Five years after the Affordable Care Act was signed into law, the battle continues for full implementation of one of its most important provisions: the expansion of Medicaid to cover more low-income people. Some 20 states still refusing to go along with this provision. (Here's a chart on which ones.)
As we've reported before, a number of foundations are backing efforts to get more states to accept the Medicaid expansion and the federal funds that go with it. But this has been a quiet push, and for a good reason: It's a highly politicized issue.
One reason to be optimistic about the outcome of this fight in many states is that a wide array of groups are promoting Medicaid expansion, including for-profit healthcare outfits with a big financial stake in bringing in those federal healthcare dollars. Meanwhile, many nonprofit and faith groups have also mobilized around Medicaid expansion.
A case in point is Mercy, which is the fifth-largest Catholic Health Care system in the U.S., treating millions of patients each year with its 46 hospitals and close to 700 clinic and outpatient facilities in the South and Midwest. Of particular note are its outreach ministries in Louisiana, Texas and Mississippi. Mercy in Mississippi is pushing for citizen engagement to fully implement the ACA in that state with a grant of $200,000 from the W.K. Kellogg Foundation that runs through the end of March 2016.
It's not surprising that Kellogg is behind that push. The foundation has a big presence in Mississippi, as we've discussed before, and it's looking to help the poor of that state in every way that it can.
Despite the fact that it is dead last among U.S. health rankings, Mississippi has refused to accept federal funds to expand Medicaid for those in poverty. The expansion is opposed by the Republican establishment that currently holds the governor’s mansion, both U.S. Senate seats, three U.S. House seats, a majority in the state legislature, and 11 other statewide and regional offices. The state doesn’t even offer residents a state-run health insurance exchange.
Mercy’s health care system was founded less than 30 years ago by the Sisters of Mercy, but the order traces its roots to Catherine McAuley, a woman of modest means who received an inheritance for her work as a caretaker, with which she opened the first House of Mercy in Dublin to educate disadvantaged kids and help poor women. In 1831, she founded the Sisters of Mercy. Her nuns did not retire to the cloister but cared for the poor and sick, going so far as to visit them in their homes. Sister McAuley’s mettle was soon tested as she tackled a raging cholera epidemic. In 1843, the Sisters of Mercy began a convent in the United States.
Overall, Kellogg has pledged close to a million dollars to Mercy health since 2009, but the need in the state of Mississippi is great:
- At 9.1 deaths per 1,000 live births, infant mortality remains higher in Mississippi than in any other state. In fact, this rate is higher than Uruguay. Many of the fatalities are due to the prevalence of low birth weight.
- There’s low immunization coverage among teens.
- There isn’t enough participation in physical activity.
- The state ranks highest in chlamydia infection, a sexually transmitted disease.
- Mississippi has some of the highest rates of obesity, heart disease, and diabetes in the country
Mississippi's population has the highest percentage of African Americans in the country, 37.3 percent in the 2010 census. Nearly four times as many of them live in poverty as whites. In Mississippi, 138,000 residents who can’t afford to buy health insurance, even with the national subsidies, and have no Medicaid option, get no health insurance at all. Most of them are black, a situation that doesn’t seem to bother major Republican office holders in the state, who at first glance all seem white.
Fully funding Medicare should be a priority in the state of Mississippi. As Sister Catherine McAuley wrote in 1838, “Since there is very little good can be accomplished or evil avoided without the aid of money, we must look after it in small as well as in great matters.”