April 2022

Washington DC — Yesterday, Representative Kevin Brady (R-TX) and Senator Mike Crapo (R-ID) sent a letter in opposition of the Biden administration’s efforts to fix the “family glitch” and expand affordable health coverage to millions of working families. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Republicans’ opposition to fixing family glitch and other common sense, popular policies shows they don’t care about helping American families. While offering zero solutions to lower people’s cost of living, Republican lawmakers are simply restating their opposition to the ACA and its protections for millions of Americans. The truth is every Republican voted against the American Rescue Plan, which delivered lower premiums for millions, and they continue to block Medicare negotiation, insulin cost caps, and expanded access to affordable coverage. If the GOP gets their way, it means you pay more and you get less — greater premiums, higher prescription drug prices, and worse care at the doctor’s office.”

Throughout Medicaid Awareness Month, Protect Our Care has released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats. This week, Protect Our Care is examining the role Medicaid plays in reducing disparities and improving health care outcomes for some of our nation’s most vulnerable populations, including communities of color, people living with disabilities, seniors and older adults, women, children, and rural Americans.

Medicaid expansion has been instrumental in providing health care to America’s rural populations. Thanks to the Affordable Care Act and President Biden’s transformative American Rescue Plan, nearly 14 million Americans living in rural communities have received increased access to care and health services. Medicaid expansion has resulted in healthier people, communities and economies. 

A Closer Look At Medicaid Expansion For Rural Americans

The Affordable Care Act’s (ACA) Medicaid expansion has been a critical part of our response to the coronavirus, but Republicans in 12 states have not yet implemented the program, blocking millions from coverage and access to essential health care. Holdout states are located in the southern and midwest regions with significant rural populations with  60 million Americans residing in these areas.

By signing the American Rescue Plan into law, President Biden created historic legislation that includes the most significant health care expansion in a decade. The American Rescue Plan provided additional financial incentives for the 12 states that had not yet implemented Medicaid expansion. Since the signage of the ARP, two previous holdout states, Missouri and Oklahoma, have adopted Medicaid, expanding coverage to nearly 500,000 Americans. These measures will have profound impacts on children and their families for years to come. 

By The Numbers

• Millions Of Rural Americans Depend On Medicaid. Nearly 14 million Medicaid enrollees reside in rural areas, with an estimated 1.7 million gaining coverage through ACA expansion in 2015.

• Rural States Need Medicaid. There are 7.8 million uninsured Americans living in rural areas. Non-expansion states are disproportionately rural with over 4 million Americans eligible for Affordable Care Act premium tax credits.

• Rural Hospitals Rely On Medicaid. Since 2010, 138 rural hospitals have closed, including 20 closures in 2020 alone. One in four rural hospitals face closure without more federal funding in 2022. Rural hospitals in Medicaid expansion states are 62 percent less likely to close.

• Medicaid Strengthens Health In Rural America. Overall, rural residents have worse health outcomes and tend to be older, poorer, and sicker than those in urban areas. 
• Rural Hospitals Strengthen Local Economies. Hospitals employ six percent of all employees in rural counties that report having any hospital employment, and 41 percent of counties with hospital employment rely on hospitals for more than 10 percent of total county employment. 673 rural hospitals are at risk of closing, and estimated that if those hospitals shut down, 99,000 health care jobs in rural communities would be lost.

How Medicaid Expansion Helps Rural Americans

Nearly 14 million Medicaid enrollees reside in rural areas, with an estimated 1.7 million gaining coverage through ACA expansion in 2015. Health care for rural Americans is especially important due to higher prevalence of pre-existing conditions and barriers to accessing health care. The success of Medicaid expansion across the country demonstrates the need for the 12 holdout states to finally adopt expansion.

There are 7.8 million uninsured Americans living in rural areas. Non-expansion states are disproportionately rural with over 4 million Americans eligible for Affordable Care Act premium tax credits, including 2.2 million uninsured individuals stuck in the Medicaid coverage gap.

Medicaid Expansion Saves Lives. Medicaid expansion has been proven to increase access to care, improve financial security, and save lives. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in people aged 20 to 64 by 3.6 percent. Medicaid expansion also saved the lives of 424 individuals in high rural states, Alaska and West Virginia between 2014 and 2017.

Medicaid Expansion Reduces Income Inequality And Medical Debt. Medicaid expansion under the ACA significantly reduced poverty and income inequality across the board. In states that have expanded Medicaid, the likelihood of falling into medical debt is 20 percent lower than in non-expansion states. Additionally, a 2018 National Bureau of Economic Research analysis found that Medicaid expansion led to a nearly $6 billion decline in unpaid medical bills and to higher credit scores. 

Medicaid Expansion Plays A Central Role In Fighting The Opioid Crisis. In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide. Among those with opioid addiction, people covered through Medicaid are more than twice as likely as those with private insurance or no insurance to receive treatment. Medicaid expansion covers an estimated four in ten people with an opioid use disorder. Recent research finds that Medicaid expansion reduced the unmet need for substance use treatment by 18.3 percent. 

Medicaid Expansion Is A Lifeline For Rural Hospitals

In states that haven’t expanded Medicaid, rural hospitals are drowning under financial pressure. 

Low occupancy rates, high levels of uncompensated care, competition with other hospitals, and struggling local economies create a financial burden that rural hospitals face all over the country. Since 2010, 138 rural hospitals have closed, including 20 closures in 2020 alone. One in four rural hospitals face closure without more federal funding in 2022. 

