Skip to main content

Republican War on Medicaid Threatens 90 Million Americans

By February 2, 2023No Comments

GOP Attacks on Medicaid Continue As GOP Eyes Cuts

Republicans have declared war on Social Security, Medicare, and Medicaid. They are promising to defund all three programs and repeal the Inflation Reduction Act’s provisions to lower drug costs under Medicare and make Affordable Care Act coverage more affordable through premium tax credits. But in many ways, their biggest target appears to be Medicaid. Over 90 million Americans receive their care through Medicaid. Medicaid has been proven time and time again to save lives, increase coverage and – in turn – access to needed care, and help reduce racial, rural, and other health disparities. Republican attacks on Medicaid are especially harmful for communities of color, rural Americans, people with disabilities, and low-income families.

How The GOP Is Threatening Medicaid:

  • Promising draconian cuts to Medicaid in debt ceiling and appropriations negotiations
  • Attempting to abruptly end the Public Health Emergency, which could throw 5 to 14 million people off Medicaid coverage
  • Refusing to expand Medicaid in the 11 holdout states with Republican legislatures causing hospital closures in rural America due to lack of funding
  • Committing to repeal the Affordable Care Act and its provisions to expand Medicaid adopted by 39 states 

Medicaid Saves Lives

Thousands Of Lives Saved Each Year. As of September 2022, over 90 million Americans are enrolled in Medicaid. At least 19,000 lives were saved due to the ACA’s Medicaid expansion. An additional 7,000 lives per year could be saved if the 11 Republican hold out states expand Medicaid coverage. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in non-elderly adults by nearly four percent

Expansion Of Lifesaving Care. Medicaid expansion has helped patients access preventive care, including colon cancer screenings. Expansion also increased patient access to kidney transplants and made diabetes medication more affordable for low-income patients. The program was also tied to earlier diagnosis of colorectal cancer and reducing diabetes-related amputations. Expansion is associated with improvements in access to care and outcomes related to substance use disorder and mental health care

Medicaid Reduces Racial Disparities In Health Care

Reduced Racial Disparities In Coverage And Access. Increasing Medicaid access is the single most important action available to expand coverage and, together with other actions that address access as a driver of health and other determinants of health, reduce racial disparities in health care. The ACA led to historic reductions in racial disparities in access to health care, but racial gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. States that expanded their Medicaid programs saw a 51 percent reduction in the gap between uninsured white and Black adults after expansion, and a 45 percent reduction between white and Hispanic adults. 60 percent of Americans who would gain coverage if the remaining 11 hold out states expanded Medicaid are people of color. 

Medicaid Coverage Is Critical To Improving Maternal Health. The United States is only one of two nations that has reported an increase in maternal mortality since 2000. 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, more than 720,000 individuals would receive quality coverage.This is an important step combined with other efforts to address peripartum health outcomes, like the Momnibus legislation. In the 11 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 and 65 percent of women of reproductive age living in the coverage gap are women of color. 

Better Access To Care. Medicaid expansion reduced racial disparities in cancer care and resulted in earlier diagnosis and treatment for Black patients. In 2021, over 11 million Black Americans were covered by Medicaid, with an additional 2.4 million stuck in the coverage gap.

Medicaid Reduces Rural Disparities In Health Care

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.

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.

Medicaid Benefits Children

Almost Half Of Births Are Covered By Medicaid. According to the Kaiser Family Foundation, more than 4 in 10 births are covered by Medicaid. Under the American Rescue Plan, states were given the option to extend coverage to new mothers for one year postpartum, which will improve maternal health outcomes. Out of expansion states, 2 states, Texas and Wisconsin, have limited postpartum coverage. 

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 Helps Those In Need Of Long Term Care

Low-Income Seniors With Medicare Depend On Medicaid For Long-Term Care. Nearly 70 percent of people aged 65 and older will need some form of long-term care for at least 3 years.  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.