Tag

Medicaid Archives — Page 2 of 8 — Protect Our Care

Wisconsinites Beware: Trump Administration Approves Walker’s Restrictive Medicaid Waiver

Washington DC – Today CMS approved Wisconsin’s plan to dramatically restrict Medicaid enrollment by taking coverage away from people who do not meet new burdensome work requirements or who cannot afford to pay new burdensome premiums. In response to the announcement, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Let’s be clear: At a time when Scott Walker is in the political fight of his career — promising over and over again that he’ll protect people with pre-existing conditions — here he is teaming up with Donald Trump to rip health care away from the families who need it the most. Wisconsinites, the vast majority of whom want to ensure people with pre-existing conditions get the coverage they need, must judge Scott Walker by what he does, not what he says. Because despite all his recent talk about protecting people, all he really does is use his power as Governor to put barriers between the hardworking people in his state and the care and coverage they need.”

BACKGROUND

MEDICAID IS A LIFELINE FOR…

…CHILDREN & FAMILIES

  • Nearly 36 Million Children Are Enrolled In Medicaid And CHIP. Roughly 35.7 million children in the United States are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP).
  • 38 Percent Of Children In America Are Covered By Medicaid. Nationally, nearly 2 in 5, or 38% of children in America have health insurance through Medicaid.
  • 49 Percent Of Births Are Covered By Medicaid.
  • 17 Percent of Parents Have Health Insurance Through Medicaid.
  • In 2010, Medicaid Kept 2.6 Million Americans Out Of Poverty.

…PEOPLE WITH DISABILITIES

  • Nearly 8.7 million adults enrolled in Medicaid have a disability. Of this group, only 43 percent qualify for social security income.

…SENIORS

  • More than 6.9 million American seniors have Medicaid coverage. 6,920,200 seniors, age 65 and older, are enrolled in Medicaid.
  • Medicaid funds 53 percent of long-term care nationwide. As seniors age, long-term care services become more and more vital, serving half of seniors over age 75 and three in four seniors over age 85.
  • 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.

…PEOPLE SUFFERING FROM OPIOID USE DISORDER

  • In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.

IN STATES WHERE SIMILAR RULES HAVE TAKEN EFFECT, THOUSANDS OF PEOPLE HAVE LOST CARE

  • Early results in Arkansas confirm that Medicaid work requirements are fundamentally bureaucratic hurdles, threatening access to health coverage for thousands across the state. “The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours. Of the remaining third — about 20,000 people — 16,000 didn’t report qualifying activities to the state. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.” [New York Times, 9/24/18]
  • This summer, a federal district court blocked Kentucky from imposing similar rules for the negative effects it would have on Kentuckians. Said the court in its ruling, “[Secretary Azar] never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid. This signal omission renders his determination arbitrary and capricious. The Court, consequently, will vacate the approval of Kentucky’s project and remand the matter to HHS for further review.”
  • In Indiana, 25,000 people with health insurance through Medicaid were dropped from coverage because they were unable to pay their premiums. The Washington Post reported, “About 25,000 adults were disenrolled from the program between its start in 2015 and October 2017 for failure to pay their premiums, according to state reports. Yet, state officials estimate that based on surveys of recipients, about half of those who were disenrolled found another source of coverage, most often through a job…In addition to those who were disenrolled, another 46,000 adults who signed up for Medicaid during 2016 and 2017 were not accepted because they did not pay their initial premium, the state reported.”

TAKING AWAY SOMEONE’S HEALTH CARE DOES NOT HELP THEM TO WORK

  • Evidence suggests that such work requirements hurt, rather than help enrollees’ ability to find work. A study of Michigan’s Medicaid “illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they are better able to seek employment.” In both Ohio and Michigan, having access to health care made it easier for the unemployed to find work: “majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment.

WORK REQUIREMENTS ADD ADMINISTRATIVE HURDLES, MAKING IT HARDER FOR PEOPLE WHO ARE ELIGIBLE FOR CARE TO GET IT

  • Requiring People On Medicaid To Prove They Are Working Adds An Administrative Burden That Is Hardest On Low-Income Americans. “[Administrative hurdles] may be especially daunting for the poor, who tend to have less stable work schedules and less access to resources that can simplify compliance: reliable transportation, a bank account, internet access.  There is also a lot of research about the Medicaid program, specifically, that shows that sign-ups fall when states make their program more complicated.” [New York Times, 1/18/18]
  • Documentation Requirements Increase The Chances That People Will Lose Care, Simply Because They Have Trouble Navigating The Process. “There is a real risk of eligible people losing coverage due to their inability to navigate these processes, miscommunication, or other breakdowns in the administrative process. People with disabilities may have challenges navigating the system to obtain an exemption for which they qualify and end up losing coverage.” [Kaiser Family Foundation, 1/16/18]