Medicaid Helps Rural Hospitals Stay Open. Rural hospitals in Medicaid expansion states are 62 percent less likely to close. The two most common types of supplemental Medicaid payments are disproportionate share hospital payments, that pay hospitals for uncompensated care for Medicaid and uninsured patients, and upper limit payments, which supplement the gap between fee-for-service Medicaid base payments and the amount that Medicare covers. Some states are also testing the use of global hospital budgets to increase care and improve health outcomes in rural hospitals.

Closure Of Specialized Care And Obstetrical Services. Some hospitals opt to close specific services or facilities that cause patients in rural areas to have to travel further for specialized care. On average, when a rural hospital closes patients have to travel over 20 miles further to access inpatient or emergency care. A 2021 study found that fewer than half of all rural counties in the United States had hospital-based obstetric care. When hospitals face financial hardship, obstetric services are among the first to be cut. African American and Native American women in rural areas are particularly at risk. African American and Native American women are two to three times more likely to die from pregnancy-related causes than white women.

Medicaid Expansion Boosts State Budgets. Medicaid expansion generates enough savings that it is well worth the initial cost, eventually helping boost states budgets. Expansion allows states to access federally matched funds for some people covered by traditional Medicaid. The American Rescue Plan provides states with additional funding from the federal government. From 2022 to 2025, the 12 states that haven’t expanded Medicaid yet would gain $90 billion in federal matching funds in addition to $17.6 billion in ARP bonus payments and $6.6 billion from higher state and local tax revenue.

Rural Hospitals Are Large Employers In Their Communities. For rural areas that often have high unemployment rates, hospitals contribute significantly to local economies by employing large numbers of people with relatively high-paying jobs.

Beyond just being a source of jobs, hospitals tend to pay higher wages than other rural industries. As the House of Representatives Minority Staff report on rural hospitals highlights, “The average pay of hospital employees in rural counties is 43 percent higher than the average pay of other workers in the same counties.”  As Mark Holmes, the director of the Rural Health Research Program at the University of North Carolina, emphasizes, hospital closures in rural communities can be like losing a factory: “Losing an employer of 150 people with good jobs is like losing a manufacturing plant…Hospitals are usually the largest, or the second-largest, employer in a community. That’s something that’s easy to lose sight of because we think of this from a health standpoint. But the effects are wide-ranging when a hospital closes.”

Rural Hospitals Boost Local Economies. Besides hospitals providing higher paying jobs in the health care sector, rural hospitals also stimulate the local economies of other industries. Hospitals purchase goods or services from local private businesses which helps stabilize and reinforces the local economy. In turn, strong private sector employment allows for more tax dollars for public goods, such as education and safety services.

U.S. Representative Chris Pappas (D-NH-01), State Lawmakers, and Health Care Advocates Called for Protecting and Strengthening Medicaid Coverage for Millions

April is Medicaid Awareness Month, and there has never been a more urgent time to highlight Medicaid’s overwhelming importance for millions of Americans in communities across the nation. Medicaid has served as a lifeline for the past two years, providing nearly 79 million Americans with access to high-quality, affordable care when they need it most. 

In the final week of Medicaid Awareness Month, Protect Our Care examined the role Medicaid plays in reducing disparities and improving health care outcomes for some of our nation’s most vulnerable populations, including communities of color, people living with disabilities, seniors and older adults, women, rural Americans, and children.

Nearly one in four Americans is now covered by Medicaid, making it a pillar of the American health care system. Still, there is more work to be done. Between closing the Medicaid coverage gap and ensuring American families can continue to access affordable coverage, lawmakers must prioritize protecting and strengthening this vital program for years to come. 

Throughout the month, Protect Our Care released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats. 

A look back at Medicaid Awareness Month 2022 themed weeks:

• Week 1: Medicaid is Working! Week one focused on how Medicaid has improved the lives of millions even amid the COVID-19 pandemic. 
• Week 2: Close the Coverage Gap. Week two brought attention to the urgent need to close the Medicaid coverage gap. 
• Week 3: Protect Medicaid Coverage. Week three focused on how millions of Americans face losing their Medicaid coverage coverage when the COVID-19 public health emergency ends and how Republican officials across the country are waging a relentless war on Medicaid. 
• Week 4: Medicaid & Health Equity. The final week highlighted how Medicaid is our most powerful tool in fighting for health equity. 

ARIZONA

On Friday, April 22, Arizona’s health care experts and advocates joined Protect Our Care Arizona for an event highlighting how Medicaid has provided Arizonans with access to quality, affordable health care, strengthened local economies, and improved health outcomes across the state. “The provisions under the National Public Health Emergency that were in place due to COVID, that actually froze Medicaid disenrollment across the country– meaning that people wouldn’t be dropped during this period of a public health emergency, that’s all at risk right now,” said Carmen Heredia, CEO of Valle del Sol. You can watch the event here.

