April is Medicaid Awareness Month and there has never been a more critical time to highlight Medicaid’s overwhelming importance as the country grapples with a crisis that threatens every Americans’ health and safety. Medicaid is an essential program for more than 70 million Americans currently receiving coverage, including more than 35 million children, and 7.2 million seniors. Despite its successes, Medicaid is continuously under attack from President Trump and Republicans. From proposing massive cuts to Medicaid in his budgets, his Texas lawsuit that would end Medicaid expansion to encouraging states to impose draconian work requirements and block grants that would kick people off the rolls, Trump has been on a warpath to end Medicaid since the day he took office. 

Trump’s attacks on Medicaid are exacerbated by the coronavirus crisis that grips the nation. Taking away health care when Americans are more concerned than ever about their health and safety is not only cruel but will actively hurt our ability to stop the coronavirus as more Americans fall ill and need lifesaving treatment. Throughout April, Protect Our Care will highlight Medicaid’s successes while bringing attention to Trump and Republicans’ years-long quest to end the program and take health care away from Americans when they need it most during this crisis. 

To mark the start of Medicaid Awareness Month today, Protect Our Care Chair Leslie Dach released the following statement: 

“There has never been a more important time to illustrate just how critical Medicaid is for millions of Americans who rely on it for essential health care and protections than this April as our country stares down the coronavirus crisis. From providing health insurance to children and those with disabilities to coverage for seniors and Americans in rural communities, Medicaid is a lifeline to millions of Americans across the country who would suffer greatly without it. Despite its successes, Medicaid is still under attack from President Trump and Republicans who want to gut the program and end Medicaid expansion at a time when the health and safety of Americans has never been more at risk.”

Medicaid is A Critical Part of America’s Response to the Coronavirus, But President Trump Wants to Gut It 

The Medicaid program is a critical part of our response to coronavirus, but President Trump is waging a war on Medicaid. Here are the ways the Trump administration is trying to gut Medicaid and the ways Medicaid is essential to America’s coronavirus response: 

Trump Administration’s War On Medicaid Threatens The U.S. Coronavirus Response

Trump Wants To Repeal Medicaid Expansion Through His Texas Lawsuit To Overturn The ACA. The Trump administration is currently backing a lawsuit to overturn the Affordable Care Act and, if they are successful, 20 million people would lose insurance and protections for pre-existing conditions would be eliminated overnight. The lawsuit would also terminate Medicaid expansion, threatening to rip away coverage from 17 million and cut key funding for already-struggling rural hospitals during the pandemic.

Trump Continues To Support Medicaid Block Grants. Under the Trump administration’s recently finalized block grant proposal, federal funding would no longer necessarily increase in response to a public health emergency like coronavirus. This could lead to people losing coverage and access to care, undermining prevention and treatment of diseases nationwide. 

Trump Paved The Way For Medicaid Work Requirements. The administration has encouraged states to impose illegal work requirements on Medicaid beneficiaries that are designed to throw people off coverage. When Arkansas imposed the nation’s first work requirement program, 18,000 people lost coverage. The policy has since been struck down by the courts. While the federal government has temporarily halted any state efforts to impose new eligibility requirements that make it more difficult to enroll, including work requirements, states like Oklahoma and Utah are continuing to pursue Medicaid work requirements and other enrollment restrictions.

Trump Wants To Gut The Medicaid Budget. Trump has repeatedly sought deep health care cuts in his budget proposals, most recently seeking more than a trillion in cuts to Medicaid and the Affordable Care Act for 2021. This budget essentially ends Medicaid expansion by eliminating the enhanced federal payment and proposes nationwide work requirements. 

