Medicaid Archives — Page 3 of 8 — Protect Our Care

Medicaid Expansion, Junk Plan Bans, and a Law to Shore Up the Marketplace: the ACA Has a Banner Week in the States

While congressional Republicans and their cheerleaders, like former U.S. Senator Rick Santorum, are on the verge of making another run at health care repeal, legislators and everyday citizens in states across the country this week took actions to expand health care access and shore up their marketplaces. Here’s what happened this week, from Virginia to California:

In Virginia, the state Senate joined with the House of Delegates, sending a measure to expand Medicaid to Gov. Ralph Northam to sign into law. The expansion will extend health insurance to 400,000 Virginians.

Richmond Times-Dispatch: Virginia Set To Expand Medicaid As Senate And House Back Budget Deal. “Six years after the U.S. Supreme Court left the decision to states on whether to expand their Medicaid programs under the Affordable Care Act, Virginia is about to extend health care coverage to hundreds of thousands of Virginians without it… [Republican State Senators Ben Chafin and Jill Vogel] defended their decisions as necessary to invest in core public services, while expanding health coverage to people who need it and the hospitals that provide it. ‘I came to the conclusion that ‘no’ just wasn’t an answer anymore,’ he said.” [Richmond Times-Dispatch, 5/31]

In New Jersey, the legislature acted to stabilize the state’s insurance marketplace by implementing a state-level individual mandate, following in the footsteps of Maryland, which passed stabilization measures last month. Congressional Republicans repealed the federal mandate in December’s tax bill, which, combined with the Trump Administration’s short-term plan regulations, had been projected to increase premiums in New Jersey by nearly 11%.

NJ.com: Phil Murphy Signs Law Protecting Obamacare From Trump With N.J. Mandate To Have Health Insurance. “Gov. Phil Murphy on Wednesday signed a law preserving a critical yet controversial part of the Affordable Care Act that President Donald Trump’s administration repealed last year… State Sen. Joseph Vitale, D-Middlesex, one of the prime sponsors of the law, said keeping the mandate ‘was needed to maintain a foundation for the insurance market and to allow the success of the ACA to continue.’ Trump’s actions ‘will usher in an era of higher health insurance costs for everyone and lower health coverage rates. We want to protect New Jersey from the negative impact,’ said state Sen. Troy Singleton, D-Burlington, also a sponsor. About 800,000 people obtained insurance coverage under the law — 500,000 through Medicaid and about 300,000 through a commercial plan.” [NJ.com, 5/30]

In Illinois, the state legislature is expected to implement a six-month limit on the Administration’s proposed short-term junk plans, restoring them to their original intention and protecting Illinoisans’ health and the state’s insurance marketplace. The move follows similar legislative actions in Hawaii and California, which is considering banning short-term plans entirely.

Chicago Tribune: Illinois Groups Push To Restrict Short-term Insurance, As Trump Administration Seeks To Expand It. “Dozens of Illinois advocacy groups, under the umbrella of the Protect Our Care Coalition, are supporting a bill that would impose a six-month limit on the use of short-term insurance plans — coverage originally meant to serve as a stopgap for consumers between health insurance plans, such as people changing jobs who can’t afford continued coverage under a previous employer’s plan or students taking a semester off school… Short-term plans can leave consumers in a lurch because they often don’t cover things like maternity care, pre-existing conditions, mental health or prescription medications. In addition to the six-month time limit, the bill would require warnings about what the plans do not cover to be read aloud to consumers buying the plans or featured on websites where they’re sold. The state Senate on Friday unanimously passed the bill.” [Chicago Tribune, 5/25]

Speaking of Medicaid expansion, Utah and Idaho both advanced ballot measures to expand Medicaid, too:

The Hill: Medicaid Expansion Qualifies For Ballot In Utah. “A measure to expand Medicaid under ObamaCare in Utah will appear on the ballot in November after it was certified as having enough signatures. Liberal groups hailed the announcement from the state’s lieutenant governor as they hope to make the deep-red state the 33rd to expand the health insurance program for the poor under the health law. Medicaid expansion would extend coverage to about 150,000 people in the state.” [The Hill, 5/30]

Associated Press: Medicaid Expansion Moves Closer To Possible Referendum. “A Medicaid expansion proposal has passed the signature threshold, officials confirmed on Thursday, but said further review is needed before it gets on the November ballot. Ada County Chief Deputy Clerk Phil McGrane says county clerks across the state have verified roughly 58,000 signatures that organizers submitted earlier this month.” [US News & World Report, 5/24]

In Maine, the Bangor Daily News Editorial Board called for the legislature to fund the state’s Medicaid expansion, which passed overwhelmingly in a referendum last fall:

