Medicaid cuts: A very bad idea

by Jeanette Wenzl

Federal budget battles threaten the livelihood of millions of Americans by placing our most vital programs – Social Security, Medicare, and Medicaid – at risk. While Medicare and Social Security get most of the public attention, it is Medicaid that is more likely to be slashed and burned. We should all be frightened of this possibility, and take action in defense of Medicaid.

There are 1.25 million Medicaid enrollees in Washington State, one in five residents. Since without Medicaid these enrollees would be uninsured, there are 1.25 million good reasons to save Medicaid in our state alone. But beyond the numbers, there are at least four major reasons why proposed budget cuts are dangerous for Medicaid, and why the pro¬gram needs and deserves our protection.
First, any cuts to Medicaid are ex¬treme cuts. Medicaid is far more efficient than private insurance programs, with very little administrative overhead from which to extract savings. There is simply no way to cut billions in Medicaid fund¬ing without dramatically impacting access to needed health care.

Proposals to cut come in many shapes and sizes – Paul Ryan’s House Republican Budget proposes block grants, the Obama Administration suggests “blended rates”, Senate Republicans have offered spending cap proposals, House Republicans have advanced balanced budget amendments – they all have the same effect. Low-income people will suffer more, live sicker, and die younger.

A second reason why we must not cut Medicaid is its impact on seniors and people with disabilities. Millions of seniors receive nursing home care thanks to Medicaid. Many Medicaid beneficiaries already have limited access to physician care, particularly from specialists, due largely to Medicaid’s already low reim¬bursement rates. Dual-eligibles (Medicare/Medicaid) are now being required to pay cost-sharing for their medications despite having income of only $674 per month. Many seniors and people with disabilities are already on the edge. Further cuts will push them off the cliff.

We need to preserve Medicaid for its importance to people of color and for racial equity. Racial disparities in health coverage are severe in this country, but they could become worse - if not for Medicaid, an additional 25 million people of color would likely be uninsured.

Finally, Medicaid is the building block for the Affordable Care Act – the signature health care legislation enacted by President Obama and a hard-fought progressive victory. The promise of the ACA was to make quality, affordable health care accessible to everyone in the U.S., and the ACA relies on the expansion of Medicaid to cover the most vulnerable of the uninsured. Cuts to the program not only reduce the ability of our state to enroll uninsured low-income people in health coverage, but undermine the very foundation on which health care reform rests.

Jeanette Wenzl is a PSARA member and on the Executive Board of Washington Community Action Network