by Sharon Kayne
January 25, 2016

In his January 14 column, Winthrop Quigley called Medicaid an essential part of a social safety net but took issue with the notion that the federal funding is good for the state’s economy. He claimed that Medicaid cannot help people out of poverty. I disagree on both counts.

I’ve suffered from depression most of my life. Untreated, my depression impacted my decision-making process and, consequently, I could not handle the kind of stress that is inherent in most professional jobs. So, despite having earned my college degree, I was making poverty-level wages waiting tables. I was in a classic Catch-22 situation: without access to health care, I could not handle the kind of job that would provide me with health insurance. Without health insurance, I could not access the health care I needed.

I was fortunate enough to find a health care program serving low-income New Mexicans through UNM Hospital. It was not Medicaid but it was publicly funded. It allowed me to see a doctor and get prescription medications that were otherwise cost prohibitive. The medications stabilize my brain chemistry and that has enabled me to work in my chosen profession, where I earn a middle-class income and health insurance. In the 20 years since I needed that program, I’ve more than paid back what it cost the state with the higher income taxes I pay. That makes the program a good financial investment from the state’s point of view. It was life changing from my point of view.

Unfortunately, Quigley’s column was not really about extolling the virtues of safety-net programs like Medicaid. The crux was to criticize New Mexico Voices for Children for calling Medicaid an economic engine. Apparently, we should only urge full funding of Medicaid because it’s the right thing to do. Pointing out the economic benefits, he argued, was the same as saying “poverty is good” for New Mexico. As if we think getting people enrolled in Medicaid so New Mexico can collect the federal dollars is an end unto itself.

Like Quigley, we believe that funding Medicaid is the right thing to do, but we’ve found that argument only gets you so far with the people who hold the state purse strings. Even lawmakers who agree must admit that the state has limited money.

We learned years ago that the best way to counter the “we can’t afford it” argument was by making the economic argument. Medicaid creates demand for health care, and that creates jobs in the health care sector. Those jobs create other economic activity as salaries are spent in the community. Every dollar the state spends on Medicaid brings in almost four dollars of federal money. So, really, we can’t afford to not fully fund Medicaid. Over the past year, the Medicaid expansion has created more jobs than anything else. Lawmakers need to remember that before they decide we can’t afford to fully fund it.

But that’s just the economic argument. We don’t advocate for Medicaid funding because we believe poverty is a federal gravy train. We don’t see poverty as some sort of perverse industry. We advocate for full funding of Medicaid because we know—some of us in a very personal way—that safety-net programs help people lift themselves out of poverty. We know that poverty is caused by more than low-wage jobs. It’s also caused by chronic health conditions that limit a person’s employability, by the toxic stress of a dysfunctional home life that limits a child’s ability to concentrate in school, and much more.

We advocate for safety-net programs because people need support systems in order to fulfill their potential. For those with resources, these support systems are provided by families and communities. For those without resources, support systems need to be provided some other way. But like the “economic engine” argument, these supports are merely a means to an end. Medicaid is an investment in human capital. Healthy, motivated, well-educated human capital is what drives economic development.

Social safety nets can change lives. I’m proof of that and I am deeply grateful for it.

Sharon Kayne in Communications Director for New Mexico Voices for Children