled that one part of the Affordable Care Act, Medicaid expansion, was optional for states.
“In Nebraska right now, if you are poorer than poor and you meet a couple of certain conditions, you are eligible for Medicaid,” Sheldon said. “But for those who don’t make a lot of money and can’t qualify for Medicaid, there is no way for them to get health coverage unless Nebraska passes a plan to specifically allows them to get health coverage.”
He said for the last four years, the State Legislature has attempted to pass such a plan but has not been successful.
“You can be someone who is making $10,000 per year and struggling to pay all of their bills but still can’t receive any help to buy health insurance,” Sheldon said.
And those daily expenses are getting harder and harder to pay. According to the annual State of the Nation’s Housing Report from the Joint Center for Housing Studies of Harvard University, the number of renters who have to spend half or more of their monthly salary for rent has hit a record high of 11 million people.
“Housing costs are very high and, for the people we are talking about who would be eligible for Medicaid, housing costs comes first, keeping the lights on and buying food,” Sheldon said. “They are all basic necessities and it doesn’t leave a lot of money left over to see the doctor.”
Nebraska Appleseed is a nonprofit organization that fights for justice and opportunity for all Nebraskans. Sheldon said one of Nebraska Appleseed’s missions is that every Nebraskan should be able to afford health insurance.
“You are just a better state when everyone is healthy,” Sheldon said. “The economy is healthier. You don’t have as many bankruptcies because people don’t have as much medical debt. Parents and spouses are better when they are healthy. People are better employees when they are healthy.”
Sheldon said by creating more public awareness about the coverage gap in Nebraska, Nebraska Appleseed hopes to generate positive action during the next legislative session to finally pass legislation to address the widening coverage gap.
“We have found that people all over the political spectrum recognize that this is a problem that needs a solution,” Sheldon said.
He said 32 states have already expanded its Medicaid program to address the coverage gap and it is “inevitable” that it will eventually happen in Nebraska.
“The only question now is, ‘How much more dollars are we going to let go to waste and how more people are we going to let suffer before we do the right thing,’” Sheldon said.
To find out more about Nebraska Appleseed, visit their website at https://neappleseed.org.