Bangor Daily News: Lawmakers Must Fund Medicaid Expansion, Which Is The Law, ‘Not A Suggestion.’ “By expanding Medicaid, Maine will make insurance coverage available to as many as 80,000 Mainers. These are people who work but can’t afford health insurance or their employer doesn’t offer it. They are not poor enough or do not have a disability to qualify for Medicaid without an expansion. Under the Affordable Care Act, the federal government covers 90 percent of the cost. Maine is estimated to receive more than $525 million per year for a state investment of about $55 million annually, beginning in 2021, the first full year of implementation. Expanding Medicaid means thousands of Mainers who don’t have insurance will be able to access preventative care, vaccinations, addiction treatment, counseling and other needed care. It will also help stabilize the state’s hospitals, many of which are struggling financially.” [Bangor Daily News, 5/31]

And in Alabama, Jim Carnes, Policy Director of Alabama Rise, eloquently made the case for Medicaid expansion in an op-ed published by the Anniston Star:

Anniston Star: Expanding Medicaid Would Improve Alabama’s Health, Budgets And Economy. “The new Urban Institute report estimates that 314,000 Alabamians would enroll in Medicaid if Alabama extended eligibility to low-income workers. That would mean an additional $1.54 billion in federal funding surging into Alabama’s economy each year under the 9-to-1 federal match rate. It also would mean rural hospitals – like the one in Jacksonville that announced in May that it plans to close – would no longer be bleeding red ink through services to uninsured patients… In any other industry, the prospect of such gains would have political candidates of all stripes blowing trumpets and leading parades. And those other economic development plans wouldn’t have the added advantage that this one brings: giving people a new lease on life by helping them get the health care they need. Isn’t it time we broke the partisan gridlock on the coverage gap? Isn’t it time we demanded that anyone seeking to lead our state offer a vision of a healthier Alabama – and a path to getting there?” [Anniston Star, 5/29]

So while President Trump continued peddling lies about health care in Washington, D.C., states across the country continued the work of expanding health care access to hundreds of thousands of Americans. The ACA remains the law of the land, and its staying power shows it has become woven into the fabric of our nation’s health care system.

“Another Nail In the Coffin for Efforts to Repeal Obamacare”: Virginia Legislature Votes to Expand Medicaid for 400,000 Virginians

Yesterday afternoon, the Virginia Senate approved a bipartisan measure to expand Medicaid. Now Gov. Ralph Northam (D), who campaigned extensively on Medicaid expansion, is expected to sign expansion into law. Advocates secured expansion despite attempts from the White House and conservative activists to stop it, paving the way for Virginia to become the 34th state, including the District of Columbia, to expand Medicaid – with Utah, Idaho, and Nebraska seeking to follow suit through ballot measures this fall.

Here’s a roundup of reactions:

Washington Post: “It’s Another Nail In The Coffin For Efforts To Repeal Obamacare.” “As Joe Biden put it a little differently when Barack Obama signed the Affordable Care Act eight years ago, Virginia’s expansion of Medicaid on Wednesday is a big dang deal. And not just because 400,000 low-income citizens will now have access to government health insurance. It’s another nail in the coffin for efforts to repeal Obamacare… Years of obstruction in the commonwealth gave way because key Republicans from rural areas couldn’t bear to deny coverage for their constituents any longer, moderates wanted to cut a deal and, most of all, Democrats made massive gains in November’s off-year elections.” [Washington Post, 5/31]

Republican State Senator Ben Chafin: “I Came To The Conclusion That ‘No’ Just Wasn’t An Answer Anymore.” “In the final hours, Sen. Ben Chafin, a Republican lawmaker from Virginia’s economically depressed southwest coal country, announced his support for expansion on the Senate floor. He said his rural area needs expansion to bolster its hospitals and provide care for constituents. ‘I came to the conclusion that no just wasn’t the answer anymore,’ Chafin said.” [USA Today, 5/31]

Republican State Senator Frank Wagner: “It Is The Number One Issue On Our Voters’ Minds.” “‘This is not just about helping this group of people,’ said Sen. Frank Wagner (Virginia Beach), one of four Republicans in the Senate who split from their party to join Democrats and pass the measure by a vote of 23 to 17. ‘This is about getting out there and helping to bend the cost of health care for every Virginian. . . . It is the number one issue on our voters’ minds. By golly, it ought to be the number one issue on the General Assembly’s mind.’” [Washington Post, 5/30]

Richmond Times-Dispatch: GOP State Senators “Defended Their Decisions As Necessary,” Supported Expanding Coverage “To People Who Need It And Hospitals That Provide It.” “In the end, three other Republican senators — Frank Wagner of Virginia Beach, Ben Chafin of Russell County and Jill Vogel of Fauquier County — joined Hanger and the Senate’s 19 Democrats in adopting the pair of budget bills to end a standoff that has been watched closely by national bond-rating agencies and institutional investors who hold the state’s AAA-rated bonds… But Chafin and Vogel defended their decisions as necessary to invest in core public services, while expanding health coverage to people who need it and the hospitals that provide it.” [Richmond Times-Dispatch, 5/31]