THE VAST MAJORITY OF  PEOPLE WITH MEDICAID COVERAGE WHO WHO CAN WORK ARE WORKING

  • 60 percent of nondisabled people with health coverage through Medicaid have a job and are working, including 42 percent working full-time.
  • 51 percent of working adult Medicaid enrollees have full-time jobs year-round, but their salaries are still low enough to qualify for Medicaid coverage or have Medicaid because their employers do not offer insurance.  
  • Nearly 80 percent of nondisabled people with Medicaid coverage live in a family where at least one person is working, including 64 percent working full-time. The other adult family member may not be working because they have caregiving or other responsibilities at home.
  • A state by state breakdown can be found HERE

Seema Verma Continues to Spread Misinformation When Promoting Harmful Medicaid Work Requirements

Today, in defense of the Trump Administration’s indefensible work requirements that have kicked thousands of people off of their health care, Seema Verma, the Administrator of the Centers for Medicare and Medicaid Services, continued to argue  that these requirements help Medicaid enrollees attain “skills they need” and “jobs that are available.”

Say what?

Here’s the truth: TAKING AWAY SOMEONE’S HEALTH CARE DOES NOT HELP THEM TO WORK

  • Evidence suggests that such work requirements hurt, rather than help enrollees’ ability to find work. A study of Michigan’s Medicaid “illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they they are better able to seek employment.” In both Ohio and Michigan, having access to health care made it easier for the unemployed to find work: “majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment.

 

  • In Michigan, Medicaid Work Requirements Hurt, Rather Than Help Enrollees’ Ability To Find Work: “The Michigan study illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they they are better able to seek employment.” [Georgetown University Health Policy Institute, 12/15/17]

 

  • In Ohio, Health Coverage Made It Easier For The Unemployed To Look For Work: “In studies of adults who gained coverage in Ohio and Michigan under the Affordable Care Act’s Medicaid expansion, majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment. [CBPP, 1/11/2018]

 

WORK REQUIREMENTS ADD ADMINISTRATIVE HURDLES, MAKING IT HARDER FOR PEOPLE WHO ARE ELIGIBLE FOR CARE TO GET IT

  • Early results in Arkansas confirm that Medicaid work requirements are fundamentally bureaucratic hurdles, threatening access to health coverage for thousands across the state. “The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours. Of the remaining third — about 20,000 people — 16,000 didn’t report qualifying activities to the state. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.” [New York Times, 9/24/18]

 

  • Requiring People On Medicaid To Prove They Are Working Adds An Administrative Burden That Is Hardest On Low-Income Americans. “[Administrative hurdles] may be especially daunting for the poor, who tend to have less stable work schedules and less access to resources that can simplify compliance: reliable transportation, a bank account, internet access.  There is also a lot of research about the Medicaid program, specifically, that shows that sign-ups fall when states make their program more complicated.” [New York Times, 1/18/18]

 

  • Documentation Requirements Increase The Chances That People Will Lose Care, Simply Because They Have Trouble Navigating The Process. “There is a real risk of eligible people losing coverage due to their inability to navigate these processes, miscommunication, or other breakdowns in the administrative process. People with disabilities may have challenges navigating the system to obtain an exemption for which they qualify and end up losing coverage.” [Kaiser Family Foundation, 1/16/18]

 

Today in Health Care Sabotage: Administration Shifts Millions Away From Health Care Services…and Toward Child Detention

Health and Human Services Secretary Alex Azar Undermines Health Care in Decision to Shift Funds Away from Health Care Services

Washington, D.C. – In its latest act of health care sabotage and in support of its cruel immigration policy, HHS Secretary Azar is shifting nearly half a billion dollars away from medical research, HIV/AIDS treatment and Affordable Care Act implementation toward detention of migrant children. Leslie Dach, chair of Protect Our Care, released the following statement in response:

“This is more than just health care sabotage, this is health care sabotage committed for the purpose of keeping children and families apart. It is shameful and outright wrong. Azar is only the latest Republican to play a dangerous game with the individuals who need health care the most.”

Paul Ryan Spreads Lies To Save Face After Working To Dismantle Medicare For Years

Yesterday, Speaker Paul Ryan claimed that Republicans support Medicare. On the topic of health care and entitlement reform, Ryan said: “I think they want to see that we have Medicare on a path to solvency.”

