Sunday, July 20, 2014

Obamacare, combined with lack of Medicaid extension in VA, creates real personal quandaries in DC area


The variability of the impact of the Patient Protection and Affordable Care Act in different states has an impact on where people live, how (and how many hours) they work, and whom and even how they love.  All of this appears in the Washington Post today in Business Page story “After a breast cancer diagnosis, her choice: Marriage or Medicaid”, by Damielle Paquette.  The story concerns a young woman, twice divorced, who does not want to marry again, but has to decide whether to follow her boyfriend as unmarried to Virginia, from DC, when Virginia does not accept the Medicaid extension.

The boyfriend is taking a job transfer to Reston, which could be difficult for someone living in the District.  If she marries him, she is covered.  Virginia does not any adults without children on Medicaid.

It’s pretty apparent how social conservatives can play this situation as promoting marriage.  Obvious, in Virginia, the possibility of getting insurance even through marriage for an indigent person in a same-sex coupling would not (yet) be possible, until litigation is over.

It's also easy to moralize about the willingness (or lack of) by someone to marry a partner after learning she has breast cancer.  It's easy to imagine other variations on this situation.
  
To me, the idea that refusing the Medicaid extension (paid for by the federal government) makes any sense at the state level does not compute, no matter how one feels about people on welfare.   It's interesting to me, though, that residents of intentional communities (income-sharing arrangements in rural areas) are often able to get Medicaid. 
  
This sort of problem will be particularly a problem in the Washington DC area, where Virginia’s politics are much more “red state” than Maryland or the District.  



The story was   not yet available online as of mid afternoon July 20,  but is supposed to be available soon (Monday?) on a feature called “Storyline”.  



Update: July 22, 2014

Paquette's story appeared on the Post site Tuesday morning, link here

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