COVERAGE:

• KJZZ (NPR): Half a million Arizonans at risk of losing Medicaid coverage

GEORGIA

On Thursday, April 28, State Representative Rebecca Mitchell and advocates joined Protect Our Care Georgia to highlight the critical role Medicaid plays in providing Georgia’s women and mothers with access to quality, affordable health care, and urge Republican lawmakers to finally expand Medicaid and close the coverage gap in Georgia. “We know that Medicaid is a lifeline for Georgians and is an integral part of the fabric of our communities,” said State Representative Rebecca Mitchell. “But despite this, we’re seeing Georgia’s Republican leadership put politics over the health and well-being of Georgians, and refuse to fully expand Medicaid. The bottom line is Medicaid expansion is the right thing to do and is long overdue.“ You can watch the event here.

NEW HAMPSHIRE

On Wednesday, April 27, U.S. Representative Chris Pappas (D-NH-01) joined public health experts and Protect Our Care NH to highlight how Medicaid has provided Granite Staters with access to quality, affordable health care, strengthened local economies, and improved health outcomes across the state. “Nothing is more important to the folks I meet than making sure that they and their families have access to quality, affordable health care, and can access affordable prescriptions that aren’t going to break the bank,” said Congressman Pappas. “We’ve got more work to do on this issue in Washington, but I think it’s important to recognize the foresight that folks had in New Hampshire in expanding Medicaid, and making sure that more individuals in our state have access to the kind of coverage that would really be life-changing, and life-saving for tens of thousands of individuals.” You can watch the event here.

COVERAGE:

• The Tip Sheet: Roundtable Highlights Success of Medicaid in NH

OHIO

On Thursday, April 14, Protect Our Care Ohio was joined by State Senator Tina Maharath and State Representative Thomas West to discuss the importance of protecting and strengthening Medicaid. Speakers also addressed the State of Ohio’s concerning approach to determining Medicaid eligibility when the federal COVID-19 public health emergency order ends. “Having health insurance through Medicaid helps Ohioans stay healthy, get to work, care for our families, and it helps alleviate the decision of paying for medical expenses or putting food on the table,” said State Senator Tina Maharath. “Medicaid has served as a lifeline during the pandemic. It has helped ensure access to quality health coverage for Ohioans, and we have to keep that coverage going and make sure Ohioans continue to have health insurance.” You can watch the event here.

COVERAGE:

• Statehouse News Bureau: Democrats warn many Medicaid recipients in Ohio could lose coverage soon
• Gongwer: Health Emergency Extended, Leaders Urge Caution In Medicaid Redetermination
• Columbus Dispatch: More than 400,000 Ohioans at risk of losing Medicaid coverage this summer as COVID emergency ends
• Ohio Capital Journal: As pandemic ebbs, fears grow that Ohioans will be improperly forced off of Medicaid

WISCONSIN

On Thursday, April 21, State Representatives Greta Neubauer (Racine) and Kristina Shelton (Green Bay) joined Protect Our Care and Peggy M., from Tomahawk, to discuss the critical role Medicaid plays in providing Wisconsinites with access to quality, affordable health care, and urge Republican lawmakers to finally accept the federal expansion of Medicaid available under the Affordable Care Act. “Across Wisconsin, there are many stories of folks who are facing unimaginable choices when it comes to their health,” said State Rep. Neubauer. “This session, the Republican-controlled legislature missed numerous opportunities to expand Medicaid for our fellow Wisconsinites. Despite public support and federal incentives, Republicans continued to ignore the calls to expand Medicaid.” You can watch the event here.

Throughout Medicaid Awareness Month, Protect Our Care has released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats. This week, Protect Our Care is examining the role Medicaid plays in reducing disparities and improving health care outcomes for some of our nation’s most vulnerable populations, including communities of color, people living with disabilities, seniors and older adults, women, rural Americans, and children.

Medicaid is a lifeline for children and families in America. As a result of the Affordable Care Act and President Biden’s American Rescue Plan, which expanded the Medicaid program, millions of young Americans gained coverage and critical protections. Currently, roughly 39.6 million children in the United States are enrolled in Medicaid or the Children’s Health Insurance Program, including 48 percent of children with special health needs and 83 percent of poor children. 

A Closer Look at Medicaid For Children & Families

April is Medicaid Awareness Month. For decades, Medicaid and the Children’s Health Insurance Program (CHIP) have been crucial sources of coverage for America’s children. The Medicaid program remains widely popular as it has served as a lifeline for children and families during the coronavirus pandemic. As millions of families have lost their jobs and health care, Medicaid and the ACA have given them a place to turn to for comprehensive, affordable coverage. Unsurprisingly, by November 2021, total Medicaid and CHIP enrollment grew to an all-time high of 85.8 million Americans.  

By signing the American Rescue Plan into law, President Biden created historic legislation that includes the most significant health care expansion in a decade. The American Rescue Plan provided additional financial incentives for the 12 states that had not yet implemented Medicaid expansion. Since the signage of the ARP, two previous holdout states, Missouri and Oklahoma, have adopted Medicaid, expanding coverage to nearly 500,000 Americans. These measures will have profound impacts on children and their families for years to come. 

Without legislation or extension of the Public Health Emergency, 6.7 million children will lose Medicaid/CHIP coverage or go without coverage for a period of time. Due to the expansion in coverage from the COVID-19 pandemic, nearly half of the nation’s children are now covered by Medicaid/CHIP. 

By The Numbers

• More Than 37 Million Children Are Enrolled In Medicaid And CHIP. Roughly 39.6 million children in the United States are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). Nearly 2 in 5, or 37.5% of children in America have health insurance through Medicaid.
  • Medicaid covers 48 percent of children with special health needs and 83 percent of poor children. 
  • Medicaid covers roughly 7.7 million, or 48.8 percent of young children, ages three and below.

