Reuters1 reported that U.S. senators made a last-ditch effort on Monday (Sept. 25, 2017) to secure support for the latest Republican attempt to repeal former President Barack Obama’s signature healthcare law, releasing revised legislation to appeal to undecided senators. The repeal of Obamacare would affect Medicaid, one of the most important healthcare safety nets for Americans.
The ironic thing about destroying Medicaid is that many of Donald J. Trump’s supporters would be negatively affected. An article by Bryce Oates of the Daily Yonder2 states that Medicaid Cuts In Senate Obamacare Repeal Bill Would Hit Rural Hard2 . The map below shows the U.S. counties that are most reliant on Medicaid.
Significant clusters of these counties are in the Appalachian coal counties, Mississippi River Delta, and tribal or reservation communities of the West.
One Trillion Dollar Cut in Medicaid?
The Congressional Budget Office3 (CBO) also found that federal spending on Medicaid would be cut by about $1 trillion from 2017 to 2026 under the Graham-Cassidy proposal and that millions of people would lose their coverage in the program, mainly from a repeal of federal funding for Obamacare’s Medicaid expansion.
The same Reuter’s article4 on Sept. 25, 2017 that forecasts a one trillion dollar cut in Medicaid states that the Senate held its first hearing all year on the proposed Obamacare repeal on Monday, but it was immediately disrupted by protesters who forced Senate Finance Committee Chairman Orrin Hatch to postpone its start by about 15 minutes.
Police arrested 181 demonstrators, including 15 in the hearing room. The protesters, mainly from a disability rights group and many of whom were in wheelchairs, were forcibly removed one-by-one from the hearing room as they yelled, “No cuts to Medicaid, save our liberty.” The hearing eventually proceeded for about five hours, but protests could be heard outside for more than an hour.
Jay Harold wants you to know more about this vital program, which is one of the centerpieces of the United States healthcare system.
69 Million Americans are enrolled in Medicaid Programs
States establish and administer their own Medicaid programs and determine the type, amount, duration, and scope of services within broad federal guidelines. Federal law requires states to provide certain “mandatory” benefits and allows states the choice of covering other “optional” benefits. Mandatory benefits include services like inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services, among others. Optional benefits include services like prescription drugs, case management, physical therapy, and occupational therapy5 .
| Mandatory Benefits | Optional Benefits |
|---|---|
| Inpatient hospital services | Prescription Drugs |
| Outpatient hospital services | Clinic services |
| EPSDT: Early and Periodic Screening, Diagnostic, and Treatment Services | Physical therapy |
| Nursing Facility Services | Occupational therapy |
| Home health services | Speech, hearing and language disorder services |
| Physician services | Respiratory care services |
| Rural health clinic services | Other diagnostic, screening, preventive and rehabilitative services |
| Federally qualified health center services | Podiatry services |
| Laboratory and X-ray services | Optometry services |
| Family planning services | Dental Services |
| Nurse Midwife services | Dentures |
| Certified Pediatric and Family Nurse Practitioner services | Prosthetics |
| Freestanding Birth Center services (when licensed or otherwise recognized by the state) | Eyeglasses |
| Transportation to medical care | Chiropractic services |
| Tobacco cessation counseling for pregnant women | Other practitioner services |
| Private duty nursing services | |
| Personal Care | |
| Hospice | |
| Case management | |
| Services for Individuals Age 65 or Older in an Institution for Mental Disease (IMD) | |
| Services in an intermediate care facility for Individuals with Intellectual Disability | |
| State Plan Home and Community-Based Services- 1915(i) | |
| Self-Directed Personal Assistance Services- 1915(j) | |
| Community First Choice Option- 1915(k) | |
| TB Related Services | |
| Inpatient psychiatric services for individuals under age 21 | |
| Other services approved by the Secretary* | |
| Health Homes for Enrollees with Chronic Conditions – Section 1945 |
This includes services furnished in a religious nonmedical health care institution, emergency hospital services by a non-Medicare certified hospital, and critical access hospital (CAH).
Medicaid Program History6
The Center for Medicaid and CHIP Services (CMCS) serves as the focal point for all national program policies and operations related to Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). These critical health coverage programs serve millions of families, children, pregnant women, adults without children, and also seniors and people living with disabilities.
Medicaid
Authorized by Title XIX of the Social Security Act, Medicaid was signed into law in 1965 alongside Medicare. All states, the District of Columbia, and the U.S. territories have Medicaid programs designed to provide health coverage for low-income people. Although the Federal government establishes certain parameters for all states to follow, each state administers their Medicaid program differently, resulting in variations in Medicaid coverage across the country. Beginning in 2014, the Affordable Care Act provides states the authority to expand Medicaid eligibility to individuals under age 65 in families with incomes below 133 percent of the Federal Poverty Level (FPL) and standardizes the rules for determining eligibility and providing benefits through Medicaid, CHIP, and the health insurance Marketplace
In 2015, Medicaid celebrated its 50th birthday by posting program highlights, research findings and the voices of our beneficiaries in 50 days of postings7 .
Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program8 (CHIP) was signed into law in 1997 and provides federal matching funds to states to provide health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage. All states have expanded children’s coverage significantly through their CHIP programs, with nearly every state providing coverage for children up to at least 200 percent of the Federal Poverty Level (FPL).
Basic Health Program
The Basic Health Program9 was enacted by the Affordable Care Act and provides states the option to establish health benefits cover programs for low-income residents who would otherwise be eligible to purchase coverage through the Health Insurance Marketplace, providing affordable coverage and better continuity of care for people whose income fluctuates above and below Medicaid and CHIP levels.
Medicaid includes many programs that are vital to over 20% of all Americans and we must be very careful about making changes that affect so many people.
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Bibliography
- https://www.reuters.com/article/us-usa-healthcare/republicans-revise-obamacare-repeal-bill-amid-tepid-support-idUSKCN1C00BT
- http://www.dailyyonder.com/healthcare-repeal-bill-hits-rural-medicaid/2017/09/22/21481/
- https://www.cbo.gov/about/overview
- https://www.reuters.com/article/us-usa-healthcare/obamacare-repeal-on-the-ropes-as-pivotal-republican-rebuffs-trump-idUSKCN1C00BT
- https://www.medicaid.gov/medicaid/benefits/list-of-benefits/index.html
- https://www.medicaid.gov/about-us/program-history/index.html
- https://www.medicaid.gov/about-us/program-history/medicaid-50th-anniversary/index.html
- https://www.medicaid.gov/chip/index.html
- https://www.medicaid.gov/basic-health-program/index.html