Experts Agree: Attacks On Medicaid Put The Country Even More At Risk During the Coronavirus Crisis 

Sara Rosenbaum, Medicaid Expert At George Washington University, Said Trump Administration’s Anti-Medicaid Ideology “Is Clouding Their Response To A Crisis.” “’Medicaid could be the nation’s biggest public health responder, but it’s such an object of ire in this administration,’ said Sara Rosenbaum, a Medicaid expert at George Washington University. ‘Their ideology is clouding their response to a crisis.’” [Los Angeles Times, 3/13/20]

Joan Alker, Executive Director Of The Center For Children And Families At Georgetown University, Said That “Work Requirements And Premiums Are Precisely The Kinds Of Policies That Are Dangerous Now.” “‘Work requirements and premiums are precisely the kinds of policies that are dangerous now and divert energy for state government staff, who are under enormous stress,’ said Joan Alker, executive director of the Center for Children and Families at Georgetown University. ‘They need to focus on facilitating as many people’s access to care as they can.'” [Modern Healthcare, 3/18/20]

Gregg Bloche, M.D., J.D., Professor Of Law At Georgetown University, Argued Medicaid Expansion Should Be Part Of The Coronavirus Response. “Nationwide Medicaid expansion should be part of our emergency response to coronavirus. Texas, Florida, and 12 other states are putting lives at risk across America by refusing to extend Medicaid coverage to millions who are poor and uninsured. This ensures that many Americans who become infected will go undiagnosed and untreated: people for whom going to the doctor portends financial calamity tend not to do so before their health circumstances become dire.” [The Hill, 3/9/20]

Why Medicaid Is So Important

Medicaid’s Funding Can Increase In Response To A Public Health Emergency Like Coronavirus. “Medicaid fills an essential role as a safety-net insurer because of its special flexible design made possible by its open-ended federal funding base. This sets it apart from all other sources of health insurance and allows the program to fund major, unexpected health care costs other insurance plans are structured to avoid.” [Commonwealth Fund, 3/9/20

Unlike Private Insurance, Medicaid Allows Eligible People To Enroll Whenever They Need Health Care. “Unlike traditional insurance, which depends on specific enrollment periods to avoid adverse selection, people can enroll in Medicaid whenever health care is needed. In addition, Medicaid provides for offsite enrollment at hospitals and clinics, and temporary eligibility (also known as presumptive eligibility) can be granted.” [Commonwealth Fund, 3/9/20

Medicaid Can Provide Retroactive Coverage. “Eligibility can begin three months prior to the date of application, which means that providers will not be penalized financially for furnishing emergency care to Medicaid-eligible patients who have not yet enrolled.” [Commonwealth Fund, 3/9/20

Medicaid’s Flexibility Gives States The Opportunity To Cover More Services When Necessary. “State Medicaid programs can rapidly scale up benefits and adjust normal cost-sharing rules when conditions demand it. This flexibility allows programs to quickly add coverage for new vaccines or begin paying for treatment in nontraditional settings, such as the temporary emergency housing that Washington State is now pursuing for coronavirus patients.” [Commonwealth Fund, 3/9/20

Why Medicaid Expansion Is So Important

More than three million workers have already lost their jobs during the pandemic, so it is especially important for low-income adults to have a place to turn for coverage in this public health emergency. 

Medicaid Expansion Covers More Than 17 Million. Thanks to the ACA, states can get additional federal money to expand Medicaid to vulnerable populations. More than 17 million Americans now have coverage through Medicaid expansion. 

Expansion Provides Key Support For Rural Hospitals. The ACA led to a $12 billion reduction in uncompensated care costs. Between 2013 and 2015, hospitals’ uncompensated care costs decreased by $12 billion, or roughly 30 percent. As hospitals prepare for an influx in patients, it is critical that they are paid for the treatment they provide.

  • Rural Areas Are Vulnerable To Coronavirus Outbreak, Especially In States That Have Not Expanded Medicaid. “‘Vulnerable’ states, where more than 40% of rural hospitals risk closure, include Florida, Mississippi, Missouri and Tennessee. Alongside Texas, none expanded Medicaid under the Affordable Care Act, which would have insured more low-income people. Rural hospitals in non-Medicaid expansion states are treating more people who have no insurance. Therefore, they are providing more care for which they aren’t reimbursed.” [Stateline, 3/17/20]