• Nearly 4 Million People Would Gain Coverage If Remaining States Expanded Medicaid. Estimates from the Kaiser Family Foundation found that roughly 4 million people, including children, would enroll in Medicaid and the Children’s Health Insurance Program (CHIP) if the remaining states implemented expansion. 

• The Children’s Uninsured Rate In Medicaid Holdout States Is Double The Rate In Expansion States. According to the Georgetown Center for Children and Families, in 2019, the child uninsured rate was 8.1 percent in holdout states, compared to 4.1 percent in states that adopted expansion.

• Almost Half Of Births Are Covered By Medicaid. According to the Kaiser Family Foundation, 42 percent of births are covered by Medicaid. Thanks to the American Rescue Plan, states have the option to extend coverage to new mothers for one year postpartum, which will improve maternal health outcomes. 

• 17 Percent Of Parents Have Health Insurance Through Medicaid. 17 percent of parents have health insurance through Medicaid. When parents are covered, their children are more likely to have access to health care. 

• In 2010, Medicaid Kept 2.6 Million Americans Out Of Poverty. Even before the Affordable Care Act’s expansion of Medicaid, the program kept 2.6 million people out of poverty, “making it the third largest anti-poverty program in the country,” according to the Georgetown University Center for Children and Families. 

Medicaid Coverage Has Long-Term Benefits For Children 

Research Shows Medicaid Prevents Children From Dying Young And Saves Federal Dollars. A 2020 study found that children who received health insurance through Medicaid were less likely to die young, be employed in their adult life, and less likely to develop a disability as an adult. Medicaid for children also saves the government an estimated $200 billion when compared to the average cost of the program at $92 billion.

Medicaid Helps Children Stay Healthy, Leads To Long-Term Benefits For Children When They Grow Up. Medicaid eligibility during childhood lowers the high school dropout rate, raises college enrollment, and increases four-year college attainment. Medicaid for children also has a positive impact on employment opportunities later in life. For each additional year of Medicaid eligibility as a child, adults by age 28 had higher earnings and made $533 additional cumulative tax payments due to their higher incomes.

Thanks To Medicaid, Students Have Access To The Resources They Need To Focus In School. Medicaid’s Early Periodic Screening Diagnostic and Treatment benefit gives children under 21 years old access to comprehensive and preventative health services, such as yearly physicals, hearing, vision, and dental screenings, and physical, mental, and developmental disability treatments. The benefit also helps students gain access to medical supplies, such as hearing aids, glasses, and assistive technology, to help them succeed in school. 

One Study Found Medicaid To Have A Larger Impact On Child Poverty Than All Other Tested Benefits Combined. Medicaid reduces child poverty by an estimated 5.3 percentage points. This has a larger effect on reducing childhood poverty than all non-health means tested benefits combined.

Medicaid Helps Keep Families Out Of Debt. Out-of-pocket spending on health care pushed over 10.5 million Americans into poverty in 2016. Since the expansion, the program has covered the medical expenses of millions more poor and near-poor adults than it did previously, helping prevent households from becoming poor because of medical spending.

The ACA’s Medicaid Expansion Helps Children Gain Access To Care

After the Affordable Care Act expanded access to Medicaid, the children’s uninsured rate fell to an all-time low. Research confirms expanding access to Medicaid for parents has had ripple effects for their children. At the same time, states that continue to reject expansion are limiting children’s health care access: 

When Parents Have Medicaid, Their Children Are More Likely To Have Regular Care. The children of parents enrolled in Medicaid are 29 percent more likely to receive a well-child visit. This relationship is even stronger among families enrolled in Medicaid with household incomes at the federal poverty line as they are 45 percent more likely to receive a well-child visit. 

Medicaid Expansion Led To Gains In Coverage For Children As Well As Parents. Parents enrolled in Medicaid are more likely to access the support they need to be a healthy and effective parent. When parents gain coverage they are more likely to enroll the whole family, so the family will be protected from the economic strains of medical debt and lay the groundwork for optimal child development.

The Children’s Uninsured Rate In States That Have Rejected Expansion Is Twice The Rate In States That Expanded The Program — And That Gap Is Growing. The rate of uninsured children in states that have not expanded their Medicaid coverage grew at nearly three times the rate than that of states that have expanded Medicaid coverage. Texas and Florida, two non-expansion states, were responsible for 41 percent of coverage losses for children in a three-year period.

Throughout Medicaid Awareness Month, Protect Our Care has released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats. This week, Protect Our Care is examining the role Medicaid plays in reducing disparities and improving health care outcomes for some of our nation’s most vulnerable populations, including communities of color, people living with disabilities, rural Americans, women, children, and seniors and older adults.

Medicaid is vital for ensuring access to quality, affordable care, especially for women of color who experience higher rates of poverty and remain less likely to have access to quality care. But thanks to the Affordable Care Act and President Biden’s American Rescue Plan,  31 million women across the nation have been able access care and coverage under Medicaid. 

A Closer Look at Medicaid For Women

April is Medicaid Awareness Month and Medicaid is an essential pillar in providing coverage for women. Generations of inequality have resulted in women experiencing high coverage costs, poor health outcomes, and health inequities. As a result, Medicaid coverage remains a critical source of coverage, especially for women of color who experience higher rates of poverty than white women and remain less likely to have access to quality care. For pregnant women, affordable health coverage is essential more than ever as the United States continues to experience the highest rates of maternal mortality among wealthy nations. 

