Dr. Goodwin’s Minority Health Minute

10 Reasons States Must Stop Denying Affordable Care Act/Obamacare Services


Nearly one-half of the US states are causing the Loss of Lives and Money” by refusing to expand their Medicaid Programs in accord with the provisions of the Affordable Care Act (ACA), or Obamacare. However, the Supreme Court ruling permitting states to opt out of Medicaid expansion has turned out to be a giant loophole, although the Act was found to be constitutional. 

When consideration is given to the benefits lost to the holdout states as a result, it is clear that their holdout decision is political, and apparently linked to dislike/disrespect of President Obama.

An important Historical Point: Having followed much of the controversy, untruths, fog and miscommunication associated with the development and passage of the Affordable Care Act, the Supreme Court ruling, the botched ACA rollout, and the subsequent impressive 9 million + enrollment results during since the rollout, we recall very well that it was opponents of President Obama who first unveiled the term “Obamacare” in a mocking fashion, apparently with no expectation that it would evolve to be used widely in recognition of the President’sleadership in having ACA become a national law and reality.

10 key reasons denial of expanded Medicaid Programs in these holdout states must stop follow.

1.     The associated increased cost of Medicaid expansion is fully paid for by the federal government for the first 3 years, and then 90% until 2022.
-In other words, 90-100% of expansion cost is paid for during the first 8 years.
-In fact, some of the participating states have indicated that expanding Medicaid has increased their budgets.

2.     They are withholding access to important preventive health education and services for their neediest residents, such as childhood immunizations, HIV, and breast and colon cancer.

3.     The holdout states are causing: 

– delayed detection of serious and costly chronic diseases such as diabetes, hypertension and heart disease, and thus also their delayed treatment; and

– associated significant financial, social, workplace related and human costs. Further, the longer those in need of expanded care services do not receive them, the greater these associated costs. 

4.     Five (5) million needy residents in the holdout states must apparently wait years for better health and longer lives, as compared to residents of the states with expanded Medicaid programs.  

  1. The holdout states are making it necessary for most of their uninsured residents to use emergency rooms (ER’s) for non-emergency care, which is more costly and of

lower quality in ER settings because:
–         The basic setting is inappropriate, and
–         There is a lack of appropriate follow-up, and continuity of care after ER visits.
6.      Although residents in the holdout states pay taxes in support of Medicaid, their states do not receive Medicaid related funds, and other benefits, for residents who
would be eligible under ACA’s expanded Medicaid Program.  

  1. The viability of some hospitals in the holdout states, especially in rural and densely populated urban areas, is threatenedbecause they are not receiving expanded Medicaid Program funding.

    8.      The holdout states are blocking opportunities for increased health related training and employment opportunities resulting from increased capacity development. 

    9.      The holdout states are bypassing health related community development opportunities.

    10.   Within the context of the above losses being caused by the 23 holdout states, their
    actions are immoral. 


Because Health Power is very concerned about the wide-scale silence of “mainstream America” to this immoral situation, we have prepared “10 Reasons States Must Stop Denying Affordable Care Act/Obamacare Services” hopes that it will better inform and motivate those who share our concern to use it, if and as helpful, to

(a)   “Spread the Word” to others who may not be aware of the immorality of the actions of the withholding states; and

(b)  Help Stop the Silence regarding this immoral national situation. 

Other simply
stated Health Power articles on the Affordable Care Act/ObamaCare can be found by clicking on our website Home Page feature article  atwww.healthpowerforminorities.com

I am also posting this article on the Health Power Blog (Just click on the Blog Button) so that our users and visitors can add their comments and suggestions with Health Power
as well as our Blog community. Or, feel free to write me directly atnjgoodwin@healthpowerforminorities.com


Remember: Knowledge + Action = Power! ®

Norma J. Goodwin, MD, Founder and
President, Health Power