President-elect Trump has said he will dismantle and replace the Affordable Care Act, and possibly privatize Medicaid — the insurance program for the very poor.

Several Republican governors say they're putting their state's Medicaid expansion on hold, as they wait to find out Obamacare's fate.

That news is alarming to some shooting victims and their physicians. Many of these patients, who are young, minority men and uninsured, are finally able to get follow-up care through the Medicaid expansion, which now covers any person who makes $16,000 or less a year. Previously it covered those who were poor and disabled, poor and pregnant, or poor and elderly.

Dr. James Tyburskia trauma surgeon at DMC Detroit Receiving Hospital (@DMC_Heals), joins Here & Now‘s Robin Young to discuss how the expansion has impacted his practice.

Interview Highlights

On how many trauma injuries are gang-related

“This affects all types and forms of society — it doesn’t have to violent-related. Of course, it can be gang related, that can be happen. But all sorts of people end up with penetrating trauma and even blunt trauma can result in these — you can get the need one of these in a car accident. So it was all walks of life.”

On his own experience treating patients with Medicaid expansion

“You saw things like that ability to get the colostomies taken care of and getting reversed faster. Having a colostomy is not life-threatening, but if you don’t have the wherewithal, you also can’t have the supplies to take care of your colostomy. Also having Medicaid, a lot of them have the proper colostomy bags, the appliances to put on. Otherwise, they would in times have to use very makeshift way-items — grocery bags, bread bags, tape to try to fashion themselves with colostomy bags, if they couldn’t otherwise afford the proper medical supplies.”

On the overall advantages of the Affordable Care Act

“The Affordable Care Act also allowed more elderly people that weren’t young, but 40s and 50s, and people before they were eligible for Medicare, to also get involved into Medicaid. And then things like, they could get screening coloniscopes done — we provide a lot of other care besides trauma care. And that kind of screening is good for a population across the board, holds down overall medical costs, if you can do a screening colostomy on a patient who’s 55, and discover two polyps that don’t go to cancer, you save a lot of money in the long run, let alone the suffering that goes to the patients that require major surgery. It does certainly affect the trauma patients and their abilities to recover and to get physical therapy and occupational therapy and to get back to jobs, but it also affected a wider variety of people than just trauma patients… and that was seen all across the hospital system in our particular hospital.”

Copyright 2016 NPR. To see more, visit http://www.npr.org/.

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