Wall Street Journal: “The Growing Interest In Medicaid Expansion, Even In Some Conservative States, Suggests The Program Is Becoming More Accepted.” “Virginia is poised to expand Medicaid after a hard-fought legislative battle, making it one of a growing number of states where there is interest in expanding the program after Republicans failed to repeal the Affordable Care Act last year… Organizers who support Medicaid expansion in Utah learned this week that they had obtained enough signatures to put the initiative on the ballot in November, potentially expanding coverage to more than 100,000 people… A push is also under way to get expansion on the ballot in Idaho, where voters will select a new governor this fall. Democratic nominee Paulette Jordan supports an expansion and Lt. Gov. Brad Little, who claimed the GOP nomination in the primary, has said he would follow the will of the people if the initiative passes… The growing interest in Medicaid expansion, even in some conservative states, suggests the program is becoming more accepted as it appears less likely congressional Republicans will successfully revive efforts to repeal the ACA.” [Wall Street Journal, 5/30]

New York Magazine: “For A Health Care Law That Donald Trump Has Been Declaring ‘Dead’ Or ‘Dying’ Since 2013, Obamacare Seems To Have A Lot Of Life Left In It.” “One of the nation’s longest and bitterest battles over implementation of the Affordable Care Act looks likely to end very soon as the Virginia Senate approved a budget that included funds to expand Medicaid… For a health-care law that Donald Trump has been declaring ‘dead’ or ‘dying’ since 2013, Obamacare seems to have a lot of life in it yet, no thanks to his administration. Obama himself is probably sharing a bit of the good feelings among Democrats in Virginia.” [New York Magazine, 5/30]

CNN: “Despite Years Of Resistance, The State Will Become The Latest To Expand Access To Medicaid.” “Virginia lawmakers crossed an important hurdle Wednesday, ensuring that, despite years of resistance, the state will become the latest to expand access to Medicaid. The move to broaden the federal health care program for low-income Americans comes as a direct result of the political fallout from last November’s election.” [CNN, 5/31]

Los Angeles Times: Medicaid Vote “Serves As Something Of A Retort To President Trump And His Republican Allies In Congress.” “The breakthrough — made possible by a coalition of Democrats and a handful of Republicans in the statehouse — continues the expansion of the government safety net made possible by the 2010 healthcare law, often called Obamacare. Virginia’s move also serves as something of a retort to President Trump and his Republican allies in Congress, who have called for sweeping cuts in federal aid to states for Medicaid… Medicaid, the half-century-old government health plan for the poor, is a pillar of the 2010 healthcare law’s program for guaranteeing coverage, and it has helped drive a historic drop in the nation’s uninsured rate.” [Los Angeles Times, 5/30]

Business Insider: Medicaid Expansion “A Move That Shows The Resiliency Of The Landmark Healthcare Law.” “Virginia’s state Senate voted Wednesday in favor of a plan that would expand the state’s Medicaid program under the Affordable Care Act, or Obamacare, in a move that shows the resiliency of the landmark healthcare law. The Virginia Senate voted 23 to 17 to pass a budget that included Medicaid expansion, which could extend healthcare coverage to roughly 400,000 low-income Virginians. The House must re-vote on the Senate package, but a similar measure already made it through that chamber and the second vote is expected to follow suit.” [Business Insider, 5/31]

Politico: “Trump Administration Officials And Conservative Activists Had Tried To Derail” Expansion.” “Trump administration officials and conservative activists had tried to derail the Virginia plan. White House budget director Mick Mulvaney in March urged the state to reject Medicaid expansion, and White House health care aide Brian Blase joined phone calls with Americans for Prosperity as the Koch brothers-supported group tried to rally opposition. Former Sen. Rick Santorum, who is pushing for another Obamacare repeal vote in Congress this summer, was spotted in the Virginia Statehouse on Wednesday before the vote to brief Republicans on the status of that effort.” [Politico, 5/31]

Talking Points Memo: “Lobbying Against The Expansion By Trump Administration Officials” Was “Not Successful.” “After years of political battles and weeks of procedural delays, the Virginia House and Senate voted Wednesday to expand Medicaid to cover between 300,000 and 400,000 more low-income residents. Four Republicans joined every Senate Democrat in voting for the expansion Wednesday afternoon. Later Wednesday evening, the House followed suite, passing a multi-year budget including the expansion by an overwhelming majority. Last-minute lobbying against expansion by Trump administration officials, former Sen. Rick Santorum (R-PA) and the Koch brothers’ group Americans for Prosperity was not successful.” [TPM, 5/30]

