Medicaid is the backbone of health coverage


As the Senate revisits “repeal or replace” this week, it is important to place Medicaid in its proper context – both the population it serves and the implications of proposed cuts.

Medicaid is the backbone of health coverage for more than 74 million Americans. It is not a distant program that benefits any one group – it helps Americans across all demographics – racially, economically and generationally, including “able-bodied” workers for whom health insurance is otherwise out of reach.

{mosads}Unfortunately, Senate proposals would put millions of jobs at risk. Cutting Medicaid or even its expansion would move America’s healthcare system, and our entire economy, in a dangerous and harmful direction. The Senate bill will phase out Medicaid coverage for millions of Americans and threatens the viability of the Medicaid system through underfunded per capita allotments.

Medicaid isn’t welfare; it benefits working Americans. Nearly 60 percent of adults with Medicaid coverage work. Nearly half of them work for small businesses with fewer than 50 employees. The vast majority of those who are not working have reasons for not working, such as sickness or disability.

Medicaid is essential for hardworking Americans to keep their jobs. Medicaid helps people manage their chronic illnesses – so they can keep working. It is critical to supporting drug rehabilitation programs to counter the opioid epidemic sweeping the nation – so people can get well, and get back to work. Nearly two-thirds of older and disabled Americans rely on Medicaid to help pay for nursing homes and care, lifting a burden off family members – so they can continue to work.

In state after state, we see evidence of the benefits of Medicaid for people from all walks of life, and the economic and job security that Medicaid coverage brings.

  • In Ohio, new Medicaid enrollees have provided strong testimonials to the lawmakers who expanded Medicaid, such as, “I had a lot of health problems before, but a lot had changed in my life. Now I am able to work more.” And “I am finally getting everything that was wrong with me fixed so that I can go back to work. It’s a great help.” And “Give me the ability to seek employment without worrying about my health.” 
  • In Louisiana, nearly 14,000 people have sought substance abuse treatment under Medicaid expansion, making a real difference in the state’s opioid epidemic. Jobs in the healthcare sector in Louisiana are at an all-time high, and Louisiana reaped $200 million in state budget savings from Medicaid expansion in its first year. 
  • In West Virginia, where Gov. Jim Justice told members of the Senate Finance Committee that, “Many West Virginians, including those who have lost employment as coal miners, have used Medicaid expansion as a bridge to address any healthcare issues that develop, or manage chronic conditions until employment opportunities return.”

In his campaign, and throughout his term, President Trump has promised that, “Every single American will have the opportunity to realize his or her fullest potential. The forgotten men and women of our country will be forgotten no longer.” Millions of these forgotten Americans are able to work only because they receive healthcare coverage through Medicaid.

This is not to say the Medicaid program cannot be improved or cost savings realized. A new report from the Menges Group, commissioned by the Association for Community Affiliated Plans (ACAP), entitled, “Potential Savings of Medicaid Capitated Care: National and State-by-State Estimates” examines the current savings of the managed care model in Medicaid, as well as the additional savings that could occur if remaining fee-for-service (FFS) expenditures were moved into a capitated managed care organization setting. As the report demonstrates, even if all of the currently excluded Medicaid-eligible populations and services were moved into coordinated care plans, the 10-year accumulated savings resulting from that change would be $63.2 billion across the 2017-2026 timeframe for both federal and state governments. The federal savings over this 10 year time-period are $35.7 billion.

This finding is critical because many members of Congress may mistakenly believe that the Medicaid spending levels proposed in both the American Health Care Act and the Better Care Reconciliation Act can be achieved through increased efficiencies like moving additional Medicaid eligible populations and services into managed care plans. To be clear, managed care can provide significant efficiencies and care coordination that can reduce the cost of care relative to Medicaid fee-for-service. However, federal policymakers should not be under the illusion that simply expanding the use of Medicaid managed care will yield the levels of savings currently being considered by Congress as part of the effort to repeal and replace the Affordable Care Act. In fact, the report shows that moving all remaining non-managed care populations into managed care would account for less than 5 percent of the total proposed $756 billion in federal Medicaid spending reductions over a 10-year period.

In sum, it is important to maintain focus on the impact of Medicaid on job creation and economic well-being. At every point in our lives, Medicaid is there to ensure that we and our loved ones have the health security they need to maintain their economic security. Medicaid belongs to everyone and benefits everyone. In this debate, there is no us versus them – there is only us.

Margaret A. Murray is CEO of Association of Community Affiliated Plans.

The views expressed by this author are their own and are not the views of The Hill.


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