Much has been made of the failure of House Republicans to repeal the Affordable Care Act and pass their own healthcare plan. Now, with recent reports that Congressional leaders are negotiating with the White House to resurrect the failed legislation, it’s important to keep in mind what forced Speaker of the House Paul RyanPaul Davis RyanPaul Ryan researched narcissistic personality disorder after Trump win: book Paul Ryan says it's 'really clear' Biden won election: 'It was not rigged. It was not stolen' Democrats fret over Trump-district retirements ahead of midterms MORE to spike his disastrous piece of legislation, the American Health Care Act (AHCA), in the first place: the practical and political importance of Medicaid.
The simple fact is that no amount of caving to conservatives on insurance market regulations changes the reality that millions of Americans, particularly the elderly, children and people with disabilities, rely on Medicaid for their health insurance
And no amount of tinkering to the bill changes the fact that the Republican plan would force Members of Congress to vote for, and Governors to oversee, kicking millions of their most vulnerable constituents off of the healthcare they depend on.
We’ve already seen how this story ends.
At times like these, it’s worth looking at how it all began. Established as a relatively small program in 1965, Medicaid has grown in its lifespan to become an integral part of our country’s healthcare system. Overall, the program helps over 70 million people, or roughly 1 in 5 Americans, receive health insurance.
The largest share of the program’s beneficiaries are kids, 36 million of whom rely on it for regular doctor visits, dental care, and other services that help them grow up healthy. Millions of seniors depend on the program’s services to maintain their independence or manage the costs of nursing homes or assisted living.
And 15 percent of those served by the program are people with disabilities, who utilize the program for specialized care.
But Medicaid is not just a short-term safety net program that helps connect our country’s most at-risk with care vital to their well-being. It is also an investment that benefits us all in the long run.
Moreover, the program also helps bend the cost curve for our entire health system by helping patients establish regular relationships with doctors — which makes possible smart preventive care, early diagnosis and treatment, efficient treatment of chronic conditions, and avoidance of expensive ER visits and hospitalizations.
Medicaid is also central to the long-term fiscal health of states. As the largest source of federal funding for state budgets, Medicaid provides dollars that help balance budgets and allow states to invest in other important priorities, like education, transportation, and public safety.
Put short: Medicaid matters to all of us.
Yet despite the crucial role that Medicaid plays in our healthcare system and the day-to-day lives of millions of Americans, central to Speaker Ryan’s health agenda are draconian cuts to the program.
The Congressional Budget Office (CBO) estimates that AHCA would have slashed the program by $839 billion over the next decade — resulting in roughly 14 million fewer people receiving health insurance. These cuts would have wiped out access to care and services for millions of our country’s most at-risk and blown huge holes in state budgets all around the country.
The potential cuts to Medicaid inspired outcry from constituents, advocates, and health groups. But they also shake moderates within the Republican Party.
Just look at the many Republican Governors, Senators, and representatives who are on record expressing concern about what the cuts would mean for their states and home districts. The lesson learned from ACHA’s massive attack on Medicaid remains an important one to be mindful of as the GOP negotiates further healthcare reform options.
Americans value health insurance and want real change that lowers costs, provides quality, affordable care, and protects pocketbooks as well as our most at-risk neighbors. We must look for ways to reform our healthcare system without undermining those goals.
Speaker Ryan and House Republicans would do well to remember this as they continue their negotiations and develop new plans. It is and always will be an arduous, politically costly battle to try to attack a program that is so vital to the whole country — not just the millions whose health and well-being it directly serves.
John Bouman is the president of the Sargent Shriver National Center on Poverty Law.
The views of contributors are their own and are not the views of The Hill.