Research confirms that Medicaid expansion saves lives and drastically reduces health disparities. States that expanded their Medicaid programs saw millions of women gain coverage. In 2019, eight states with women’s uninsured rates above the national average had not adopted Medicaid expansion. By rejecting expansion, these states are worsening the maternal health crisis and limiting health care access for the women who need it most. Despite Medicaid expansion’s proven role in reducing disparities in health care access and improving outcomes, Republicans have spent years undermining the expansion of Medicaid, blocking millions from coverage. Currently, an estimated four million uninsured adults are locked out of coverage in the 12 holdout states, with 2.2 million trapped in the Medicaid coverage gap. As of 2021, approximately one million women are in the coverage gap.

By The Numbers

• Medicaid Covers Over 30 Million Women Nationwide. 31 million adult women rely on Medicaid for coverage. In 2020, Medicaid covered 16 percent of nonelderly women in the United States. Women comprise the majority of adult Medicaid enrollees.
• Medicaid Is A Major Source Of Coverage For Women Of Color. Due to systemic inequality, women of color are disproportionately likely to be covered by Medicaid. Nearly 33 percent of Black Americans, 30 percent of Hispanic or Latino individuals, nearly 15 percent of Asian and Pacific Islanders, and 34 percent of American Indian and Alaska Native individuals are enrolled in Medicaid, compared with 15 percent of white individuals.
• Medicaid Covers Nearly Half Of Women With Disabilities. Medicaid covers more than 44 percent of nonelderly women with mental and physical disabilities. As of 2019, Medicaid was the source of health coverage for one in four American women with mental illness.
• Most Women On Medicaid Are Working. According to Kaiser Family Foundation, the vast majority of women enrolled in Medicaid work, including mothers on Medicaid. In 2019, 93 percent of women enrolled in Medicaid were either working, going to school, at home caring for young children or relatives, or experiencing an illness or disability that does not permit them to work. 
• More Than 4 Million People Would Gain Coverage If Remaining States Expanded Medicaid. Over four million people would gain Medicaid coverage if the remaining states implemented expansion, including 2.2 million trapped in the Medicaid coverage gap. 

Medicaid Is The Largest Payer Of Reproductive Health Care Coverage. Medicaid covers about one in five women of reproductive age, giving them access to reproductive health care services such as birth control, cancer screenings, and maternity care without cost-sharing. Two thirds of women enrolled in Medicaid are of reproductive age, with Medicaid accounting for 75 percent of all public expenditures on family planning services.

• Expanding Access To Care At Every Stage. There is an urgent need for quality, affordable health coverage prior to, during, and after giving birth. While 48 percent of maternal deaths occur during pregnancy and delivery, more than half, 52 percent, occur in the year following the birth of a child. 12 percent of maternal deaths are deemed ‘late’, occurring between six weeks and one year following delivery, demonstrating the immense need for continuous health access and coverage for a minimum of one year following the birth of a child. The Biden administration has established a pathway to coverage, providing states the opportunity to extend postpartum coverage under Medicaid from 60 days to 12 months following birth. Currently, four states have begun offering continuous Medicaid or CHIP coverage for 12 months after pregnancy and an additional 11 states and the District of Columbia are working to expand coverage. 
• More Than Four In 10 Births Are Covered By Medicaid. In 2020, 42 percent of births were financed by Medicaid, with 40 percent or more births covered by the program in 24 states and the District of Columbia. Rates varied across the nation, with 61 percent of births financed by Medicaid in Louisiana, and 22 percent in Utah. In the 12 states that have refused Medicaid expansion, eight had more than 40 percent of births covered by Medicaid. Medicaid covers 65 percent of all births to Black mothers. 
• Expanding Medicaid & Closing The Coverage Gap Is Critical To Improving Maternal Health. Women of color consistently experience higher rates of maternal mortality than white women, with the Center on Budget Policy and Priorities finding this to be the result of a combination of factors, including life-long toxic stress resulting from racism and the impacts of structural racism in the health care system. If post-partum Medicaid coverage was expanded to a full year in every state, more than 720,000 individuals would receive quality coverage. 65 percent of women of reproductive age living in the coverage gap are women of color. 
• Medicaid Expansion Improved Access To Primary Care & Family Planning. Two studies from Michigan showed that Medicaid expansion doubled low-income patients’ access to primary care, and that enrollees experienced improved access to birth control and family planning. 

Medicaid Improves Access To Care For Women. Women with Medicaid are far more likely to receive care than uninsured women. According to the Kaiser Family Foundation, women with Medicaid coverage are less likely than women with private insurance to report delaying or forgoing care due to cost. Women with Medicaid coverage receive preventive care at roughly the same rates as women with private coverage and at a higher rate than women without insurance. 

Medicaid Helps Pay For Long-Term Care, Mostly For Elderly Women. Medicaid pays for roughly half of the nation’s long-term services and supports. In 2020, women accounted for 61 percent of the 12.3 million dual-eligibles, or people who rely on both Medicare and Medicaid for coverage. Most dual-eligibles are elderly, and many need Medicaid coverage for their long-term care needs. Medicaid covers nearly 40 percent of Latina and Black women over 65 who are also covered by Medicare.

