Huffington Post Op-Ed by Ethan Rome, HCAN Co-Director, Medicaid Matters: The GOP Attack On 74 Million Americans

By February 9, 2017No Comments

There is good news in the battle over health care – GOP members of Congress are getting pummeled in their districts for trying to take away their constituents’ Obamacare. Voters overwhelmingly oppose repealing the Affordable Care Act (ACA) without an adequate replacement, and Obamacare is more popular than ever in the polls. At the same time, the Republican timeline for repeal is slipping (and slipping), they still don’t have anything remotely close to a replacement plan, and there is growing division within the GOP’s ranks about what to do.

This is why we need to keep up and intensify the pressure, and at the same time hammer home the need to protect Medicaid – especially as Republicans are now talking about including drastic cuts and changes to Medicaid as part of their repeal of the ACA.

What’s the GOP plan to destroy Medicaid? The Republicans would like to radically restructure Medicaid and cut as much as $1 trillion over the next ten years. The results would be devastating.

Seniors would be thrown out of nursing homes or lose home care services. Children and people with disabilities would go without needed care. Families would be slammed with crushing health care costs for their parents. Huge costs will be shifted to state governments, health care and other jobs will be lost, and the economy will be hurt.

Who benefits from Medicaid? Medicaid is the biggest health insurer in the U.S., providing benefits to about one in four Americans. 74 million working families, children, seniors and people with disabilities, including 33 million children, receive Medicaid benefits. Half (46%) of Medicaid spending is on long-term care for seniors and people with disabilities. Medicaid finances nearly half of all births in the U.S., accounts for 75% of all publicly-funded family planning services, and covers more than half of all long-term care spending. Of people who rely on Medicaid, 41% are White, 25% are Latino and 22% are African American.

Total Medicaid spending is roughly 17 percent of overall health spending. Along with education, Medicaid is one of the two largest expenditures by state governments, which administer the program and fund it in partnership with the federal government.

Not surprisingly, Medicaid is popular and a majority of people think it works well. In fact, because of how large and diverse the Medicaid population is, half of Americans report a positive and personal connection with the program. We need to capitalize on this and stop the Republican effort to destroy this program in its tracks.

How would the Republican Medicaid scheme work? Under the current system, state Medicaid programs receive federal matching funds based on the number of people in need and the costs of care in that state. Under the GOP’s proposal, Medicaid would be radically restructured by forcing states to accept reductions in federal funding through either a “per capita cap” or a block grant, both of which would shrink federal funding for state Medicaid programs over time, relative to current law, beginning with a cut as large as $1 trillion over ten years. Simply put, the Republican approach would effectively eliminate Medicaid’s guarantee of coverage, starve the program, and shift billions of dollars of costs to state taxpayers.

If states wanted to maintain their current level of Medicaid services, they’d have to make unacceptable cuts in other areas (such as education) or raise new revenues, and that’s not likely. In reality, states would be forced to make deep and painful cuts. Fewer people would likely be covered, and their benefits would be scaled back.

These cuts would have a far-reaching impact on families, businesses, state governments and regional economies.

  • Millions of jobs would be lost. According to a new report, the repeal of key provisions of the ACA, including Medicaid expansion, could lead to substantial job losses in every state – 2.6 million people could lose their jobs in 2019 alone, and nearly 3 million positions in health care and other sectors could be lost by the year 2021. Massive Medicaid cuts would only exacerbate this job crisis.
  • Millions of children in low-income families would have to make do without adequate medical services, hurting their quality of life and the quality of their education. For example, children with conditions such as unmanaged asthma and chronic allergies would miss school and find it difficult to concentrate when they are in attendance, compromising their school performance and limiting their educational and economic prospects.
  • Millions of seniors would be left without nursing home coverage and other long-term care services, forcing their families to shoulder the burden. The average cost of nursing home care in the U.S. is now upwards of $90,000 a year, while the median household income is only about $55,775.
  • Millions of Americans in the sandwich generation would find it impossible to save the hundreds of thousands of dollars they will need for their own retirement and health care along with the health care needs of their parents. Combined with other pressures such as rising college tuition costs, working and middle class families will fall farther and farther behind.
  • Billions of dollars in health costs would be shifted to the states, which will no longer be able to turn to the federal government for resources to care for more people in need because of economic downturns or emergencies.
  • What’s more, starving Medicaid would force states to cut payments to doctors and hospitals, sending private health plan premiums higher and putting strains on the provider community.

The Republican Medicaid plan isn’t just an attack on health care — it’s a systematic effort to weaken the role of government and undermine the economic security of all of America’s families. We can’t preserve and expand the middle class if people don’t have affordable health care they can count on.

Now more than ever, we must make the case that Medicaid matters.