The truth is that Paul Ryan and the Republican Party have attempted to gut Medicare every chance they could:

  1. Paul Ryan, December 2017: “It’s the biggest entitlement we’ve got to reform.” Ryan said: “We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit…Frankly, it’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements…In- think the president is understanding that choice and competition works everywhere in health care, especially in Medicare…This has been my big thing for many, many years. I think it’s the biggest entitlement we’ve got to reform.”
  2. Paul Ryan is targeting Medicare and Medicaid to pay for tax cuts for the wealthiest. Last December, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. How do Republicans plan on paying for it? Speaker Ryan’s answer is clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt.” In an attempt to pay for these tax cuts, in April, House Republicans passed a budget amendment that would slash Medicare funding by $537 billion over the next decade.
  3. Ryan proposed these cuts after passing a budget resolution last year that cut Medicare by $473 billion. The 2018 budget resolution passed by Republicans in December 2017 cut Medicare by $473 billion.
  4. Ryan has called to transform Medicare into a voucher program, which experts warn would lead to the “demise” of the program. Speaker Ryan has spoken about turning Medicare into a voucher system, and in Fall 2017, the Centers for Medicare and Medicaid services filed a Request for Information concerning a shift in a “new direction” for Medicare, which Senate Democrats worried might entail a voucher system. Experts warn, and Republicans including Newt Gingrich acknowledge, that such a shift would lead to the demise of traditional Medicare as premiums increase.
  5. Led by Ryan, Congressional Republicans repealed several components of the ACA designed to help keep Medicare’s costs down, effectively driving up costs for the program. By repealing the requirement that most people have insurance, Congressional Republicans knowingly voted for a measure expected to increase the number of uninsured. The 2018 Medicare Trustees Report predicts that this increase will increase the share of subsidies paid to hospitals via Medicare. Similarly, by repealing the Independent Payment Advisory Board, Congressional Republicans took away a mechanism that slowed Medicare cost growth.
  6. A report published by the Medicare Trustees finds that the program is worse-off financially because of Paul Ryan and Congressional Republicans’ actions. In the 2018 Medicare Trustees Report, trustees found that actions taken by President Trump and Congressional Republicans actually push make Medicare less financially stable. The Trustees point to the elimination of the Independent Payment Advisory Board (IPAB), which had been developed to extend the solvency of Medicare and slow cost growth. Without the IPAB, there is no mechanism to achieve those ends. Similarly, Republican tax cuts will reduce income for Medicare. In conjunction, both actions damage the financial stability of Medicare.

Five Ways the Trump Administration is Dismantling Medicaid and Medicare

Today marks the 53rd anniversary of Medicaid and Medicare, two crucial health programs that serve as a lifeline to more than one-third of Americans. Despite the essential health care services these programs provide 125 million people, President Trump and Congressional Republicans have worked to dismantle Medicaid and Medicare. Here’s how:

  1. As the cost of drugs skyrocket, President Trump and his Republican allies in Congress will not allow Medicare to negotiate for better prescription drug prices. Under current law, the Secretary of the Department of Health and Human Services (HHS) is explicitly prohibited from negotiating directly with drug manufacturers on behalf of Medicare Part D enrollees. Although it would decrease both federal spending and beneficiaries’ out-of-pocket costs for prescription drugs, a policy allowing the federal government to negotiate drug prices for Medicare beneficiaries was noticeably absent from President Trump’s recent prescription drug announcement.

  2. President Trump and his Republican allies in Congress have repeatedly tried to slash funding for Medicaid and impose per-capita caps on coverage. Last year, the House of Representatives passed the American Health Care Act (AHCA) repeal bill, which included a per capita limit on federal Medicaid spending that would have resulted in huge cuts to Medicaid across states. After failing to pass the AHCA in the Senate, Republicans have continued to launch relentless attacks on Medicaid. Last December, the Trump Administration budget called for $1.4 trillion in cuts to Medicaid.

  3. The Trump Administration is encouraging states to impose work requirements and other bureaucratic restrictions on Medicaid enrollment in order to deny coverage. Experts warn that work requirements are fundamentally bureaucratic hurdles designed to restrict access to health care rather than increase employment. Previous examples show that requiring enrollees verify their employment or work-related activities will reduce enrollment among those eligible for Medicaid.

    Requiring people to work to maintain Medicaid coverage is particularly burdensome for older adults. Less than half of American adults ages 55 to 64 work. Some are retired, and for many others, chronic health conditions make it difficult to maintain steady employment.

  4. President Trump and Congressional Republicans are targeting Medicaid to pay for tax cuts for the wealthiest. Last December, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. How do Republicans plan on paying for it? Speaker Ryan’s answer is clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt.” In an attempt to pay for these tax cuts, in April, House Republicans passed a budget amendment that would slash Medicaid funding by $114 billion in a single year alone.

