Good call

It seems like a long time ago that WV Governor Tomblin made the decision to expand Medicaid under the Affordable Care Act. I was there in the crowd celebrating that victory when it went down, but none of us who worked for it dreamed WV would do such a great job of signing up folks. We're talking 150K in a year.

We know that this was good news to those who got covered. Now it looks like it's good news in the states that expand Medicaid for both taxpayers and other health care consumers. It turns out that it's also good news for people who get jobs in the health care and service sector. According to Fitch Ratings,

The states that expanded health insurance access under the Affordable Care Act (ACA) have seen substantially faster growth in healthcare jobs than those that did not since the first expansions began last January. If this trend continues, Fitch Ratings says it could support a broader economic and tax base for state budgets and improve nonprofit hospital finances in those states....

According to data from the Bureau of Labor Statistics, healthcare and social assistance jobs grew over 30% faster between December 2013 and December 2014 for 24 states that implemented ACA expansion on Jan. 1, 2014 than those that did not. On average, those states saw jobs in the healthcare and the social-assistance sectors grow by 2.4% YOY. Twenty-four states that didn't expand grew at 1.8%. Data for Alaska (a non-expansion state) and New Mexico (an expansion state) was not available.

(In case you were wondering what the YOY abbreviation meant, like I was, it's "year over year.")

Epic (non) fail

As Paul Krugman points out in today's New York Times, the Affordable Care Act is significantly failing to fail, although you might not know that by following the media. One place where that is especially true is El Cabrero's beloved state of West Virginia. According to this article from last weeks Charleston Daily Mail,

6.59 percent of West Virginians are uninsured today; compared to 17.34 percent of West Virginians uninsured before the implementation of the Affordable Care Act, also known as Obamacare. Based on the data...West Virginian saw the biggest drop in adult uninsured rate and had the most new Medicaid enrollees per capita than any other stat that expanded Medicaid coverage.

West Virginia now has the sixth lowest uninsured rate in the country.

In addition, the Charleston Area Medical Center (CAMC), the state's largest hospital system, has seen "a dramatic decrease in self-pay patients, charity care, uncompensated care and bad debt since Medicaid and subsidized private insurance policies started becoming effective on Jan. 1."

In 2013, for example, five to seven percent of CAMC patients were uninsured. In Jan. 2014, the percentage dropped to 1.7 percent and is now around 1 percent. This could mean:

*a $20 million or 35 percent drop in charity care from one year to another;

*a $35.5 million or 51 percent drop in bad debt; and

*a $55.5 million or 43.8 percent drop in uncompensated care.

A lot of credit for all this goes mainly to Gov. Earl Ray Tomblin, who made the call to expand Medicaid in May 2013. But it also should be noted that the WV Department of Health and Human Resources has done a magnificent job of signing people up.

To paraphrase Joe Biden, it really is kind of a big....deal.