Republican leaders are worried about the future of Medicare, but are proposing cuts to Medicaid that could kill or harm millions of Americans. Today, Medicaid is the nation’s single largest health insurer, covering more than 80 million Americans. This affects low-income families, seniors, adults with disabilities, and those dealing with mental health disorders alike. Without these cuts, they would continue to be a lifeline for these vulnerable populations.
Medicaid is the primary payer of long-term care for seniors, including their healthcare costs, especially for seniors in nursing homes. Nearly 4 in 5 of these affected residents rely on this program for their coverage. It has important impacts for adults who would struggle with activities of daily living, such as eating, bathing, and dressing without their coverage. Notably, nearly 40% of nonelderly adults enrolled in Medicaid reported having mental health issues or substance use disorders in 2020. Medicaid covers about 20 million people with the ACA expansion. It is a vital cog, insuring 40% of all births in the U.S.
Impact on Vulnerable Populations
The proposed cuts in federal Medicaid funding would result in the loss of access to care for millions. Advocates and community experts alike are sounding warnings that people will lose coverage eligibility, leading to a collapse in care facilities as they become financially unsustainable. Kelley highlights the gravity of the situation:
“The cuts would ultimately lead to reduced access to care for many individuals. People would be ineligible for coverage, and facilities would have to close due to a lack of money,” – Kelley.
This funding cut would only increase the existing health disparities. Low-income households that are dependent on the use of Medicaid for critical health care services are especially vulnerable. Adams elaborates on the broader implications:
“The first-round effects would be reductions in numbers of lower-income households with insurance access to needed services, reduced access to preventive and primary care as well as services needed to manage chronic conditions (e.g. diabetes, heart disease) which are higher among these vulnerable populations,” – Adams.
Or that cuts to Medicaid will worsen Americans’ health. They will lead to increased delays in accessing medical care and drive patients—particularly those in rural communities—further away from receiving the care they need. Kelley notes that:
“Those in rural areas may have to travel farther to clinics and hospitals. There may also be increased wait times due to a lack of staff and facilities,” – Kelley.
Economic Consequences
The economic consequences of slashing Medicaid dollars are dire. As our nation’s health equity experts consistently warn, these cuts would go well beyond worsening individual health outcomes to directly fuel the national medical debt crisis. Kelley emphasizes the financial strain that could arise:
“Lack of insurance will lead to delays in medical care, increased morbidity, increased mortality, and increased medical debt for American citizens,” – Kelley.
Moreover, as Medicaid serves as a lifeline for many, its cuts would likely lead to an increase in uninsured individuals, further straining the healthcare system. The ramifications stretch past short-term health care availability; they threaten to exacerbate maternal health disasters in the long run too. Adams points out:
“We could see a worsening of our maternal health crises and in turn, gestational age, and birthweight of our infants,” – Adams.
Long-term Care and Family Planning Services
Medicaid is the single most important payer of long-term care services for older and disabled Americans. It stretches over an incredible range of services that most families could never afford independently. Adams states:
“Long-term care for our elderly and disabled is largely paid for through Medicaid. Its funding is critical to our ‘safety-net,’ rural hospitals, and nursing homes,” – Adams.
Medicaid provides a full range of family planning services without any out of pocket expense. This support enables them to take control of their reproductive health and make informed decisions. Friedrich-Karnik emphasizes the importance of these services:
“Further, Medicaid’s coverage of a robust package of family planning services, including a wide range of birth control methods with no out-of-pocket costs, is integral to ensuring person-centered care and upholding enrollee’s right to decide whether and when to become pregnant,” – Amy Friedrich-Karnik.
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