  5. Congressional Republicans have also repeatedly voted to pay for tax cuts for the wealthiest by cutting funding for Medicare. The 2018 budget resolution passed by Republicans in December 2017 cut Medicare by $473 billion and more recently, the FY2019 budget passed by Republicans on the House Budget Committee cuts Medicare by an additional $537 billion.

As we celebrate this important health care anniversary, Protect Our Care calls on our leaders to protect health care for our most vulnerable and end their assault on the health and wellbeing of the millions of Americans who rely on Medicare and Medicaid.

###

On ADA Anniversary, Our Leaders Must Protect Health Care for Americans with Disabilities

On the twenty-eighth anniversary of the Americans with Disabilities Act, Leslie Dach, chair of Protect Our Care, released the following statement:

“Twenty-eight years ago the Americans with Disabilities Act was signed into law by Republican President George H.W. Bush, providing critical rights for the more than 57 million Americans with disabilities. Unfortunately, today’s Republicans seem hell bent on doing everything they can to harm these Americans’ health care through their constant attacks on Medicaid and the Affordable Care Act. Nearly nine million adults with disabilities depend on Medicaid for care, including the more than one in three adults under 65 enrolled in Medicaid who live with a disability, and the ACA provides a lifeline for these individuals by preventing insurance companies from discriminating against people with pre-existing conditions and removing annual and lifetime limits on coverage. On this important milestone, we urge leaders to advance bipartisan solutions to the health care concerns of Americans with disabilities, and stop meddling with the Medicaid and health care protections they rely on.”

The Affordable Care Act and Medicaid are Lifelines For People With Disabilities

BY THE NUMBERS:

57 million Americans have a disability. Thanks to the Affordable Care Act, insurance companies can no longer deny them coverage, drop their coverage for no reason, or charge them more because of a pre-existing condition.

8.7 million nonelderly adults with disabilities depend on Medicaid for care. Nearly 8.7 million adults enrolled in Medicaid have a disability. Of this group, only 43 percent qualify for social security income.

More than 1 in 3 adults under age 65 enrolled in Medicaid lives 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.

Medicaid covers nearly a third of adults with disabilities. 31 percent of U.S. adults with disabilities have Medicaid coverage.

More than half of adults with disabilities covered through Medicaid earn less than 100 percent of the federal poverty line (FPL). A majority, 52 percent, of adults with disabilities who have Medicaid coverage earn annual incomes of less than 100 percent of the FPL, $12,060 for an individual, and could not afford needed care without the program.

Medicaid helps people who need long-term care to stay in their communities. Of nonelderly people with disabilities who rely on Medicaid for long-term care, 80 percent receive community-based care, while only 20 percent receive institutional care.

HOW PRESIDENT TRUMP & CONGRESSIONAL REPUBLICANS ARE TRYING TO DISMANTLE THE AFFORDABLE CARE ACT AND MEDICAID:

The Trump Administration’s Department of Justice went to court last month to argue that the Affordable Care Act and its protections for people with pre-existing conditions be overturned. This lawsuit could repeal the ACA and with it, its Medicaid expansion and protections for people with pre-existing conditions, including people with disabilities.

President Trump and his administration are pushing junk short-term health plans, that allow insurance companies to discriminate against people with pre-existing conditions. The Trump administration is bringing back health plans that are allowed to discriminate against people with pre-existing conditions, and designed to suck health people out of the individual market, thus raising premiums for people who depend on the individual market for comprehensive coverage.

President Trump and his Republican allies in Congress have repeatedly tried to slash funding for Medicaid and impose per-capita caps on coverage. Last year, the House of Representatives passed the American Health Care Act (AHCA) repeal bill, which included a per capita limit on federal Medicaid spending that would have resulted in huge cuts to Medicaid across states. After failing to pass the AHCA in the Senate, Republicans have continued to launch relentless attacks on Medicaid. Last December, the Trump Administration budget called for  $1.4 trillion in cuts to Medicaid.

The Trump Administration is encouraging states to impose work requirements and other bureaucratic restrictions on Medicaid enrollment in order to deny coverage. Experts warn that work requirements are fundamentally bureaucratic hurdles designed to restrict access to health care rather than increase employment. Previous examples show that requiring enrollees verify their employment or work-related activities will reduce enrollment among those eligible for Medicaid.

Requiring people to work to maintain Medicaid coverage is particularly burdensome for people with disabilities. Though some states are claiming to exempt people with disabilities from their work requirements, these exemptions are narrow and leave many behind. Among those who should qualify for exemptions, work requirements make it more difficult to keep coverage by requiring enrollees provide documentation, testimony, and records to prove they have disabilities.