The Daily Beast: Law To Be Signed By Gov. Ralph Northam, Who “Campaigned On Expansion.” “The Virginia Senate on Wednesday voted to approve Medicaid expansion, which would impact the lives of up to 400,000 citizens in the state. As such, Virginia becomes just the second state during the Donald Trump presidency to approve such a program, following only Maine. Yet even there, Republican Gov. Paul LePage faces a lawsuit for his refusal to actually implement the program. Virginia’s Democratic Gov. Ralph Northam, who handily won election last November sweeping in enough Democrats to nearly flip the state’s House of Delegates, campaigned on expansion and will undoubtedly sign it into law.” [Daily Beast, 5/30]

Vox: Medicaid Expansion “Top Item On The State’s Agenda.” “In political terms, expansion is a huge victory for the state’s Democratic governor, Ralph Northam, who made expansion a key campaign priority, and for the many Democrats who swept into the state legislature last November and came extraordinarily close to securing a majority in the House of Delegates… Even since Northam won the governor’s mansion in November and down-ballot Democrats narrowed the GOP’s House majority dramatically, Medicaid expansion became the top item on the state’s agenda.” [Vox, 5/30]

Protect Our Care Statement on Idaho Medicaid Expansion Ballot Question Success

Washington, D.C. – After Idaho health care advocates announced that they have collected more than enough signatures to get Medicaid expansion on the ballot this November, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“While Idaho Governor Butch Otter was working to sabotage the Affordable Care Act, the people of Idaho were quietly working to secure a vote on covering 62,000 more of their neighbors by expanding Medicaid. Today they succeeded. Republican-governed states would do well to take heed: when you actively work to make your constituents’ health coverage worse, citizens take matters into their own hands. Congratulations to the people of Idaho, and especially to the committed grassroots activists who secured today’s success. I couldn’t imagine a better way to cap off this year’s Medicaid Awareness Month.”

Trump Administration Targets Native Americans As GOP War on Health Care Continues

Washington, D.C. – This week, Politico reported that the Trump Administration may impose work requirements on Native Americans who have Medicaid coverage. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Medicaid work requirements are yet another form of health care sabotage: nothing more, nothing less.  They serve no purpose but to shrink Medicaid enrollment, a goal that President Trump and Republicans continue to pursue through administrative sabotage as well as their efforts to repeal the Affordable Care Act. These requirements are burdensome, unnecessary, and expensive to administer, and now the Trump Administration has decided to target Native Americans’ coverage, marking a new low in their war on health care.  

“Enough already. Medicaid is vital to the health and well-being of vulnerable populations – children, seniors, Americans with disabilities, and Native Americans – who frequently face unique barriers to high-quality health care, and imposing additional barriers upon Native Americans to access health care is mean-spirited and wrong. We urge Congress and the American people to speak out against President Trump’s ongoing war on health care and ensure that policies like these are reversed or don’t see the light of day in the first place.”  


This Is Not The Trump Administration’s First Attack On Native Americans’ Health: “The Trump administration also targeted the Indian Health Service for significant cuts in last year’s budget, though Congress ignored those cuts in its omnibus funding package last month, H.R. 1625 (115). The White House budget this year proposed eliminating popular initiatives like the decades-old community health representative program — even though tribal health officials say it is essential.” [Politico, 4/22/18]

Caitrin McCarron Shuy, Indian National Health Board: “It’s Very Troublesome.” “‘It’s very troublesome,’ said Caitrin McCarron Shuy of the National Indian Health Board, noting that Native Americans suffer from the nation’s highest drug overdose death rates, among other health concerns. ‘There’s high unemployment in Indian country, and it’s going to create a barrier to accessing necessary Medicaid services.’” [Politico, 4/22/18]

POLL: Voters Strongly Support Medicaid, Oppose Any Cuts

To: Interested Parties

From: Jim Williams, Public Policy Polling

Subject: Voters Strongly Support Medicaid,  Oppose Any Cuts

Date: 4-24-18

A new national Public Policy Polling survey finds that voters nationally strongly support Medicaid and are opposed to cutting it, especially to fund tax breaks. 66% of voters oppose cutting Medicaid, as opposed to just 19% who support cuts.  

  • 74% of Democrats and Independents oppose cutting Medicaid, while a plurality of Republicans, 49%,  also oppose cuts.
  • Only 34% of Republicans support cutting Medicaid.

71% of voters overall say they are opposed to cutting Medicaid to fund the Republican tax plan passed last year – including 82% of Democrats, 70% of Independents and 60% of Republicans. Rather than cut Medicaid, a majority of voters (52%) want to see it expanded, compared to just 35% who don’t.

  • Learning that Medicaid covers 6 in 10 nursing home residents, and 40 percent of costs for long-term care that seniors depend on, made voters 63% less likely to support cuts.
  • Voters were 53% less likely to support cuts after learning that if Medicaid funding is cut, 1 in 5 Americans—seniors, children, and individuals with disabilities—will be at risk of losing access to healthcare.

