Dr. Céline Gounder explains how Medicaid recertification paperwork causes low-income workers to lose coverage, then argues that zip code is the strongest predictor of health outcomes in America. Wealthier people can move to healthier neighborhoods; poorer people are stuck in areas with worse air, water, and food access.
Chapters
requirements, which actually might sound on the face of it like, well, why not require people to work to get health insurance? Um, well, it's a little more complicated because they're basically new bureaucracy requirements is what they are. It's a lot of red tape. And if you're somebody who's already maybe working two jobs, earning an hourly wage, having to shuttle your kids to daycare, and, you know, whatever it is, to have to then do that kind of paperwork on top of it, it's actually a lot of work. It's a huge onus. And so a lot of people just lose their Medicaid because they haven't recertified that they're eligible. So I think that's one major issue there. I think also, you know, our goal should be that the best healthcare is the healthcare you don't need, that you start off healthy, that you stay healthy. And it's no accident that your zip code is your best predictor, is the best predictor of your health status and your life expectancy in this country. How much do you control your zip code? Well, you control your zip code if you have the means and you can buy into a nice neighborhood. If you can't, if you don't have those kinds of means, you have a lot less control over where you live and the circumstances of that. So I, you know, I do think we need to think about what does it mean to have healthier communities in terms of things like air and water quality, access to to whole healthy foods.