President Trump and Congressional Republicans are targeting Medicaid to pay for tax cuts for the wealthiest. Last December, President Trump signed a $1.5 trillion tax bill that disproportionately benefits the wealthy. How do Republicans plan on paying for it? Speaker Ryan’s answer is clear: “Frankly, it’s the health care entitlements that are the big drivers of our debt.” In an attempt to pay for these tax cuts, last Thursday, House Republicans passed a balanced budget amendment that would slash Medicaid funding by $114 billion in a single year alone.

REPUBLICANS WANT TO REPEAL THE AFFORDABLE CARE ACT, WHICH PROVIDED AFFORDABLE COVERAGE AND HEALTH SECURITY TO PEOPLE WITH DISABILITIES

The Affordable Care Act Prevents Insurance Companies From Charging Americans With A Disability More, Or Denying Them Coverage Altogether. Prior to the ACA, insurance companies were allowed to charge people more or deny coverage simply because they had a pre-existing condition. The ACA banned this practice, requiring that insurance companies offer people coverage regardless of their health status.

Thanks To The Affordable Care Act, Insurance Companies Can No Longer Impose Annual And Lifetime Limits On Coverage. Before the ACA, insurance companies could restrict the amount of dollar amount of benefits someone could use per year or over a lifetime. At the time the ACA was passed, 91 million Americans had health care through their employers that imposed lifetime limits. Many such plans capped benefits at $1 million annually, functionally locking people with complex medical needs out of coverage.

Insurance Companies Can No Longer Practice Medical Underwriting, A Process That Let Insurers Make It Harder For People With Disabilities To Get The Coverage They Needed. Before the ACA, insurance companies could screen applicants for any conditions that might be costly to the company. If someone had condition that was predicted to cost the insurance company more, the insurance company would follow a practice called “medical underwriting” that allowed them to charge the applicant a higher premium, specifically exclude coverage for the condition that was expected to be costly, charge the applicant a higher deductible, or limit the applicant’s benefits (for instance, offer a policy that did not cover prescription drugs).

The ACA Requires Insurance Companies To Cover Basic Health Services. The Affordable Care Act established the ten essential health benefits, requiring insurance companies to cover rehabilitative or habilitative services, hospitalization, maternity care, prescription drugs, maternity care, and mental health services.

MEDICAID IS A VITAL SOURCE OF CARE FOR PEOPLE WITH DISABILITIES

Medicaid Helps People With Disabilities Receive Comprehensive, Consistent Care. “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.” [Kaiser Family Foundation, 3/16/17]

Medicaid Covers A Broad Range Of Preventive And Medical Services. “Through Medicaid, nonelderly adults with disabilities have access to regular preventive care as well as medical care for illnesses and chronic conditions.  States must provide certain minimum services for adults, such as inpatient and outpatient hospital, physician, lab and x-ray, and nursing home services. States also can choose to provide a broad range of optional services, many of which are important to people with disabilities, such as prescription drugs, physical therapy, private duty nursing, personal care, rehabilitative services, and case management.” [Kaiser Family Foundation, 3/16/17]

Adults With Disabilities Are More Likely To Have Medicaid, And Less Likely To Have Private Insurance, Than Those Without Disabilities. “Those with disabilities are about three times as likely to be covered by Medicaid and about half as likely to have private insurance compared to those without disabilities. These differences are influenced by the greater health needs of people with disabilities and the fact that they are less likely to have access to employer-sponsored coverage.” [Kaiser Family Foundation, 3/16/17]

PEOPLE WITH DISABILITIES DEPEND ON MEDICAID FOR LONG-TERM CARE

Medicaid Provides Half Of Long-Term Care In U.S. “Medicaid provides half the nation’s long-term care. Over the decades, states, CMS, 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 Medicaid program reached a major milestone: for the first time, 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.” [Centers For Medicare & Medicaid Services, January 2017]

Americans With Disabilities Depend On Medicaid For Community Based Care. Nearly 1.7 million nonelderly people with disabilities rely on Medicaid for long-term care. Medicaid helps the vast majority get the care they need in their communities, rather than an institution. In 2011, 80 percent of nonelderly people with disabilities who used Medicaid were served in their community; only 20 percent were served in institutions. [Kaiser Family Foundation, 3/16/17]

Julie Reiskin, Executive Director of ColoradoCross Disability Coalition: Medicaid Helps People With Chronic Disabilities To Access The Care They Need In Their Communities. “It is Medicaid that provides the in-home aid who helps get an adult with quadriplegia out of bed, dressed and able to go to work in the morning. It is Medicaid that provides the in-home occupational therapist who works with the autistic child so she can live at home with her family — not be pushed into an institution.” [Reiskin, The Hill, 6/21/17]

