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Kevin Tran
Mrs. Honey
Government 2
22 October 2015
Mock Congress Research Paper: Health Reform
Bernie Sanders, a presidential candidate in the 2016 election, once said, Look, if you have
somebody who doesn't have health insurance, who doesn't have a doctor or dentist, and in order to deal
with their cold or flu or dental problem, they go to an emergency room - in general, that visit will cost ten
times more than walking into a community health center. Unfortunately, about 5.2 million or more
Americans are faced with the hardship of not having health insurance even now when two years have
elapsed since Obamacare was passed in March of 2010. In 2012, the Supreme Court ruled that States
could have the choice of either participating or opting out of Medicaid expansion. This simple ruling
ultimately resulted in 21 states opting out of the expansion program of the Affordable Care Act, or the
ACA. In these non-expanding states, Medicaid eligibility only covers up to 44 percent of the federal
poverty line, or $8,840 annually for a family of three, and marketplace subsidies starts at 100 percent of
the federal poverty line, or $11,770 for an individual. This flawed system has essentially created a
coverage gap where millions of poor and hard-working Americans are trapped without any insurance.
These states should expand their Medicaid programs because it will allow all citizens to have equal access
to healthcare coverage, create more jobs in the healthcare field, and benefit the states economies.
Health care reform has been a major issue in the United States during the past decade. The
struggle for a universal health care system that will give all Americans health care coverage has been
lengthy and onerous. Even after Obamacare, which promised that everyone would be covered with health
insurance, was passed, millions of low-income citizens remained uninsured. In states that chose not to
expand Medicaid, it left about 8 million who live in poverty (19,530 for a family of three) without any
assistance for health insurance, (Sandmeyer 2013). These low-income families were put in an arduous
situation where they are at risk of bankruptcy due major medical expenses that were created because of

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the coverage gap. As a result, even elderly people, whose health is most fragile and in need of
attention, stopped buying their prescription drugs because the prices were too high without health
insurance coverage. Moreover, many of those eight million people left without health insurance were
forced to abstain from any hospital visits due to their high cost. This later resulted in even more
expensive trips to the emergency room that could have been avoided had the patients visited the hospital
regularly. Expanding Medicaid would open benefits up to more of these people, providing them with
timelier healthcare, reducing non-paying hospital visits as well as unclogging some of the emergency
rooms to make way for actual emergencies, (Palmer 2015). Not only would an expansion of the
Medicaid program help millions of people receive care and avoid expensive medical bills, but it would
also increase emergency room availability for those actually in need of emergency care, all while creating
jobs in the medical field.
By expanding Medicaid, states would be able to lower their unemployment rates with all the new
jobs and positions that would be created through the Medicaid program. An enlargement of the Medicaid
program would give more people access to health care and aid, and therefore more of them would
voluntarily go to hospitals and visit doctors instead of avoiding them due to high cost. This would
increase the need for doctors and other medical personnel, creating a niche for new employment
positions. Medicaid expansion would create more jobs because more staffing would be needed since
more people are visiting the doctors, (Palmer 2015). Granted this is true, many nurses and other medical
personnel who were laid off because of insufficient need for their position of employment would get their
jobs back. Furthermore, with a high interest level in the field of healthcare, the expansion of Medicaid
would help many college graduates who have studied medicine obtain jobs quickly and without adding on
to the unemployment rate. The new study, published by the market trend research group FitchRatings,
found that Medicaid expansion states experienced 30 percent faster growth in health sector jobs in 2014,
compared to the states that havent accepted the expansion, (Culp-Ressler 2015). Expansion of
Medicaid led to increase in patient numbers, and as the number of patients increased, the demand for staff
increased also. The growth of jobs and the health sector have proven to greatly benefit state economies.