Medicaid Creates Jobs In The Health Industry, Which Is Overwhelmingly Female. Kaiser Family Foundation estimates that there are 15.5 million frontline health care workers — 77 percent of which are women — establishing Medicaid as a major job creator for women. 

***MEDIA ADVISORY FOR WEDNESDAY, APRIL 27 AT 10:00 AM ET***

Medicaid Is More Important Than Ever Before. Lawmakers Must Work To Strengthen the Program and Ensure Access to Quality, Affordable Care.

Manchester, NH — Today, April 27, 2022 at 10:00 AM ET, U.S. Representative Chris Pappas (D-NH-01) will join Granite State Progress and Protect Our Care New Hampshire during Medicaid Awareness Month to highlight how Medicaid expansion has provided Granite Staters with access to quality, affordable health care, strengthened local economies, and improved health outcomes across New Hampshire.

Medicaid has served as a lifeline during the pandemic, providing health coverage to a record number of Americans at a time they need it most. While the federal COVID-19 public health emergency order was extended, preventing vulnerable Granite Staters from falling off of Medicaid, speakers will discuss opportunities for lawmakers to strengthen Medicaid, and ensure ongoing access to care.

VIRTUAL PRESS CONFERENCE:

WHO:
Rep. Chris Pappas (D-NH-01)
Sandra Pratt, Bilingual Service Coordinator at Gateways
Tom Cochran Executive Director Laconia Housing
Zandra Rice-Hawkins, Granite State Progress
Protect Our Care NH

WHAT: Virtual Press Conference

WHERE: Register for the Event Here

WHEN: Wednesday, April 27, 2022 at 10:00 AM ET

Throughout Medicaid Awareness Month, Protect Our Care has released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats. This week, Protect Our Care is examining the role Medicaid plays in reducing disparities and improving health care outcomes for some of our nation’s most vulnerable populations, including communities of color, people living with disabilities, rural Americans, women, children, and seniors and older adults.

Medicaid provides crucial support for seniors and older Americans. Thanks to the Affordable Care Act and President Biden’s American Rescue Plan, over 8.5 million adults aged 50 to 64 rely on Medicaid as a source of long-term care or to fill in gaps in Medicare coverage, such as transportation to medical appointments and medical equipment. As seniors age, long-term care services become more essential, serving half of seniors over age 75 and three in four seniors over age 85. Without Medicaid’s supplements to Medicare, millions of seniors and older Americans would not have access to necessary care and treatment. 

A Closer Look at Medicaid For Seniors & Older Adults

April is Medicaid Awareness Month and Medicaid is an essential pillar in providing coverage for seniors and older Americans. Medicaid remains a critical source of coverage as Americans age, with Medicaid serving as a primary funder for long-term care and filling many of the gaps in Medicare coverage, such as transportation to medical appointments and medical equipment. More than 7.2 million American seniors and 8.5 million adults aged 50 to 64 rely on Medicaid coverage. The benefits of Medicaid for America’s aging population often go unnoticed, but are essential to the health and wellbeing of this population. For seniors and older Americans with low incomes, Medicare premiums are paid by Medicaid, as well as deductibles and health care that requires cost-sharing. Without Medicaid’s supplements to Medicare, millions of seniors would be forced to go without needed care. 

States that expanded their Medicaid programs saw millions of seniors and older Americans gain coverage. Between 2014 and 2017, Medicaid expansion saved the lives of 19,200 older adults. At the same time, 15,600 older adults died prematurely as a result of their states’ decision not to expand the program. By rejecting expansion, these states are limiting the care older Americans can receive. Despite Medicaid expansion’s proven role in reducing disparities in health care access and improving outcomes, Republicans have spent years undermining the expansion of Medicaid, blocking millions from coverage. Currently, an estimated four million uninsured adults are locked out of coverage in the 12 holdout states. 

By The Numbers

• Millions of Seniors & Older Americans Rely On Medicaid Coverage. 7.2 million Americans over 65 are enrolled in Medicaid and more than 8.5 million Americans ages 50 to 64 have health coverage through Medicaid – many thanks to the Affordable Care Act’s Medicaid expansion.
• Nearly 1 in 3 Seniors Live Below 200 Percent Of The Federal Poverty Line. For millions of seniors and older Americans on fixed incomes, Medicaid is a critical lifeline.
• Medicaid Funds Over Half Of Long-Term Care Nationwide. As seniors age, long-term care services become more essential, serving half of seniors over age 75 and three in four seniors over age 85.
• More Than 4 Million People Would Gain Coverage If Remaining States Expanded Medicaid. Over four million people would gain Medicaid coverage if the remaining states implemented expansion, including 2.2 million trapped in the Medicaid coverage gap. 
• Medicaid Covers 6 In 10 Nursing Home Residents. The average annual cost of nursing home care is $82,000 — nearly three times most seniors’ annual income. 

• Over 1 In 5 Medicare Beneficiaries Also Have Medicaid Coverage. More than 20 percent of Medicare enrollees are dually eligible. Most dual-eligibles are over age 65, and are more likely to have complex and chronic health needs.

Thousands Of Lives Saved Each Year. According to the Center on Budget and Policy Priorities, Medicaid expansion saved the lives of 19,200 older adults aged 55 to 64 between 2014 and 2017. At the same time, 15,600 older adults died prematurely as a result of their states’ decision not to expand the program. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in non-elderly adults by nearly four percent.

