The ongoing congressional effort to repeal the landmark Affordable Care Act has prompted much conversation aboutand push back against – changes that would jeopardize people with pre-existing conditions and eliminate the Medicaid expansion. Less attention has been paid to an even more dangerous change included in the bill the House passed a few weeks ago – a proposal to cap federal Medicaid spending based on the 2016 cost of care, with yearly increases in that spending that are less than actual increases in the cost of care. The idea, in other words, is to slowly starve Medicaid to death. That’s bad policy, for states, for individuals who need health care, including women of all ages, and for our country. Great challenges lie ahead for us; we can’t afford to lose out on the contributions of huge portions of our population because they aren’t healthy enough to take advantage of the liberty and opportunity that we brag to the world about.
The vast majority of Americans know someone who receives all or some of her health care through Medicaid. It is this nation’s largest health care provider, covering 70 million people -- one in five of us. And yes it is both popular and effective, despite the rhetoric from those who want to save money by cutting its funding. The National Health Law Program (NHeLP), founded in 1969, has worked with health advocates in all states to ensure the health rights of low-income individuals and underserved populations. In its multi-faceted efforts to protect Medicaid from radical cuts to its funding, NHeLP is collecting stories from Medicaid beneficiaries from around the country about their experience with Medicaid -- the stories are flooding in, and they tell a very different story than the rhetoric being pushed by the other side.
Rachel, a young woman working a part-time job in Illinois, told NHeLP of her ability to access Medicaid, which ensured she had a healthy pregnancy. Her job in Illinois did not provide adequate health insurance, not providing her maternity coverage. Rachel was at a loss about where to turn for health care, but a midwife provided some good direction. She told Rachel that she was likely eligible to get Medicaid coverage to pay for the cost of prenatal care and labor and delivery. Indeed after contacting the state Medicaid agency, Rachel learned she was eligible for pregnancy-based Medicaid. As she told NHeLP, she was able to use Medicaid for all the care she needed during her pregnancy, such as lab work, ultrasounds, screening tests and dental care. Rachel gave birth to a healthy son, surrounded by family. Care through Medicaid did not stop there. Rachel was able to access all of her postpartum care through Medicaid, including getting an IUD to avoid getting pregnant again before she was ready. Medicaid provided Rachel support with breastfeeding, and her newborn son was immediately enrolled into Medicaid, providing him well-visits, screenings, and immunizations needed in his first year of life. Rachel told NHeLP, “Medicaid is what allowed me to get the care I needed as a new mom and to take care of my baby.”
Medicaid, which covers nearly half the births in the U.S., provides so much more care that is vital to the ability of women to lead healthy and fulfilling lives. As a recent report from the Center on Budget and Policy Priorities finds, Medicaid is providing “essential health services to women of all ages.” For example, the report shows that Medicaid is providing crucial care to women as they age, women who, because they live longer than men, are more likely to need long-term care services through Medicaid. “Sixty nine percent of the 9 million dually eligible beneficiaries – people covered by both Medicare and Medicaid – are women.” Medicaid, moreover, plays an integral role in providing vital care to older women of color, “covering nearly 40 percent of Latina and African American women over 65 who are enrolled in Medicare.”
The success of Medicaid, as Paul Rosenberg wrote for Salon, undercuts every aspect of the tired arguments some politicians and think-tank activists have been making for years. Polls show that Medicaid recipients approve of their health care at higher rates than those who are covered by private health insurance plans; Medicaid is far more efficient than private health insurance plans, and states actually do have flexibility to provide innovations to delivering Medicaid services.
But the proposal pending in Congress in the form of the so-called American Health Care Act (AHCA) is aimed at destroying this successful program. Indeed in this blog post, NHeLP Senior Attorney Amy Chen explains how AHCA’s proposed cuts to Medicaid (more than $800 billion in cuts) would seriously damage California’s Medicaid program, Medi-Cal. “Any federal cuts to Medicaid,” Chen writes, “would require the state to make difficult choices with an underfunded Medi-Cal budget.”
Congressional leaders pushing these cuts are not being upfront with the public – they are using the same old lines to bash Medicaid and mislead people by ignoring just how integral Medicaid is to our health care system. And by the way, the impact of cutting more than $800 billion in Medicaid funding would be widespread – it would cost health care jobs in every state and would drive up health care costs for all other groups of people, except for the very wealthy. And it would leave at least 23 million people uninsured and without access to regular health care. That ultimately is what is so wrong with this picture.
An increasingly successful and popular health care program is in the crosshairs of politicians who need the savings from Medicaid to help pay for outlandish tax breaks for the nation’s wealthiest. We must say no.