When it comes to the Affordable Care Act, 66% say they want to keep what works about the law and fix what doesn’t, while just 29% say they want to repeal it and start over with a new healthcare law. 82% of Democrats and 68% of Independents want to keep and fix the law and , 44% of Republicans want to keep what works about the ACA.  

Public Policy Polling interviewed 741 national registered voters on April 18-19, 2018. The margin of error for the survey is +/-2.1%. This survey was conducted using automated telephone interviews. The poll was conducted jointly for Protect our Care and SEIU.

Advocates Nationwide Highlight How Medicaid Supports Seniors and Older Adults

Throughout the third week of Medicaid Awareness Month, advocates across the country highlighted the significant role Medicaid plays supporting seniors and older adults, and spoke out against Republican proposals to weaken and cut Medicaid. Medicaid covers more than 15 million Americans over age 50.

In Arizona, the the Arizona Alliance for Retired Americans and Arizona Alliance for Healthcare Security joined state Reps. Daniel Hernandez and Cesar Chavez to discuss how Medicaid serves a lifeline to Arizona’s Seniors and older Americans.

How does Medicaid help seniors and older adults in the United States? Here are some of the many ways:

  • More Than 6.9 Million American Seniors Have Medicaid Coverage. 6,920,200 seniors, age 65 and older, are enrolled in Medicaid.
  • More Than 8.5 Million Adults Ages 50 To 64 Are Enrolled In Medicaid. 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 many of these seniors, Medicaid is a critical lifeline.
  • 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.
  • Over 1 In 5 Medicare Beneficiaries Also Have Medicaid Coverage. Most dual-eligibles are over age 65, and are more likely to have complex and chronic health needs.

In West Virginia, West Virginians Together for Medicaid, West Virginians for Affordable Health Care, West Virginia Citizen Action Group, and the West Virginia Center on Budget and Policy joined together to discuss the importance of Medicaid for seniors in the state and how cuts to the program be devastating for older West Virginians.

In the Daily Post-Athenian, Pam Weston of Sweetwater, Tennessee highlighted the benefits Medicaid provides for Tennessee residents:

In Tennessee alone, Medicaid provides coverage for 1,539,743 of our citizens, a number which includes children, senior citizens, and persons with severe disabilities. If Tennessee had implemented Medicaid expansion, the number eligible for coverage would have easily surpassed 2 million.

What many may not realize is that Medicaid provides $4 billion annually to support school-based health services. Sixty-eight percent of Tennessee’s schools use Medicaid funds to provide school nurses, counselors, and speech therapy. Outside the school setting, Medicaid covers 43 percent of all Tennessee’s children.

At a time when the opioid epidemic is a concern for most of Tennessee, it is important to note that 10 percent of all buprenorphine used to treat opioid addiction is paid for by Medicaid dollars.

Lastly, three out of five nursing home residents rely on Medicaid to cover their healthcare needs, and nearly a quarter of all seniors and individuals with disabilities are covered by Medicaid.

If $1.4 trillion is to be cut from Medicaid to offset the tax breaks provided to cororations under the recent “tax reform” plan, should the cuts be applied to medically fragile seniors, children, or to those with disabilities? It is said that a nation is judged by how it cares for it’s most vulnerable citizens. Cuts and per capita caps applied to Medicaid services will leave our most vulnerable without the care they require, and that does not speak well for what we have become.

In Tennessee, six Nashville residents, including small business owners, non-profit directors, and reverends, shared their personal stories of how Medicaid has benefitted their mother, fathers, and grandparents and grandparents.

Lindsey Copeland highlighted the work of Medicaid Awareness Month for the Medicare Rights Center.

And in The Hill, Max Ritchman, president and CEO of the National Committee to Preserve Social Security and Medicare, highlighted how just how important Medicaid is for older Americans’ health. Read his post:

April is Medicaid Awareness Month, but many Americans are truly unaware of what the program does for seniors. Medicaid is typically viewed as a health insurance program for the poor, which, of course, it is. But it also provides crucial supports for older Americans. Medicaid covers nearly 7 million seniors and more than 8.5 million “near seniors” aged 50-64. One in five Medicare beneficiaries (known as “dual eligibles”) also have Medicaid coverage to help pay premiums and co-pays.

Many people don’t realize that Medicaid helps millions of seniors to pay for long-term care  — in skilled nursing facilities as well as in-home and community-based care. In fact, Medicaid pays for more than 50 percent of long-term care nationwide. The program covers 6 in 10 nursing home residents. At an average annual cost of $82,000 (nearly three times most seniors’ annual incomes) long-term care would simply be out of reach for millions of elderly Americans if it weren’t for Medicaid.

“Seniors often need services from Medicaid that are not covered by Medicare,” says Rebecca Vallas, VP of the Poverty Program at the Center for American Progress. “These services include assistance with bathing and dressing, preparing meals, and many other activities of daily living.” Vallas explains that Medicaid “allows millions of seniors to age in place, to stay with their families and in their communities.”

