Low-income people in states that haven't expanded Medicaid are much more likely to forgo needed medical care than the poor in other states, according to a government report due out Monday amid election debates from Georgia to Utah over coverage for the needy.
The nonpartisan Government Accountability Office worked with the National Center for Health Statistics to analyze federal survey data from 2016. The research focused on low-income adults ages 19-64 in states that did not expand Medicaid under the Obama-era Affordable Care Act, compared to their peers in states that did.
Medicaid expansion is an issue in several high-profile gubernatorial contests and in states where supporters have gotten referendum questions on the ballot. Under the law, states may expand Medicaid for low-income people making up to roughly $16,750 for an individual or $34,640 for a family of four. Seventeen states have not adopted the expansion, opposed by many — but not all — Republicans.
Among the report's findings:
—Nearly 20 percent of low-income people in states that did not expand Medicaid said they passed up needed medical care in the past 12 months because they couldn't afford it. That compared to 9.4 percent in states that expanded the program.
—About 8 percent of those in states that did not expand Medicaid reported they either skipped medication doses to save money or took less medication than prescribed. That compared to about 5 percent in states that expanded. For people with chronic conditions such as high blood pressure, diabetes and asthma, staying on a medication schedule is considered essential.
—About 22 percent of those in states not expanding Medicaid said they needed but could not afford dental care, as compared to 15 percent of similar low-income adults in expansion states.
—About 11 percent of those in non-expansion states said they needed to see a specialist but weren't able to afford it, as compared to about 6 percent of those in expansion states.
"States around the country have an opportunity to expand Medicaid to more people; these findings help show why it's a winning proposition for states and the millions of Americans currently left out," said Sen. Ron Wyden, D-Ore., who requested the analysis.
Aides to Wyden said the 70-page report is the most detailed look yet at real-world differences that Medicaid expansion can make. In states that did not expand Medicaid, low-income adults are more likely to be uninsured.
Medicaid is a federal-state program that has grown to cover about 1 in 5 U.S. residents, from many newborns to severely disabled people to elderly nursing home residents. Its total cost is about $570 billion a year. Former President Barack Obama's health care law expanded Medicaid to allow states to cover low-income adults with no children living at home.
On Election Day, voters in Idaho, Nebraska and Utah will decide whether their states should expand the program. Montana voters will decide on maintaining that state's expansion.
Expansion also is an issue in gubernatorial races in Florida, Georgia and Wisconsin, which have not expanded Medicaid.
With the federal government covering at least 90 percent of the cost, expansion proponents argue states turning it down are leaving on the table tax dollars their own citizens send to Washington. Backers include hospital systems and health insurers, and many local business groups.
Opponents contend that the cost is still too high for states, which have other major financial responsibilities for education, infrastructure and law enforcement, and must balance their budgets.
President Donald Trump's administration is strongly opposed to Medicaid expansion and tried unsuccessfully to repeal it during Trump's first year.
Medicare and Medicaid administrator Seema Verma argues that Medicaid was originally intended as a safety-net program for the most vulnerable in society and covering able-bodied adults is beyond its scope. Verma is encouraging states to set work requirements for Medicaid, contending that will encourage people to earn their way out of poverty and dependence on government insurance.
KYIV, Ukraine (AP) — A Ukrainian court on Friday ordered the detention of the country’s farm minister in the latest high-profile corruption investigation, while Kyiv security officials assessed how they can recover lost battlefield momentum in the war against Russia.
Ukraine’s High Anti-Corruption Court ruled that Agriculture Minister Oleksandr Solskyi should be held in custody for 60 days, but he was released after paying bail of 75 million hryvnias ($1.77 million), a statement said.
Ukraine’s National Anti-Corruption Bureau suspects Solskyi headed an organized crime group that between 2017 and 2021 unlawfully obtained land worth 291 million hryvnias ($6.85 million) and attempted to obtain other land worth 190 million hryvnias ($4.47 million).
Ukraine is trying to root out corruption that has long dogged the country. A dragnet over the past two years has seen Ukraine’s defense minister, top prosecutor, intelligence chief and other senior officials lose their jobs.
That has caused embarrassment and unease as Ukraine receives tens of billions of dollars in foreign aid to help fight Russia’s army, and the European Union and NATO have demanded widespread anti-graft measures before Kyiv can realize its ambition of joining the blocs.
In Ukraine's capital, doctors and ambulance crews evacuated patients from a children’s hospital on Friday after a video circulated online saying Russia planned to attack it.
Parents hefting bags of clothes, toys and food carried toddlers and led young children from the Kyiv City Children’s Hospital No. 1 on the outskirts of the city. Medics helped them into a fleet of waiting ambulances to be transported to other facilities.
In the video, a security official from Russian ally Belarus alleged that military personnel were based in the hospital. Kyiv city authorities said that the claim was “a lie and provocation.”
Kyiv Mayor Vitali Klitschko said that civic authorities were awaiting an assessment from security services before deciding when it was safe to reopen the hospital.
“We cannot risk the lives of our children,” he said.
Meanwhile, Ukrainian President Volodymyr Zelenskyy was due to hold online talks Friday with the Ukraine Defense Contact Group, which has been the key international organization coordinating the delivery of weapons and other aid to Ukraine.
Zelenskyy said late Thursday that the meeting would discuss how to turn around Ukraine’s fortunes on the battlefield. The Kremlin’s forces have gained an edge over Kyiv’s army in recent months as Ukraine grappled with a shortage of ammunition and troops.
Russia, despite sustaining high losses, has been taking control of small settlements as part of its effort to drive deeper into eastern Ukraine after capturing the city of Avdiivka in February, the U.K. defense ministry said Friday.
It’s been slow going for the Kremlin’s troops in eastern Ukraine and is likely to stay that way, according to the Institute for the Study of War. However, the key hilltop town of Chasiv Yar is vulnerable to the Russian onslaught, which is using glide bombs — powerful Soviet-era weapons that were originally unguided but have been retrofitted with a navigational targeting system — that obliterate targets.
“Russian forces do pose a credible threat of seizing Chasiv Yar, although they may not be able to do so rapidly,” the Washington-based think tank said late Thursday.
It added that Russian commanders are likely seeking to advance as much as possible before the arrival in the coming weeks and months of new U.S. military aid, which was held up for six months by political differences in Congress.
While that U.S. help wasn’t forthcoming, Ukraine’s European partners didn’t pick up the slack, according to German’s Kiel Institute for the World Economy, which tracks Ukraine support.
“The European aid in recent months is nowhere near enough to fill the gap left by the lack of U.S. assistance, particularly in the area of ammunition and artillery shells,” it said in a report Thursday.
Ukraine is making a broad effort to take back the initiative in the war after more than two years of fighting. It plans to manufacture more of its own weapons in the future, and is clamping down on young people avoiding conscription, though it will take time to process and train any new recruits.
Jill Lawless contributed to this report.
Follow AP’s coverage of the war in Ukraine at https://apnews.com/hub/russia-ukraine
Ukrainian young acting student Gleb Batonskiy plays piano in a public park in Kyiv, Ukraine, Thursday, April 25, 2024. (AP Photo/Francisco Seco)
