A few points about potential cuts to Medicaid to help you get started:
 

• Slashing the Medicaid program means cutting the program that covers 40% of US children and 60% of nursing home residents. Along with the moral and human rights implications of leaving so many of our nation’s children and elders without health insurance, this dramatic cut to our safety net would be devastating for our hospitals, including our already-overcrowded Emergency Departments, our nursing homes, and would put us all at risk, regardless of our income or health insurance status.
   

• Big cuts to Medicaid could easily destabilize our nation’s hospitals, particularly those in rural areas. Many of these hospitals are already operating on razor-thin margins or with deficits. When hospitals close, everyone has to travel further to get care. That means that it takes longer to reach an ER after a heart attack, a stroke, or after trauma from a car crash. It means that waiting times in the remaining ERs will go up, as these units fill with people with nowhere else to go to seek care, and as the remaining ERs attempt to care for larger numbers of patients. And as any doctor or nurse can attest, minutes mean lives lost or saved. An extra 30 or 40 minutes of driving will absolutely cost lives, and it won’t matter whether the person suffering has private or public insurance or whether they voted Republican or Democrat. And even after arriving at the hospital, these closures will mean delayed care for true emergencies that sadly translates into preventable death and disability.
   

• Cuts to Medicaid will also result in funding cuts to nursing homes that will not only impact seniors who need to move to a residential facility, but will almost certainly translate into delays in hospital discharges for patients who are stable for discharge but not yet ready to go home. That will mean that their hospital beds are not available for patients who need to be admitted from ERs, further increasing the crowding and care delays there. And cuts to funding for home-based services will rob our elders of the ability to stay in their homes rather than enter a nursing home – if they can find one that has not closed and still has space.
   

• We have already lost many of our nation’s maternity units, as hospitals cut these critical services because reimbursements have not kept pace with costs. With more than a third of births currently covered by Medicaid, we can expect to lose even more maternity units if Medicaid cuts move forward. And that translates into increased travel time for women in labor, and into more pregnant women who do not reach a hospital before their baby is born, putting them and their infants at risk for severe complications as they struggle to labor and deliver without the medical help they should have. This problem too is likely to impact rural areas more than denser urban areas, as travel time to the nearest hospital is much longer already in our rural areas.
   

• But the rippling impacts of the potential Medicaid cuts don’t stop there. Children who don’t have health insurance are much less likely to get prompt treatment for infections like strep throat or skin infections, and less likely to get routine childhood vaccinations, making it more likely that they would spread the infections to their classmates. That doesn’t sound like a big problem because most of us have never seen the complications those infections can cause, since rheumatic fever and post streptococcal kidney disease are very rare in the US. But those complications are rare because our children get the care they need when they need it, something we will no longer be able to count on if these draconian cuts move forward. 
   

• Some members of Congress will say that they are not cutting anyone’s insurance, just trimming the funding for the overall program or mandating work requirements. But if Medicaid funding is cut, the only options for the states will be to cut the number of people covered, the services provided, or payments to providers (or all three) and the end result will be the disastrous consequences described above. And we’ve already seen that work requirements in the two states that instituted them (Georgia and Arkansas) led to increased costs and dramatically decreased coverage without any evidence that they increased employment. As a family doctor, I took care of patients in our city health centers for more than a decade and virtually every adult who came to our clinic worked if it was at all possible for them to do so. Work requirements generate administrative costs and bureaucratic red tape, but do nothing to increase work force participation. Because of this, Arkansas has already rolled back its work requirements, since they were both expensive and ineffective. 
   

• We all need to be informed about what cuts to Medicaid truly mean for us and for our communities. We are all connected and what hurts our neighbors eventually hurts us too. But the good news is that no decisions have been made yet. The Medicaid program helps to keep our healthcare facilities open and helps people to stay healthy so that they can earn a living, support their families, and avoid making others ill. Let’s make sure that we keep it that way. 

 

Resources:

Pennsylvania Health Law Project: https://www.phlp.org/en/

Pennsylvania Health Action Network: https://pahealthaccess.org

National Immigration Law Center: https://www.nilc.org

Nationalities Service Center: https://nscphila.org

HIAS PA: https://hiaspa.org

American Civil Liberties Union: https://www.aclu.org