In a Facebook Live interview this week, Rep. Joe Kennedy III (D-Mass.) told me that Medicaid is “the backbone for our healthcare infrastructure across the country.” But the Congressman isn’t confident that Americans sufficiently appreciate the crucial role that Medicaid plays. “So many [people] have heard of these programs,” said Rep. Kennedy, “But they don’t quite understand how integral they have become to preserving the dignity, the stability, the security of so many Americans.”

President Lyndon Johnson signed Medicaid and Medicare into law in 1965, and it’s no accident that the two were created simultaneously. Both programs were designed to provide health insurance to vulnerable members of society who previously went without medical coverage  — including the poor and the elderly. Over the past half a century, Medicare and Medicaid have been expanded to cover more people and more services.

Medicaid’s ability to cover older Americans at a time of their lives when chronic conditions and other health issues typically emerge took a big leap forward with passage of the Affordable Care Act (ACA). The ACA expanded Medicaid to cover people earning up to 138 percent of the poverty line. As a result, more than 15 million additional Americans received federal health coverage.

Many of those were in the 50-64 age group that typically has trouble buying private health insurance. According to the Center for Retirement Research, “The share of Americans ages 50-64 without insurance fell by 6.4 percentage points between 2012 and 2016 — due at least in part to increased Medicaid enrollment in the expansion states.”

Unfortunately, Medicaid has been under siege in Congress ever since the ACA was enacted. When the majority party took control of all branches of government in 2017, they tried relentlessly to gut the program  — starting with Obamacare repeal legislation all the way through President Trump’s first two budgets and various House GOP budget proposals.

The details vary in each dark scenario, but the commonalities included cutting more than $1 trillion from Medicaid, imposing per capita caps on payments to the states, or converting it into a block grant program. The Congressional Budget Office (CBO) estimated that these draconian measures would have resulted in 14 million Americans losing health coverage over the next ten years.

Even though those devastating proposals failed, Medicaid remains under assault from the right. The Trump/GOP tax cuts enacted last December will blow a $1.5 trillion hole in the national debt, inviting deep cuts to Medicaid (as well as Medicare and Social Security). Meanwhile, according to Americans for Tax Fairness, when the new tax law is fully phased in, 83 percent of the tax cuts will go to the wealthiest 1 percent.

Unsatisfied with the mere prospect of slashing Medicaid, the majority party offered a Balanced Budget Amendment (BBA) last week that would have triggered $114 billion in Medicaid cuts in a single year. The BBA attracted 233 votes (mostly along party lines), but fortunately failed to win the 2/3 of the House it would have needed to advance to the Senate.

The onslaught continues in the Trump administration, which is busy granting waivers for work requirements, drug testing, and other bureaucratic barriers that will result in Medicaid patients being kicked off the rolls.

“President Trump and his colleagues in Congress appear to have learned from their failed attempt to take away health insurance from tens of millions legislatively… that they need to do it in a back-door way, without the public catching on,” says Vallas.

Ironically, the right’s efforts to destroy the ACA and gut Medicaid have made Americans more aware of the program’s value. “They did something that Democrats couldn’t do for a long time. They made Medicaid popular,” says Rep. Kennedy.

Indeed, a Kaiser Health Tracking Poll conducted in March found that 74 percent of Americans have a positive opinion of Medicaid, including 65 percent of Republicans. In that same poll, 7 in 10 respondents said that they have a personal connection to Medicaid  — either because of their own medical coverage or their child’s, or indirectly through a family member or friend.

In a recent poll by the Center for American Progress, a whopping 80 percent of respondents (across party lines) said they oppose cutting Medicaid. “The Trump agenda of dismantling health care is the opposite of what the American people want,” says Vallas. “Americans want their policymakers to ensure that everyone has access to healthcare, not take away programs like Medicaid that make it possible for grandma to be in the nursing home.”

Our elected leaders need to understand that these Americans whose lives have been touched by Medicaid  — or likely will be by the time they are older — are people for whom Medicaid is a lifeline. They are not figures on a ledger, despite budget hawks’ tendency to view them that way. Even if our leadership isn’t sufficiently aware, it’s important that all of us  — their constituents — understand the myriad benefits that Medicaid provides seniors and everyone else who truly needs them. In fact, let’s make every month “Medicaid Awareness Month” until the program is safe from attack by budget slashers and properly fortified for the future.

Advocates Nationwide Highlight Medicaid’s Role In Combating Opioid Crisis

Throughout the second week of Medicaid Awareness Monthadvocates across the country highlighted the significant role Medicaid plays in combating the opioid crisis – most notable being that in 2014 Medicaid paid for one-fourth of addiction treatment nationwide – and spoke out against Republican proposals to weaken and cut Medicaid.