RESTRICTING MEDICAID THREATENS ACCESS TO CARE AND JOBS FOR FOR PEOPLE WITH DISABILITIES

Medicaid Work Requirements Make It Harder For People With Disabilities To Access The Care They Need. “Kentucky’s recently granted waiver does propose limited exemptions for people who are ‘medically frail’ and for those ‘diagnosed with an acute medical condition’ that prevents compliance, but these exemptions won’t keep beneficiaries from falling through the cracks…Arkansas, for example, estimates that just 10 percent of expansion enrollees are ‘medically frail’ — short of the third of non-SSI adult Medicaid enrollees nationwide unable to work because of a disability and far less than the 69 percent of Michigan Medicaid expansion enrollees who report serious chronic conditions that may sometimes prevent them from working.” [Center on Budget and Policy Priorities, 1/26/18]

The Arc: “Cutting Off Medicaid Won’t Help Anyone To Work.” Medicaid specifically covers services, such as attendant care, that are critical to enable people with significant disabilities to have basic needs met, to get to and from work, and to do their jobs. Requiring individuals to work to qualify for these programs would create a situation in which people cannot access the services they need to work without working – setting up an impossible standard.” [The Arc Statement, 1/11/18]

University of Kansas Report: “In Effect, Medicaid Expansion is Acting as an Employment Incentive for People with Disabilities. “People with disabilities are much more likely to be employed in states that have expanded Medicaid coverage as part of the Affordable Care Act, new research from the University of Kansas has found. Similarly, the number of those who report not working because of a disability has greatly declined in expansion states…’In effect, Medicaid expansion is acting as an employment incentive for people with disabilities,’ the researchers wrote.” [Healthcare Finance, 7/23/18]

President Trump’s Budget, Which Calls On Congress To Pass Graham-Cassidy, Would Strip Coverage Away From More Than 1.4 Million People With Disabilities. New analysis finds that, even according to conservative estimates, between 1.4 million and 1.8 million nonelderly adults with disabilities would lose vital Medicaid coverage as a result of the bill’s deep cuts, risking a return to widespread institutionalization and pushing people with disabilities—and their family members—out of the workforce.” [Center for American Progress, 9/25/17]

Republican Efforts To Repeal Medicaid Expansion Would Mean 64 Percent Of Medicaid Adults With Disabilities Would Lose Coverage. The Affordable Care Act’s Medicaid expansion covers 11 million people.  Many of them struggle with a chronic illness or a disability (such as a mental health condition) that wouldn’t, by itself, qualify them for Medicaid.  Only 36 percent of non-elderly Medicaid beneficiaries with disabilities receive Supplemental Security Income, which allows them to enroll in Medicaid even without the expansion.  While others may be eligible for Medicaid based on other criteria, many could lose Medicaid coverage under the House bill and wind up uninsured.” [Center on Budget and Policy Priorities, 8/29/17]

Kaiser Poll Show Yet Again that Americans Want Supreme Court, Congress to Protect People with Pre-Existing Conditions

Washington, D.C. – This morning, the Kaiser Family Foundation released its July tracking poll showing that protecting people with pre-existing conditions is the top health issue for voters, the latest of a series in recent months – and the second released this week – showing health care as a top issue in the upcoming elections.

Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“Poll after poll has shown the American people want their leaders to continue to protect people with pre-existing conditions from discrimination, yet Donald Trump and Republicans’ continue with their repeal and sabotage campaign to weaken these protections, raise premiums, and cut coverage. But the American people see this war on their health care and are experiencing the effects of it every day. We will make sure Americans remember who is siding with them, and who is siding with insurance companies making record profits after Republicans cut their care and gave them a huge tax cut, in November.

AMONG THE POLL’S FINDINGS:

  • Protections for people with pre-existing conditions is the top health care issue for voters.
  • From the poll: “This issue cuts across voter demographics with most Democratic voters (74 percent), independent voters (64 percent), and voters living in battleground areas (61 percent), as well as half of Republican voters (49 percent) saying a candidate’s position on continued protections for pre-existing health conditions is either the single most important factor or a very important factor in their 2018 vote.”
  • Sixty-four-percent of voters do not want the Supreme Court to overturn protections for people with pre-existing conditions, including 71 percent of Independents.
  • A majority of Americans — 56 percent of those polled — say President Trump and his Administration are working to make the ACA fail.
  • A majority — 51 percent — of people living in states that have not yet expanded Medicaid support expansion want their state to expand Medicaid.

ADDITIONAL BACKGROUND:

Since Assuming Office, President Trump And Congressional Republicans Have Repeatedly Attempted To Repeal The Affordable Care Act And With It, Protections For People With Pre-Existing Conditions.

