Opinion: Affordable health care is just common sense – UpNorthNews

Opinion: Affordable health care is just common sense – UpNorthNews

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By Dr Sophie Kramer
As a primary care doctor in Wisconsin for the past 35 years, I’ve taken care of people with and without insurance. My message is simple: medical care is better at preventing and treating disease when people have insurance coverage. That can come through their employer, through Medicare, through safety net programs for low income folks such as Medicaid, and through the Affordable Care Act (ACA), which provides options for all those who fall through the cracks.
Access to healthcare coverage is on the ballot in this election at every level of government, from Wisconsin state representatives, to Congress, to the Presidency. The stakes are high: preserving the Affordable Care Act, preserving women’s reproductive health choices, and in Wisconsin, the important opportunity to expand Medicaid.
Let’s consider the need to preserve the Affordable Care Act. Julie was a patient of mine who had good insurance through her local employer in Milwaukee when we diagnosed a rare but treatable endocrine disorder. Then she had to leave her job to take care of her elderly mother. Without insurance she stopped her treatment and her disease symptoms flared, so she would periodically go to the ER or urgent care – a very expensive and inefficient way to get care, but often the only option for the uninsured. She finally got ACA coverage and got her treatment back on track, but she was stuck with years of paying off medical debt.
Before 2014, when the ACA took effect, patients like Julie with pre-existing conditions only had the option of expensive, high-deductible health plans that usually didn’t cover preventive care. The ACA has so many benefits for Americans, but preventing insurers from denying coverage to people with pre-existing conditions is key. The ACA also mandates that there are no co-pays for preventive care, like Pap smears, cancer screening, and immunizations. Let’s remember that Sen. Tammy Baldwin introduced the popular ACA provision allowing young adults to stay on their parents’ insurance until age 26, letting them get established in the workforce without risking medical debt.
We’re also voting for candidates who can sink or swim Medicaid expansion for low income folks. At a free clinic in Janesville I saw Susie, a nursing assistant with two young kids at home. During the pandemic, she qualified for Medicaid and was able to get her diabetes under control. Last month when I saw her she’d been off medications since early 2024 after the Medicaid “unwinding” spooled her into the uninsured pool. She’d already had one ER visit after getting woozy at work with a wonky blood sugar. We cobbled together a treatment plan, not as good as what she could get with insurance, but the patchwork of intermittent, limited free care and expensive emergency care is what she’s got.
Wisconsin has a special opportunity with this election to finally join the 40 states that have taken advantage of provisions in the ACA to expand Medicaid to 138% of the federal poverty level – that’s an annual income of $20,783 for an individual and $35,632 for a family of three in 2024 – an opportunity that Wisconsin legislative leadership has blocked for the last decade. Shockingly, Wisconsin is one of only two states that has not accepted incentives to expand postpartum Medicaid coverage to 12 months after delivery for new mothers, an especially vulnerable time when access to care has tremendous benefits for infants and moms.
This intransigence has lost Wisconsin tens of millions of dollars from the federal government to support Medicaid funding. There’s no evidence to support the argument that expanding Medicaid will keep people from working, according to a Wisconsin Policy Forum report. And expanding Medicaid will save money for Wisconsin taxpayers!
While I despair at this fiscal irresponsibility, as a doctor I’m excited about the good evidence that accessing Medicaid improves treatment of chronic conditions like cancer, diabetes and mental health, reduces mortality, and improves rural health access. While Wisconsinites throughout the state will benefit from Medicaid expansion, the impact will be biggest in rural areas.
Common sense tells me that it’s better for all of us when people don’t spiral into debt for their appendectomy; when the loving choice to have a baby doesn’t cycle into calls from a collection agency; when an early breast cancer is found on a screening mammogram rather than morphing into an ulcerating mess. Common sense (and lots of data) tells me that helping the poorest among us get access to medical care is not going to keep people from working to pay their rent, utilities, and grocery bills. Common sense tells me that getting medical care to keep healthy helps people stay employed.
Most of all, common sense tells me that Wisconsin voters want their families and neighbors to be healthy. We need our elected officials to support and improve the Affordable Care Act and commit to Medicaid expansion in Wisconsin.
Dr. Sophie Kramer is a primary care physician in Dane County. She previously worked in Eau Claire and Milwaukee. She has heard hundreds of patient stories around the impact of healthcare access; the stories here are composites.
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