Sixty-one years after Medicaid and Medicare were created to protect Americans’ health and security, Republican cuts threaten to take us backward. Nearly 70 million Americans rely on Medicaid for life-saving coverage across the country. Now, the health care leaders responsible for making sure those people have coverage are sounding the alarm. After Republicans made the largest health care cuts in history, slashing more than $1 trillion from Medicaid and the Affordable Care Act to fund tax breaks for billionaires, millions of Americans lost the coverage they relied on. When coverage disappears, people skip seeing a doctor until it becomes an emergency. Emergency rooms fill up. Hospitals, especially in rural areas, stop being able to absorb the cost of uncompensated care and close their doors. Communities get left behind. And when the federal government stops helping, states are left with massive holes in their budgets that will force impossible choices between cutting coverage, raising taxes, or watching the system collapse.
The state directors who are in the trenches every day, who see the data, field the calls, and know what’s at stake, are speaking out. From California to New Jersey, their message is the same: Republican cuts will devastate the people in their communities, and states cannot fix this crisis alone.
Tyler Sadwith, State Medicaid Director, California
- “The cuts passed in HR 1 represent the most significant cuts to Medi-Cal eligibility and funding from the federal level that we’ve ever seen. What this means is that tens of billions of federal dollars critical to the Medi-Cal program may be lost as a result of this law. Up to 1.3 million Medi-Cal members are projected to lose their eligibility, and critical health care providers — safety net hospitals, clinics, and others — may be impacted as well. We are doing everything we can to mitigate the harm to members and providers, but we cannot avoid its impact entirely.” [KQED]
Adela Flores-Brennan, Medicaid Director and Health Policy Office Director, Colorado
- “Our North Star at Colorado Medicaid is to really mitigate and minimize the loss of coverage, because it’s really important to us that our members remain covered. That being said, these requirements are going to be confusing. I do imagine that, unfortunately, people will get caught up either in the paperwork requirements or not being able to meet the work requirements themselves to be able to stay enrolled.” [WBUR]
- “Flores-Brennan said the state is also worried more people could end up relying on emergency rooms after losing regular coverage. ‘People will still need to access healthcare,’ she said. ‘They just may not be able to pay for it.’” [9News]
Dr. Steven Stack, Secretary of the Cabinet for Health and Family Services, Kentucky
- “Anyone who is purchasing gasoline or groceries knows that costs have gone up,” Stack said. “Those same costs have certainly impacted the cost of providing medical care, the cost of providing foster care services, foster parent support, foster home support, the cost for providing meals through our nutrition programs. Those costs have gone up, but our funding has gone down, and in some areas, gone down quite significantly.” [Kentucky Lantern]
John Connolly, Deputy Commissioner and State Medicaid Director, Minnesota
- “‘These ripple effects, of course, are real and worrisome. But we’re committed to working with you to keep Minnesotans aware of what’s coming, what applies to them, and what doesn’t.’”
- “‘Medicaid funding reductions and new eligibility requirements in HR1 represent a dramatic change for Minnesota, and I would add a negative one in many respects. These shifts will affect health care providers and the people who rely on them to provide care when they can’t care for themselves and when they are sick. In particular, we are worried about the adults without kids in the home, the expansion group, given that they will face not only new eligibility requirements, multiple eligibility requirements, but also cost sharing. And we worry about delayed treatments and poor health outcomes as well as uncompensated care for so many providers.’” [MHA Podcast]
Greg Woods, Assistant Commissioner and Medicaid Director, New Jersey
- “Greg Woods, assistant commissioner of the state’s Department of Human Services, said the law will have a lasting effect on the Medicaid program, which started in the 1960s. ‘I think it’s probably fair to say this is the most significant federal legislation affecting Medicaid since the Affordable Care Act was enacted in 2010,’ Woods said at a meeting last month about how the law will impact New Jersey.” [NJ Spotlight News]
Alanna Dancis, Interim Medicaid Director, New Mexico
- “‘With 836,000 New Mexicans enrolled––nearly 40% of our population––we lead the nation in per capita Medicaid coverage. Congress just voted to pass nearly a trillion dollars in Medicaid cuts this week, and Americans need to understand that it’s not just Medicaid recipients who will suffer. The devastation from these funding cuts will reverberate through already-struggling rural communities nationwide, causing hospitals closures, lost health coverage, and job losses.’” [Health Care Authority New Mexico]
Amir Bassiri, Medicaid Director, New York
- “‘It could be catastrophic,’ Bassiri said of the potential for 1 million New Yorkers to lose coverage as a result of this change and others passed by Republicans in Congress. ‘When there are higher uninsured rates, that means providers are delivering care without getting reimbursed [and] people are choosing to forgo care,’ Bassiri said. ‘You start to see costs ripple through … the providers’ pockets, the insurers’ pockets and the patients’ pockets.’” [Trade Offs]
Melanie Bush, Deputy Secretary of Medicaid, North Carolina
- “Taken together, the federal rule’s heightened frailty standard and the state law’s lookback clause and ban on self-attestation put North Carolina’s county offices in a particularly demanding position compared with most other states. ‘Our county DSS [offices] are going to need a lot of support,’ Bush said. ‘It’s going to be completely overwhelming for them to take this on.’” [Charlotte Post]
- “This is the biggest change to Medicaid eligibility ever. It is incredibly confusing, and it is frustrating how confusing it’s going to be. There are going to be people who think that they have to go to work. There are going to be people who think that they’re exempt from work.” [News&Observer]
Emma Sandoe, Medicaid Director, Oregon
- “‘The administrative burden will also be felt by Oregon Health Plan members, who will be forced to navigate complex eligibility rules and fill out time-consuming paperwork, creating the probability of approximately 200,000 people losing coverage,’ Sandoe said in an email.” [Oregon Capital Chronicle]
Elizabeth Hertel, Former Director of the Department of Health and Human Services, Michigan
- “‘That’s hundreds of thousands of our friends, our family members and our neighbors who could be without health care coverage,’ she said. ‘Medicaid’s positive impact only solidifies that we must protect and strengthen our Medicaid program now and for future generations.’” [Hudson Valley Living]
Valerie A. Arkoosh, Secretary of Human Services, Pennsylvania
- “‘I have spent nearly 20 years using my experience as a physician to fight for a health care system that actually can meet patients’ needs — and the structures and supports that keep our health care system standing for all of us. Medicaid is at the heart of that, and never have we faced a threat quite as grave as what the federal government has forced on states. I hear the anxiety and fear in the voices of Pennsylvanians and providers. The ripple effects will be felt far beyond our Medicaid program. H.R. 1 is putting our entire health care system at risk, and states alone cannot solve this crisis.’” [Protect Our Care]
Daniel Tsai, Former Medicaid Director
- “‘I can’t overstate the magnitude of the challenge that states are facing. When I talk to my former colleagues running Medicaid programs all across the country, people are panicked. What Congress and the President have enacted will lead to many people who are eligible for Medicaid not being able to navigate a deeply complex, unprepared system. This will have a real impact on children, families, working adults, and people with disabilities that we care for. What we are dealing with here is not unique; it is happening all across the country as a result of Republican actions.’” [Protect Our Care]