Let’s Protect Medicaid and Health Equity

Medicaid helps millions of people in need to have health coverage

Medicaid works — and it works well. Today, 81 million people in the US get health coverage through Medicaid, the state-federal partnership that ensures access to life-saving health care for low-income children and adults, as well as people with disabilities  and seniors (Medicaid and CHIP Payment and Access Commission, 2017). This includes nearly 2 in 5 children in the US, 36 million children in households that already struggle to make ends meet, as well as children and adults with disabilities. Medicaid covers almost half of all births in the US (Kaiser Family Foundation, 2017). It also covers seniors for costs that Medicare may not cover — such as nursing homes. Nearly 1 in 10 people using Medicaid is a senior (Kaiser Family Foundation, 2016).

Currently, a person who is eligible for health care coverage through Medicaid can get that coverage. This includes people who the federal government says must be covered and those whom states have the option to cover (Centers for Medicare and Medicaid Services, 2017). This idea that people who are eligible have a right to coverage is the same in Medicare, which along with Medicaid supports elderly Americans (Medicaid and CHIP Payment and Access Commission, 2017). To pay for Medicaid, state and federal governments jointly fund the program. The amount of federal funding to states can increase or decrease along with health care costs, as the population ages, or as more or fewer people need coverage, such as during times of economic downturn (Kaiser Family Foundation, 2017).

Health Departments: Take Action to Protect Medicaid!

Educate your community and elected officials about potential health impacts of proposed changes to Medicaid for your state — or more locally if you can access that data.

For example, using Kaiser Family Foundation identify the number of people in your state covered by Medicaid — including children, pregnant women, people living with disabilities, seniors, and people with chronic illnesses. Or cite info on Medicaid use by Congressional district. If you can access local data and stories, do it! Use these data and stories to highlight: benefits of expansion if your state expanded Medicaid under ACA, how dismantling Medicaid would affect the health of individuals and families, and how undoing it undercuts the health care system (e.g., community health clinics, rural hospitals).

Encourage elected officials to whom you report to take a position on the proposed changes to Medicaid. Once they have, see if your health department can speak publicly about its position.

Talk with your jurisdiction’s legislative/policy staff and/or elected officials to ensure policy makers hear the department’s concern about the proposed changes to Medicaid. Encourage them to take a formal position on the proposals. If they do take a formal position, use your platform at the health department to ensure people know about it and amplify the message.

Mobilize professional associations and advocates to take a position and provide them with data.

Work with professional associations like national, state, and local chapters of the American Public Health Association or the National Association of City and County Health Officials to communicate the impacts of the proposals to legislators. Provide local advocacy organizations with data, helping them understand how to request data from the health department as necessary, so they can make the case to local elected officials.

Hold workshops for community members.

Public health departments can host public workshops that help people to understand Medicaid and the AHCA. Host a workshop so community members know how changes may affect them.

Public Health Professionals: Take Action to Protect Medicaid!

Attend Congressional Town Hall events and community meetings.

When members of Congress host town hall events and community meetings in home districts, ask about their plans for Medicaid and the AHCA. Visit Organizing for Action’s Toolkit for guidance on doing this during Congressional recesses. Identify yourself as a public health professional, share information from this document or information about local impacts, and ask how elected officials are protecting health.

Reach out to elected officials — repeatedly and often.

Write letters with health colleagues through professional organizations like the American Medical Association and American Public Health Association or call and visit the offices of Congressional and local elected officials. Inform them on how pending decisions will change health and equity. This resource can be a starting point.

Get proactive — call for strengthening Medicaid.

Read the evidence, join the discussion, and help advocate for strengthening instead of dismantling Medicaid. Put another choice on the table. Look for opportunities to partner with other groups or agencies with similar goals.

Tips for Talking About Proposed Cuts to Medicaid

Start with values — for example, you can say:

“No matter our differences, most of us want pretty similar things — to go through our lives in good health and to get quick, effective, compassionate care if we’re ever sick or injured.”

“Most of us can agree on the basic principle that we all should be able to see a doctor, be treated for an illness, or get care to prevent us from being sick in the first place — regardless of how much money we earn. All children should have health care, and people with disabilities, people with chronic conditions, seniors, and those in great need should get the care that is essential to helping them live.“

“Medicaid embodies these principles. And it works well.”

Here are some key points you can make about what Medicaid looks like today:

• Medicaid works well — it provides needed care to tens of millions of children, seniors, people living with disabilities, and low-income people who otherwise would not have health care.
• Medicaid costs less per person than private insurance.
• Medicaid responds to changing needs in states — including economic downturns, expensive treatments, and epidemics that may be costly to control.
• Medicaid already gives states flexibility. To ensure people across all 50 states, territories, and the District of Columbia have coverage, the federal government sets standards for health care and covers some costs, while states still have flexibility to fit programs to the specific needs of the people who live there.
• There can always be improvements. We should strengthen, not gut, Medicaid.
• The proposed changes under AHCA and the President’s suggested budget cuts will:
  • Harm the nation’s health — and that is not okay.
  • Be worse for 3 core aspects of health care: access, affordability, and quality.
  • Be worse for millions of people struggling with health issues and making ends meet.
  • Cap the amount of money coming into states, instead of responding to changing needs
  • Save the federal government money at the expense of state budgets. States will have to take away health care services people already have, states will have to find a way to pay for services, or people will have to shoulder the cost themselves. It hurts people most at risk in our states for no good reason. The proposed changes will do all this to give tax cuts to wealthy individuals.
  • Be costly — in money and in health.

If you have questions or edits, please email: info@humanimpact.org. Our thanks to Anat Shenker-Osorio for messaging suggestions included in this brief.