  • The Trump administration just asked courts to eliminate protections for people with pre-existing conditions. In early June, the Trump Administration’s Department of Justice decided to argue that courts should throw out the Affordable Care Act’s protections for people with pre-existing conditions.
  • The Senate Republican repeal bill would have allowed states to waive ACA protections, allowing insurance companies to charge sick patients more.
  • The House Republican repeal bill would have allowed insurance companies to charge people with pre-existing conditions “prohibitively high premiums.”

GOP Sabotage Has Persisted for 18 Months, and Has Caused Massive Premium Increases

  • Last year, Republican sabotage pushed 2018 insurance premiums up by a national average of 37 percent and this year GOP sabotage has resulted in 2019 premium increases in all but two states where the data is available.
  • A new report released this week found that, in 2019:
    • A typical family of four will see a marketplace premium that is $3,110 higher.
    • A 55-year-old couple will see a premium $3,330 higher on average.
    • An unsubsidized 40-year-old will pay an extra $970 on average.
  • Meanwhile, other acts of sabotage would eliminate protections for people with pre-existing conditions and raise costs. View a comprehensive list of acts of health care sabotage here.

A Year After Repeal Defeated in the Senate, Health Care is the Top Issue to Voters, and May be the Issue that Most Influences the Midterm Elections

  • The Kaiser tracking poll finds that continuing protections for people with pre-existing health conditions is the top health care campaign issue for voters across all demographics.
  • A new Protect Our Care-PPP poll found voters will support candidates who want to improve the ACA rather than repeal it, and strongly oppose the Trump Administration going to court to overturn protections for people with pre-existing conditions.
  • Last month’s June Kaiser Family Foundation tracking poll found health care to be the top issue for voters, ranked higher than all issues, including the economy and jobs.
  • A June NBC News poll found health care to be top midterm issue.
  • In a May CBS News poll, voters said health care is the most important issue in deciding who to vote for Congress in November.
  • A year ago, ACA repeal bills were among the least popular pieces of major legislation in history. When the House was considering the “American Health Care Act,” (AHCA) polls at the time showed it to be the most unpopular piece of major legislation Congress had considered in decades. Then, the so-called Graham-Cassidy repeal bill had a 24 percent approval, even more unpopular than the AHCA.

###

Four Ways Kavanaugh Could Impact People With Coverage Through Medicaid

Republicans have been on a relentless war on health care, wielding legislation, executive action and litigation as weapons in their war on the protections that prevent insurance companies from charging women, people over age 50 and people with pre-existing conditions more for health care — and on Medicaid.

Here’s how confirmation of Judge Brett Kavanaugh to the Supreme Court could wreak havoc on Medicaid:

1. Kavanaugh Could Allow States To Restrict Enrollment Through Onerous Work Requirements designed to make it harder for people to get the coverage they need. As a lawsuit against Kentucky Governor Matt Bevin’s work requirements makes its way through the courts, President Trump’s next Supreme Court justice could rule on them, shifting Medicaid’s role away from its core purpose of providing health care to the most vulnerable Americans.

  • Abbe Gluck, Yale Professor Of Health Law, Could See Kavanaugh Opening The Door To More Restrictions On Medicaid: “We don’t know very much about how Judge Kavanaugh will approach work requirements…It’s unclear to me how deferential he would be to the CMS. I could see him opening the door to more restrictions on Medicaid.”

2. Kavanaugh Could Prevent Medicaid From Covering Health Care At Planned Parenthood. Several states have taken to excluding Planned Parenthood from their Medicaid programs. In those states, Planned Parenthood is fighting back. If Kavanaugh, who just last year forced a young woman to continue a pregnancy despite her will, is confirmed, he could prevent Medicaid from covering life-saving preventive health services, such as cancer screenings, at Planned Parenthood.

3. He Could Deny Individuals And Providers The Right To Sue When A State’s Medicaid Program Isn’t Complying With The Law, Which Experts Suggest Will Enable States To Decimate Their Medicaid Programs.  As Axios has reported, conservatives on the Supreme Court including Justice Clarence Thomas and the late Antonin Scalia have argued that because Medicaid is a contract between states and the federal government, individuals and providers do not have the right to sue for entitlements the statute requires.

  • Cases Involving Providers’ and Patients’ Right To Court Are Working Their Way Up To The Supreme Court, including one case in which an appeals court ruled that Planned Parenthood does not have the right to sue Arkansas over its Medicaid program.
  • Timothy Jost, Law Professor At Washington And Lee, Thinks Kavanaugh Could Make A Huge Difference In Cases Involving The Rights Of Poor People To Sue To Enforce The Medicaid Statute: “Where I do see Kavanaugh making a huge difference is in cases involving the rights of poor people to sue to enforce the Medicaid statute.”
  • If The Right To Sue Goes Away, George Washington University Law Professor Sara Rosenbaum Warns States May Start Hacking Away At Medicaid. She says, “it’s certainly possible that a state would start hacking away at its program. There would be no deterrence at all.”