In Ohio, Chillicothe Mayor Luke Feeney, Cheryl Beverly, Operator of Cheryl’s House of Hope, and Michelle McAllister, Coordinator for the Heroine Partnership Project, held a press conference to discuss how changes to the state’s Medicaid program would leave over 150,000 Ohioans that suffer from substance abuse disorders and mental illness without care.

Protect Our Care released an opioid crisis fact sheet, showing how Medicaid provides access to treatment and gives states more resources in combating the epidemic.

In Tennessee, Chip Forrester, a father who lost his son to opioids, held a roundtable discussion about the crisis and how restricting access to Medicaid threatens lives and impedes states’ ability to respond to the epidemic.

The Center on Budget and Policy Priorities released a report analyzing how Better Integration of Medicaid and Federal Grant Funding Would Improve Outcomes for People with Substance Use Disorders.

ACA Medicaid Expansion Reduced Share of Opioid-Related Hospitalizations in Which Patient Was Uninsured


In Ohio,  Jefferson County Commissioner Thomas Graham and health care leaders in Steubenville held a press conference to talk discuss how Medicaid benefits thousands of Ohioans suffering from substance abuse disorders.

And in Alaska and West Virginia, advocates held a virtual postcard sending party throughout the week to send notes thanking Sen. Lisa Murkowski for supporting Medicaid and encouraging her to continue doing so, culminating in a stand up event outside Sen. Murkowski’s Anchorage office emphasizing the role Medicaid plays in addressing the opioid crisis, and a press conference with faith leaders which focused on the opioid crisis and how West Virginia’s faith community can address substance abuse disorders in the state, respectively.


Research Roundup: Studies Confirm That ACA, Medicaid Improve Health Care Access and Outcomes, Boost Local Economies

Over the past month, five studies looking at the impact of the Affordable Care Act have been released: three analyzing Medicaid expansion, and two analyzing marketplace coverage. These studies covered a broad scope of health care-related outcomes, from treatment for chronic conditions to jobs created in a local economy, and each came to the same conclusion: the ACA is providing clear benefits for Americans.

Here’s a look at what these five studies found:

Louisiana Department of Health: Medicaid Expansion and the Louisiana Economy

A report released in April by the Louisiana Department of Health analyzed Louisiana’s Medicaid expansion, finding that expansion not only boosted the state’s economy but also save the state money, leaving Gov. John Bel Edwards to conclude, “It is costing us less to have more people insured.” Among its key takeaways:

  • The state saw a $1.85 billion economic impact due to Medicaid expansion, with Louisianans seeing $1.12 billion in personal earnings and local tax receipts totaling $746 million, with the economic impact “spread throughout the state.”
  • Louisiana saw 19,000 new jobs created under Medicaid expansion, making clear that “such healthcare can also positive affect the labor participation rate.”
  • Over 545,000 Louisianans have benefited under Medicaid expansion, including more than 180,000 Louisianans who visited a doctor and received new preventive services, more than 35,000 Louisianans who received breast cancer screenings, and more than 48,000 Louisianans who received mental health services.
  • Medicaid expansion saved the state $317 million, leading Gov. John Bel Edwards to note, “It was the easiest big decision I’ll ever make as governor.”
  • As the study’s authors concluded, the economic impact will continue “as long as the state maintains the program and as long as no major changes are instituted by the federal government, either through acts of the U.S. Congress or regulatory decisions made by the Center for Medicare & Medicaid Services.”

University of Montana Bureau of Business and Economic Research: Medicaid Expansion Has Boosted State’s Economy, Added Jobs, Improved Health Care

A March study from the University of Montana Bureau of Business and Economic Research examined the effects of Montana’s Medicaid expansion, and found that it has not only provided insurance to more than 94,000 Montanans, but had a major impact on the state’s economy. Among its key takeaways:

  • Montana’s Medicaid expansion was responsible for creating 5,000 new jobs,  in the health care, retail, construction and hospitality industries, and $280 million of personal income.
  • Labor-force participation has increased six points, from 58 to 64 percent, among those eligible for Medicaid expansion, Montanans aged 18-64 and earning up to 138 percent of the federal poverty level .
  • Medicaid expansion has saved $40 million in Medicaid benefits, in addition to providing $902 million worth of health care services. “The savings are enough to pay for the costs,” said Bryce Ward of the BBER.
  • Medicaid expansion accounts for an estimated $564 million per year on health care spending, with nearly 70% of this being “new money,” or an economic boost spurred only by expansion.
  • As Sheila Hogan, director of the state’s Department of Health and Human Services said, “Medicaid expansion is doing what it’s supposed to do, help Montanans live healthier lives and save the state money.”