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The chain effect created by the simple expansion of the Medicaid program makes a significant difference
in the economy of the healthcare field that benefits both the states and the federal government.
The creation of new jobs through the Medicaid program would boost the economy of the states.
Especially since the United States has just begun its recovery from a recent economic and financial crisis,
growth in the economy of individual states is essential to the countrys well-being and positively affects
the country as a whole. A study in 2012 on the economic impacts on Missouri from Medicaid expansion
reported that about 24,000 jobs would be created by 2014. It is estimated that these new jobs would
produce a labor income (employee compensation) impact of approximately $977 million in 2014 and
continue to produce approximately $992 million in 2020, (DaVanzo 11). Based on the projected income
of just the single state of Missouri, one could predict how much of a positive effect there would be on the
American economy if all of the states participated in the expansion of the Medicaid program. With that
amount of money, states and the federal government would be able to invest in education, projects, and
any other necessary programs in order to ameliorate the state of the union. Unlike the state of Missouri,
Texas continues to deny Obamas policies and refuse to expand Medicare. Because Texas has opted not
to expand Medicaid, it's estimated uninsured population continues to exceed 4 million, (Rosenbaum
2015). This decision has led to a loss of approximately 7 billion dollars for Texas hospitals. As a result,
the state itself has to allot more funds to this area to make up for the loss, hindering progress in other
areas of development such as the improvement of schools in the state. It is clear that states can only
benefit from agreeing to Medicaid expansion. It gives the states a new source of income and boosts their
economy all while improving the economy of the United States as a whole. This brings America closer to
the ideal of creating a health care system that is affordable for everyone and also allows America to shift
its focus from health care to the many other pressing issues that are in need of being addressed.
It is inevitable that there would be arguments against the Affordable Care Acts expansion
program of Medicaid. Many opponents of expansion argue that expansion would cost too much money
for the state and is also an effort of the federal government to micromanage the states and what they
should do. Some may also say that because of this act, the federalist system is violated and the states do

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not have their own sphere of authority over their Medicaid program. However, the federal government is
only making an effort in order to ensure that every American has health care coverage. Nearly four
million poor uninsured adults fall into the coverage gap nationally, (Garfield 2015). Since such large
sums of people are living in poverty, it is the federal governments duty to ameliorate their living
conditions by providing health care subsidies and coverage. Not only that, but expansion has great
benefits to the United States and to the states themselves economically. However, the governors of 21
out of 50 states still reject expansion. Non-expansion states governors gave great resistance out of
concern that they would have to shoulder the cost of expansion even though their expenditures would be
reimbursed through 2020 as the Obama administration assured, (Collins 2015). When the governors
claimed that supporting Obamacare would hurt their states money, the Obama administration gave them
an assurance that all costs would be paid back to them by the federal government. Since all costs are
covered, the states have no reason to be so persistent and stubborn about rejecting the program which is
obviously benefitting states such as Missouri. Medicaid expansion would ultimately better the states
financially through the increase in federal funding provided for expansion and would allow the country to
progress out of the recent economic crisis as a whole.
In conclusion, by agreeing to expand their Medicaid programs, all states would be able to benefit
themselves and America wholistically by giving their citizens equal access to health care coverage,
expanding the healthcare field by creating more job openings, and benefitting and stabilizing their
economies. The expansion of Medicaid is about more than just the Obamacare program and health care in
the United States. It is about providing people with the basic right of access to health care and giving
them the ability to care for the health of themselves and their families. Even though America is one of the
most developed countries in the world, more people live below the poverty line in America than in many
third world countries. It is time for that to change. It is time that everyone can have equal opportunity for
a happy and healthy life in the United States. It is for this reason that the Medicaid program should be
expanded and made universal in all of the states of America. The benefits of this change greatly outweigh
any setbacks, and supporting the Medicaid program is a step in the right direction for a better America.

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Work Cited
Collins, Sam. Even After Obamacare, Some Americans Are Uninsured. Who Are They? Center For American Progress Action Fund, 21 Aug. 2015. Web. 17 Oct. 2015.
Culp-Ressler, Tara. States That Accepted Obamacares Medicaid Expansion Are Creating More Jobs. Center For American Progress Action Fund, 20 Feb. 2015. Web. 22 Oct. 2015
DaVanzo, Dobson. The Economic Impacts of Medicaid Expansion on Missouri. University of
Missouri School of Medicine, Nov. 2012. Web. 22 Oct. 2015.
Garfield, Rachel. The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid
An Update. Kaiser Family Foundation, 17 April 2015. Web. 24 September 2015.
Palmer, Pat. Medicaid Expansion: The Pros and Cons of Closing the Coverage Gap. Medical Recovery Services. Web. 17 Oct. 2015.
Pollack, Ron. Closing the Medicare Part D Doughnut Hole: The End is in Sight!
FamiliesUSA, 18 Dec. 2015. Web. 17 Oct. 2015.

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Richardson, Sam. Obamacare Survived. So Now We Need to Address the Medicaid Gap. UTNews, 26 June 2015. Web. 17 Oct. 2015.
Rosenbaum, Sara. How will Texas Affordable Care Act implementation decisions affect the
population? A closer look. 19 August 2015. Web. 24 September 2015.
Sandmeyer, Ellie. Fox News Finds A Victim - Of Republicans Obamacare Sabotage. Media Matters For America, 1 Nov. 2013. Web. 17 Oct. 2015.