4. He Could End Medicaid Expansion. The Affordable Care Act enabled states to expand access to Medicaid for people earning up to 138 percent of the federal poverty line. Should the Affordable Care Act come before the Supreme Court, Kavanaugh, who has previously criticized Justice John Roberts for voting to uphold the ACA,  could vote to end the law and its Medicaid expansion.

  • Trump’s Justice Department Has Already Backed A Texas Lawsuit Challenging The Legality Of The Affordable Care Act, And Prominent Republican Leaders Have Assured That The ACA Will Continue To Be Litigated. Senator Orrin Hatch said, “The Affordable Care Act is one of the broad, inclusive bills that you’ll ever see. And anybody who thinks it’s not going to be litigated sometime in the future is nuts.”

Why this matters: Medicaid is how one in five Americans have health insurance. If confirmed, Brett Kavanaugh could be a key player in sabotaging the program and threatening coverage for children, older adults, people with disabilities, people struggling with addiction, in states across the country.

Governor Matt Bevin Puts Partisanship Over Health of Kentuckians

Washington, D.C. – Days after a federal district court issued a scathing rebuke of the Bevin-Trump Administrations’ Medicaid scheme to impose rigid work requirements that would be impossible for many of those most in need of health care coverage to meet, Governor Bevin announced his Administration would retaliate by immediately cutting 500,000 Kentuckians enrolled in Medicaid off of critical and vision coverage. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“I have only one question for Governor Matt Bevin and President Donald Trump: why are you so hellbent on taking health care away from your constituents? Until the Bevin and Trump administrations teamed up to wage a war on health care, Kentucky was headed in the right direction: insurance coverage and access to quality care were going up — way up. But the GOP’s repeal-and-sabotage agenda is threatening these gains by driving people’s health care premiums up and kicking people off of health insurance by any means necessary, whether through so-called ‘work requirements’ or, now, by politically-motivated fiat.”

BACKGROUND:

Prior to the Bevin and Trump Administrations, Kentucky’s story was a successful case study of how the state and federal governments can work hand-in-hand to improve health care access and outcomes for people:

  • Kentucky experienced the largest uninsured rate drop among low-income adults, all while creating 40,000 jobs and harnessing a $30 billion economic impact.
  • Kentucky’s uninsured rate fell from 16.3% to 7.2% in 2016 following the implementation of Medicaid expansion.
  • Kentucky’s enrollment in Medicaid and CHIP increased 110% between 2013-2017, the largest increased of any state and nearly three-times the national average.
  • Low-wage workers made up the majority of Medicaid-eligible adults who gained coverage under the state’s expansion.
  • Medicaid is viewed favorably by 74 percent of Americans.

###

Federal Court Protects Health Care for 97,000 Kentuckians

Washington, D.C. – Today, a federal district court issued a scathing rebuke of the Trump Administration’s approval of Kentucky’s Medicaid waiver putting health care for up to 97,000 Kentuckians at risk by imposing rigid work requirements that could be impossible for many of the people most in need to meet.  In response, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“This decision is a victory for the Kentuckians who need affordable health care the most — children, people with chronic health care conditions, and low-wage workers. Nearly 100,000 Kentuckians stood to lose coverage if this mean-spirited law was to take effect. But this fight isn’t over, since Governor Bevin made it plain he’d throw health care for 500,000 Kentuckians overboard if the court didn’t rule in his favor. We call on Governor Bevin to stand down from his crusade against Kentucky families who rely on Medicaid for coverage, and instead turn his focus to the urgent health needs confronting the people of his state, like the tragic opioid crisis.”

Said the Court in its ruling today: “[Secretary Azar] never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid. This signal omission renders his determination arbitrary and capricious. The Court, consequently, will vacate the approval of Kentucky’s project and remand the matter to HHS for further review.”

BACKGROUND:

  • 500,000 Kentuckians could lose coverage if Gov. Bevin ends the state’s Medicaid expansion,  according to Kentucky Health and Family Services Secretary Adam Meier.
  • Low-wage workers made up the majority of Medicaid-eligible adults who gained coverage under the state’s expansion.
  • Those currently covered by Medicaid in Kentucky include:
    • 561,326 children, composing 39 percent of all state Medicaid enrollees;
    • 9,500 veterans and 5,300 spouses of veterans, who gained coverage under expansion;
    • 44 percent of all births in the state;
    • 90,794 elder Americans aged 65 and older, and
    • 161,380 Medicaid enrollees who are disabled or require long-term care.
  • Medicaid is supported by 74 percent of Americans.