America’s Health Insurance Plans: The Value of Medicaid: Providing Access to Care and Preventive Health Services

An April study from America’s Health Insurance Plans (AHIP) compared data from Americans covered by Medicaid, private insurance, and not covered, analyzing the access to care received under each, finding that Medicaid tremendously improves access to care. Among its key takeaways:

  • Adults (five-times as likely) and children (four-times) were significantly more likely to have access to “a usual source of care” than those without insurance.
  • Adults (four-times as likely) and children (two-to-three times) were significantly more likely to obtain preventative care than those without insurance.
  • Those enrolled in Medicaid had access to care at levels comparable to private coverage, and far better access to care than those without insurance.
  • As the authors concluded, “The findings from this study refute outdated, less rigorous studies that question the value of Medicaid, and add to the growing number of recent studies that demonstrate the value of having insurance coverage generally, and Medicaid more specifically.”

Health Affairs: Effects Of The ACA’s Health Insurance Marketplaces On The Previously Uninsured: A Quasi-Experimental Analysis

An April study published in Health Affairs, led by Harvard Medical School clinical fellow Anna Lise Goldman, MD, compared adults who had gone through periods without insurance to those with continuous coverage. It found that the ACA improved health care outcomes, especially among low-income adults. Among its key takeaways:

  • The introduction of the ACA saw the uninsured rate decrease by 11 percentage points and the number of of individuals unable to access necessary care fall by two points, as well as more outpatient visits, more prescriptions being filled, and a higher probability of a hospital stay.
  • Lower-income individuals, those with incomes of between 138 and 250 percent of the federal poverty level, saw even larger increases in the number of outpatient visits and prescriptions being filled.
  • As the study’s authors concluded, “The ACA led to a significant decline in the uninsurance rate, decreased barriers to medical care, increased the use of outpatient services and prescription drugs, and increased diagnosis of hypertension, compared to a control group with stable employer-sponsored insurance.”

Health Affairs: The Affordable Care Act’s Marketplaces Expanded Insurance Coverage For Adults With Chronic Health Conditions

An April study published in Health Affairs examined the role the ACA marketplace had on non-elderly adults with chronic conditions, finding that those far more Americans with chronic conditions obtained coverage through the marketplace. Among its key takeaways:

  • During the time period analyzed, 45% of marketplace enrollees aged 18-64 were treated for chronic conditions, compared to just 35% of those not enrolled in marketplace coverage and 38% of adults with employer insurance.
  • Those enrolled in marketplace coverage obtained more service use than those without it, underscoring the long-term benefits of the ACA.

Advocates: April is Medicaid Awareness Month

Washington, D.C. – A coalition of health care advocacy groups will observe Medicaid Awareness Month this April, conducting educational campaigns focused on a different topic each week, culminating in a national Medicaid Day of Action on April 30. As federal and state-level threats mount, advocates will highlight the full scope of this critical program.

As Kaiser Health News’ Medicaid Nation series has recently emphasized, Medicaid plays an often-unheralded but central role delivering a wide range of public services to children, seniors, working families, people with disabilities, and people coping with mental health and substance use disorders. From Medicaid’s essential role facilitating special education in K-12 schools to its financial support for over 60% of nursing home beds nationwide, Medicaid Awareness Month will enhance awareness of the many ways this popular program strengthens American communities.

Organizations participating in this year’s Medicaid Awareness Month include:

  • Protect Our Care
  • Autistic Self Advocacy Network
  • Center for American Progress
  • Community Catalyst
  • First Focus
  • Health Care for America Now
  • Health Care Voter
  • National Committee to Preserve Social Security and Medicare
  • Organizing For Action
  • SEIU

As advocates and activists across the country highlight Medicaid’s critical importance in our communities, they will also educate the public about threatened cuts to the program. These include the President’s most recent budget, which would slash the program by $1.4 trillion; ongoing Congressional leadership discussion of ‘entitlement reform’; and a series of recent actions by the U.S. Department of Health & Human Services that encourage states to cut Medicaid enrollment by imposing new restrictions and eligibility hurdles.

This year’s Medicaid Awareness Month will center around four distinct focuses: kids, families, and Medicaid; Medicaid’s key role in fighting the opioid crisis; seniors, older adults, and Medicaid; and how Medicaid serves people with disabilities.

For more information, please visit the Medicaid Awareness Month Resource Kit, which will be updated continuously throughout April.


President Trump Ignores Real Opioid Solutions

Washington, D.C. – Today, President Trump spoke in New Hampshire about the opioid crisis. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Heavy with rhetoric and short on solutions, President Trump’s speech today in New Hampshire was more of the same from a White House more committed to politicizing the opioid crisis than ending it. The Trump Administration has relentlessly attacked and sabotaged Medicaid, proposing to cut funding by hundreds of billions for the program that pays for one-fifth of all substance abuse treatment nationwide, and for two successive years has proposed a 95% cut to the Office of National Drug Control Policy, charged with coordinating the federal response to the nation’s raging opioid crisis.

“If the White House truly cared about combating the opioid epidemic, they would be calling for every state that hadn’t expanded Medicaid to do so. That they’re not tells you all you need to know.”