Passover is my favorite holiday. And my favorite part of the Passover Seder is the singing of Dayenu.  As we list each miracle and wonder that was done for us, such as freeing us from slavery or saving us at the Red Sea, we say Dayenu.  Dayenu is loosely translated to “That would have been enough for us”.

The Patient Protection and Affordable Care Act (Obamacare) was a poorly written bill.  It was compromise legislation that didn’t fully satisfy anyone on the left or the right.  But when asked over the last seven years what Obamacare did well, I have always cited the expansion of Medicaid.  If the Patient Protection and Affordable Care Act had done nothing but expand Medicaid – Dayenu!

Destigmatizing Medicaid was the first positive step we could take as a society to help the poor and working poor. And Medicaid helps more than just the poor.  It also helps the disabled and the elderly.  Medicaid is our insurer of last resort, which means that an awful lot of our friends and neighbors rely on this government provided insurance.

In Greater Cleveland Medicaid coverage allows those in need access to our world-class medical facilities, highly trained doctors, and needed prescriptions. Medicaid even covers office visits which are much cheaper and more convenient than the inefficient emergency room.

The Kaiser Family Foundation has done extensive research on Medicaid.  Their Medicaid utilization graph has appeared on numerous TV shows as well as in newspapers such as the New York Times and the Plain Dealer.  On a national level Medicaid covers:

  • 49% of all births
  • 76% of all poor children
  • 60% of all children with disabilities
  • 64% of all nursing home residents
  • 30% of all adults with disabilities

Medicaid is helping our most vulnerable. Do we have some people who could/should be paying for their own insurance?  Of course.  Can we do a better job policing utilization and reimbursement (fraud and waste)?  Of course.  Can we significantly reduce funding without impacting access to care?  NO WAY.

There has been excellent reporting on Mitch McConnell’s Senate “working draft”, the Better Care Reconciliation Act of 2017 (Trumpcare).  Steven Koff of the Plain Dealer has delivered some of his best work.  The New York Times has again proven why it is the paper of record.  The “working draft” is only 142 pages.  It is a quick read.  Follow this link.  We’re talking about the way we, all Americans, access and pay for healthcare.  We are talking about nearly 20% of our economy.  It is your responsibility to at least read McConnell’s plan.  You have the time.

We can discuss the merits of a huge tax cut for the wealthy. We can wonder how eliminating the individual and employer mandates while retaining guaranteed issue won’t destroy the insurance market.  We can go page by page through the BCRA and ask “Why?”  But for today, I just want you to read the bill.  And if you do that, it will be enough for me.



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2 Responses to Dayenu

  1. […] expansion of Medicaid under the PPACA is also part of the new normal.  Some of my most virulent anti-Obama / […]

  2. […] money, and regulation that can potentially help large segments of the American public.   The expansion of Medicaid, a federal-state partnership to provide health insurance to the poor and working poor, is one of […]

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