Medicaid Expansion Helps Americans Near Retirement Access Health Care. According to the Center for Retirement Research, after the implementation of the Affordable Care Act, the share of older adults without insurance declined as Medicaid enrollment grew, with the number of uninsured older Americans dropping from over 15 percent in 2012, to nine percent in 2016. 

Medicaid Expansion Helps Older Adults Gain Access To Care Immediately. Medicaid expansion helps older adults with disabilities gain quicker access to coverage without waiting for a disability determination, which can take years. 

Medicaid Expansion Reduces Out-Of-Pocket Health Care Spending. According to the Georgetown Center for Children and Families, between 2010 and 2015, the average out-of-pocket spending decreased in states that expanded Medicaid and increased in non-expansion states. Less than half of American adults ages 55 to 64 work and many live on fixed incomes. Some are retired, and for many others, chronic health conditions make it difficult to maintain steady employment.

Seniors And Older Adults Depend On Medicaid For Affordable, Comprehensive Care. As of 2021, there are 3.6 million older adults going without coverage. Older Americans often have more complex health issues, requiring additional medical attention that is often costly, pushing care out of reach. For seniors on Medicare, Medicaid serves to fill many of the gaps in Medicare coverage, such as transportation to medical appointments and medical equipment.

Low-Income Seniors With Medicare Depend On Medicaid For Long-Term Care. It is estimated that one in three seniors will need nursing home care at some point and two in three nursing facility residents utilize Medicaid to receive their care. Medicaid is a critical provider of home and community based care that are essential to keep loved ones at home with their families and neighbors. Without Medicaid, many seniors would not be able to afford these needed services with Medicare alone. 84 percent of individuals in nursing facilities covered by Medicaid in 2019 were dually eligible, with Medicaid covering costs once Medicare benefits have been depleted. 

Medicaid Reduces Poverty For Seniors And Older Americans. Medicaid has long been considered one of the most effective anti-poverty programs in the nation, and its expansion has significantly improved health outcomes for seniors and older adults. In a nation where out-of-pocket health care spending forced more than 10 million Americans into poverty in 2016 alone, Medicaid serves as a lifeline not only for health care, but for economic stability as Americans age. A January 2021 study from Health Affairs found that the ACA helped reduce income inequality across the board, but much more dramatically in Medicaid expansion states.

Throughout Medicaid Awareness Month, Protect Our Care released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats. This week, Protect Our Care will examine the role Medicaid plays in reducing disparities and improving health care outcomes for some of our nation’s most vulnerable populations, including communities of color, people living with disabilities, women, rural Americans, seniors and older adults, and children.

Medicaid has been a lifeline for many people with disabilities, as the program helps adults with disabilities gain quicker access to comprehensive care and coverage and increases financial security by reducing out-of-pocket health care costs. Thanks to President Biden’s American Rescue Plan, which strengthened the ACA by providing financial incentives for Medicaid expansion, Medicaid continues to have profound impacts on the lives of Americans with disabilities.

April is Medicaid Awareness Month, and Medicaid is a vital source of care for people with disabilities across the country. According to a 2019 report from the Census Bureau, approximately one in eight, or 41.1 million Americans, have a disability. Research has shown the people with disabilities covered by Medicaid are more likely to receive comprehensive and consistent care than those who are either privately insured or uninsured. The Medicaid program also provides half of all long-term care in the United States, which includes essential home- and community-based services for people with disabilities. Protecting access to Medicaid is essential to ensuring people with disabilities continue to get the care they need. 

Medicaid has served as a critical safety net as millions have lost jobs and their employer-based health insurance during the COVID-19 pandemic. Experts say an overwhelming majority of the people who have lost coverage during the pandemic have been able to get covered under the Affordable Care Act (ACA) or through Medicaid. By November 2021, Medicaid enrollment had grown to an all-time high of nearly 79 million Americans. 

President Biden took bold steps to strengthen the Medicaid program by signing the American Rescue Plan into law. This historic legislation includes the most significant health care expansion in a decade. Importantly, the American Rescue Plan provided additional financial incentives for the 12 states that had not yet implemented Medicaid expansion.Since the signage of the ARP, two previous holdout states, Missouri and Oklahoma, have adopted Medicaid, expanding coverage to nearly 500,000 Americans. These measures will have profound impacts on Americans with disabilities for years to come. If the remaining states expanded Medicaid, an estimated 500,000 people with disabilities could gain coverage. Expanding access to health care is particularly important as millions of Americans have contracted the COVID-19, with some “long haulers” facing the possibility of lifelong disabilities.

Without legislation or extension of the Public Health Emergency, millions will lose Medicaid coverage or go without coverage for a period of time. Due to the expansion in coverage from the COVID-19 pandemic, Medicaid enrollment has increased by more than 14.8 million people since the beginning of the pandemic.

By The Numbers 

• Over 41 Million U.S. Adults Have A Disability. 41 million Americans have a disability in the U.S. Thanks to the ACA, insurance companies can no longer deny them coverage, drop their coverage for no reason, or charge them more because of a pre-existing condition. 
• Nearly 7 Million Nonelderly Adults With Disabilities Depend On Medicaid For Care. Nearly 7 million adults enrolled in Medicaid have a disability. 
• Over 10 Million Medicaid Enrollees Under 65 Have A Disability. More than 10 million people under age 65 enrolled in Medicaid live with at least one disability.
• Nearly 45 Percent Of Adults With Disabilities Have Medicaid Coverage. Medicaid covers 45 percent of nonelderly adults with disabilities, including adults with physical disabilities, developmental disabilities, brain injuries, and mental illness.
• 3 in 10 Nonelderly People With Disabilities Rely On Medicaid For Long Term Care. In 2017, 3 in 10 nonelderly people with disabilities relied on Medicaid for long-term care. Nearly 85 percent of this population has incomes below 200% of the FPL.

