It’s hard to believe that just a few months ago I was sitting in a college classroom taking a course on Politics and Public Health Advocacy, while today I’m using the knowledge and tools I gained from my public health courses everyday as part of my role at NETWORK. As a public health student, I was riveted by the debate that occurred as the Affordable Care Act (ACA) made its way through Congress, and I joined many in celebration when such an historic piece of legislation was finally passed and later upheld by the Supreme Court. Yet, despite the great strides made by the ACA, public health and healthcare advocacy does not end with its passage. There is still so much to do in order to ensure that all Americans have access to quality, affordable healthcare.
One particular area for continued advocacy is the Medicaid expansion, which was essentially made optional for states by the Supreme Court’s ruling on the ACA. The expansion calls for extending Medicaid eligibility to all individuals under the age of 65 with incomes up to 133% of the poverty line, which would result in millions of newly insured individuals. As a public health student I spent time volunteering in a safety net health clinic, whose resources and dedicated staff were stretched thin trying to meet the needs of all of their uninsured patients. For many others who are uninsured, a hospital emergency room is their only source of care. For those without insurance, easily treatable, or even preventable illnesses quickly grow into major health crises, as seeking out medical care is postponed as long as physically possible.
A healthcare system that leaves so many uninsured has very serious consequences—life and death consequences, in fact. Each year in the United States, approximately 45,000 deaths are associated with a lack of health insurance . Overall, uninsured adults under the age of 65 have a 40% higher risk of death  than those who are insured. Several states have previously expanded their Medicaid programs, and a recent study  finds that in three of these states—New York, Maine and Arizona—the Medicaid expansions were associated with 6.1% fewer deaths. A similar study  out of Oregon found that not only did those on Medicaid report better health, but they also experienced improved financial security. This is what is at stake with the Medicaid expansion.
However, despite the benefits of expanding Medicaid, and despite 100% of the costs of the expansion being financed by the federal government until 2016, gradually decreasing to 90% in 2020 and after, many states  have indicated they will refuse the expansion, while still others have yet to decide. Clearly, the struggle for quality, affordable healthcare is not over.
From studying public health at a Jesuit university, I learned to critically evaluate he