Medicaid can help as America faces the coronavirus crisis — let it
Uncertainty and fear among the American public continues from coast to coast over the worsening impact of the COVID-19 (Coronavirus) pandemic.
People are hurting. According to a new poll, one in five U.S. households has faced a layoff or cut in work hours because of the pandemic. For many, that means losing health coverage, too. Small businesses, bars and restaurants have closed. Child care workers, school staff and retail workers have been laid off. Millions of people are at great risk, particularly uninsured people and low-wage workers, who are disproportionately people of color, whether living in our cities or our rural communities. We’ve seen before that any health crisis is likely to have an outsized impact on those who already face unfair and discriminatory barriers to health and health care.
To stem the spread and impact of coronavirus, lawmakers must act quickly to expand access to affordable testing and treatment to take care of people for whom health care has long been out of reach. The Families First Coronavirus Response Act passed by the House and Senate, which increases federal funding for state Medicaid programs to cover virus testing and provides additional support for paid leave and food security, is a step in the right direction. But more can and should be done, with a focus on those who are likely to be hardest hit by both the health crisis and the related economic impact.
Congress and the Trump administration are working on another major stimulus package that must address the root cause of our economic insecurity: health care access. Three steps lawmakers can take now are to increase Medicaid funding to states beyond what Congress already passed, incentivize states to expand Medicaid by fully funding it for three years, and finally, to ease enrollment processes so eligible people sign up and can get coverage and care.
Medicaid is one of the most powerful tools we have to promote coverage and treatment and it can be a powerful weapon in fighting a recession.
Medicaid is a jointly funded federal-state partnership created to provide health coverage to people and families with low-incomes. It is a cornerstone of our nation’s safety net, providing coverage to one in five Americans, the majority of whom are children, people with disabilities and older adults. Medicaid is particularly important for people who cannot afford private health coverage. With additional investment, this critical program will serve as a bedrock in the fight against COVID-19. There are several important steps Congress can take.
First, although Congress recently passed an increase in federal Medicaid financing, it is unlikely to be enough because this time it is a health crisis driving our economic crisis. Declining state revenues will collide with rising demand for health care driven by both the epidemic itself and the resulting job losses. Congress should do more to help shore up state budgets, ensure low-income people have health care security and strengthen the resources of safety-net providers. This will protect not only our health care system, but also other vital services provided by states and localities like education and public safety.
Second, there are still 14 states that have declined the opportunity to expand Medicaid under the Affordable Care Act (ACA). Congress should agree to pick up the full cost of expanding Medicaid in those states for a period of time. (The ACA originally offered three years of 100 percent payment.) There is a wealth of evidence that shows expanding Medicaid has both health and economic benefits – including better access to care and less bad debt for enrollees and health care systems. We need those benefits now more than ever.
Lastly, we not only have to expand financing and eligibility for Medicaid – we also have to get people enrolled. There are millions of people who are eligible for Medicaid but unenrolled either because they don’t know they are eligible or because they can’t manage the enrollment process. With unemployment skyrocketing, the number has ballooned in just the past week. Congress can provide additional resources and modest changes to current law that would make it easier for people to enroll.
Access to high-quality care and the ability to lead a healthy, full life should not depend on your ZIP code, the color of your skin, what language you speak or the size of your bank account. Viruses certainly don’t discriminate between the insured, uninsured or underinsured. The holes in our health care safety net affect us all.
It’s time to put the focus on what we know works – prevention, detection, treatment and continuous coverage. We need to fortify the Medicaid program to help respond as the COVID-19 crisis worsens. The health of our nation demands it.
Cindy Mann is a partner at Manatt Health and formerly served as deputy administrator at the Centers for Medicare & Medicaid Services and director of the Center for Medicaid and CHIP Services. Emily Stewart is the executive director of Community Catalyst, the largest national consumer health advocacy organization in the country.