Republican Efforts To Block Medicaid Expansion Limits Access For People With Disabilities

Twelve years ago, the ACA opened the door for states to expand Medicaid, and the results are piling in: Medicaid expansion works. In addition to providing coverage for 18 million people, expansion has resulted in healthier people, communities, and economies. 

Study after study shows that Medicaid expansion increases access to care, improves financial security, and leads to better health outcomes. The program has increased access to lifesaving cancer screenings, improved infant and maternal health, and increased access to substance abuse treatment — and the list goes on. A growing body of evidence shows that expanding Medicaid has saved lives.

People With Disabilities Rely On Medicaid Expansion For Coverage. Of the 8.7 million disabled adults enrolled in Medicaid, only 43 percent qualify for supplemental security income (SSI). More than six in 10 nonelderly Medicaid adults with disabilities do not receive SSI, meaning that they qualify for Medicaid on another basis such as low-income or as parents in non-expansion states.

Medicaid Expansion Helps Adults Gain Access To Care Without Having To Wait On A Disability Determination. Medicaid expansion helps adults with disabilities gain quicker access to coverage without waiting for a disability determination, which can take years. The ACA Medicaid expansion has allowed people who previously weren’t eligible for coverage, and would otherwise be uninsured, gain coverage. Many uninsured individuals with pre-existing conditions who would have not qualified for Social Security Disability Insurance yet, can now be covered under the ACA.

Medicaid Expansion Reduces Out-Of-Pocket Health Care Spending, Which Is Especially Important For People With Disabilities Who Often Have Limited Incomes. According to the Georgetown Center for Children and Families, between 2010 and 2015, the average out-of-pocket spending decreased in states that expanded Medicaid and increased in non-expansion states. A majority, or nearly 85 percent, of adults with disabilities who have Medicaid coverage earn annual incomes of less than 200 percent of the FPL, $12,060 for an individual, making access to affordable health care even more essential. In 2022, CMS adopted rules to lower maximum out-of-pocket costs by $400.

Medicaid Is A Vital Source Of Care For People With Disabilities

Medicaid Helps People With Disabilities Receive Comprehensive, Consistent Care. Compared to people with disabilities who are covered by private insurance, nonelderly Medicaid adults with disabilities are four times as likely to receive nursing or other health care at home, more than 2.5 times as likely to have three or more functional limitations, and more than 1.5 times as likely to have 10 or more health care visits in a year compared to people with disabilities who are privately insured.

Medicaid Covers A Broad Range Of Preventive And Medical Services. Thanks to Medicaid, nonelderly adults with disabilities have access to regular preventative care and treatment for chronic illnesses and conditions. States are now required to provide a minimum amount of services for adults, such as hospital stays, physician, lab, and x-ray services, and nursing home care. States also have the opportunity to provide a broad range of optional services, such as prescription drugs, physical therapy, private duty nursing, personal care, rehabilitative services, and case management.

Adults With Disabilities Are More Likely To Have Medicaid, And Less Likely To Have Private Insurance, Than Those Without Disabilities. Adults with disabilities are three times as likely to be covered by Medicaid and half as likely to have private insurance. This is due to the greater health needs of people with disabilities and that they are less likely to have access to employer-sponsored coverage.

Medicaid Provides Half Of Long-Term Care In U.S. Medicaid provides half the nation’s long-term care. Medicaid providers and consumers have worked to broaden access to care in home and community based settings, where many seniors and people with disabilities would prefer to live. In 2013, the majority of Medicaid spending on long term services and supports (LTSS) was for home and community based services (HCBS) rather than for institutional care.

Medicaid Helps People With Disabilities Who Need Long-Term Care To Stay In Their 80 percent of nonelderly people with disabilities who use Medicaid long-term care are served in the community, with the remaining 20 percent in institutions. Over the past few decades, states have expanded community services to serve more nonelderly adults with disabilities instead of in nursing home facilities. HCBS typically are less expensive than nursing homes and are preferred by many nonelderly adults with disabilities.

Medicaid Increases Financial Security For People With Disabilities

Medicaid Is One Of The Most Effective Anti-Poverty Programs, Particularly For People With Disabilities. Medicaid reduced the health inclusive poverty measure by 3.8 percentage points. This is comparable to the combined effect of all social insurance programs and greater than the effects of non-health means tested benefits and refundable tax credits. The poverty-reducing effects were greatest for adults with disabilities, the elderly children, and racial/ethnic minorities.

Medicaid Expansion Increased Employment For People With Disabilities. Individuals with disabilities living in Medicaid expansion states are more likely to be employed than are those living in non expansion states. They are able to access and maintain Medicaid coverage while earning at levels that previously would have made them ineligible. However, the Supreme Court’s decision to make Medicaid expansion optional created a coverage gap into which some people with disabilities still fall. For people with disabilities in non expansion states, the existing population health disparities may widen.