Working together to strengthen Medicaid for the most vulnerable

Last year, the Medicaid program celebrated its golden anniversary. A lot has changed over the last 50 years. Originally created in 1965 as a joint federal-state program to provide health care coverage for low-income, vulnerable Americans, it is now the world’s largest health insurance program.  

Today Medicaid is an important lifeline for so many in Michigan and across the country. It is estimated the program will expand to cover 83 million people this year – that’s one in four Americans. Given its rapidly growing size, it is imperative the program is working as it is intended – providing care for folks who need it most. 

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Last week, the House of Representatives voted to make a difference for the nation’s most vulnerable. Republicans and Democrats worked to strengthen Medicaid, and the White House has officially given its seal of approval to these commonsense reforms. 

It was an important day that underscores what we can accomplish when we work together.  

The bipartisan Ensuring Access to Quality Medicaid Providers Act (H.R. 3716) is the product of two bills authored by committee members Dr. Larry BucshonLarry BucshonOvernight Healthcare: Medicare fight looms on Capitol Hill Medicare battle brewing on Capitol Hill For suburban women, addiction is a key election issue MORE (R-Ind.) and Rep. Chris Collins (R-N.Y.) that unanimously cleared both the Health Subcommittee and full committee last fall. It delivers an important “one-two punch” to strengthen the critical program by curbing fraud and increasing access by making it easier for folks to find a doctor. 

Bucshon led the effort to help cut down on fraud by eliminating bad actors. The thoughtful legislation ensures that providers terminated from Medicare or a state Medicaid program for reasons of fraud, integrity, or quality are terminated across the board from all other state Medicaid programs.

With a program as large as Medicaid, it will always be a target for fraudsters, but we can work to limit their impact, and this bill is a positive step that will save millions of dollars and send the message loud and clear that bad actors in one state should not be allowed to participate anywhere, period.

In addition to reducing fraud, the legislation helps increase access for those most in need. Finding a doctor is often a difficult task, and Collins led this effort to increase access to care beyond the emergency room. If a state is using a fee-for-service or primary case management system to deliver care to Medicaid patients, this bill requires they provide those patients with a directory of physicians.

Medicaid managed care plans already provide a network of doctors and nurses to care for patients. This requirement ensures that patients in fee-for-service Medicaid programs don’t have to fend for themselves.  

Research has shown that access to doctors can be a problem for Medicaid beneficiaries, so this commonsense step will help ensure beneficiaries are empowered with better information that is more readily available. And that’s a good thing. 

This bill doesn’t solve all our problems, but it is a significant bipartisan step forward. We were also pleased when the administration announced they would “support House passage of H.R. 3716 because it improves program integrity for Medicaid and the Children’s Health Insurance Program.” 

And what happens when Republicans, Democrats, and the White House are all in lockstep supporting meaningful, 21st century reforms? The results are unanimous – a 406 to zero vote.

This bill shows that it’s possible to work together on Medicaid. Let’s keep the momentum going to help our most vulnerable folks.

Upton represents Michigan’s 6th Congressional District and has served in the House since 1987. He is the chairman of the Energy and Commerce Committee.