Five Things You Should Know About Medicaid

1 in 5.

That’s how many people in this country receive healthcare through Medicaid. In tandem with the Affordable Care Act (ACA) and the Children’s Health Insurance Program (CHIP), Medicaid has produced historic progress on health in America. It’s also one of the most effective poverty reduction programs we have.

Yet Medicaid came under incessant threat from congressional Republicans last year, and lawmakers and public officials have already begun laying the groundwork for attacks in 2018, using dubious, divisive, and even demeaning rhetoric. Indeed, as state lawmakers have begun to impose cruel, counterproductive, and wrongheaded “work requirements” on struggling men and women enrolled in Medicaid, it’s likely the Trump Administration will propose gutting funding for the program in its FY 2018 budget — just as it did last year.

In the face of these attacks, it’s worth setting the record straight about a health insurance program that has become vital in the day-to-day lives of tens of millions of Americans. Here are five things you should know about Medicaid.

1. From birth to retirement, Medicaid helps millions stay financially and physically healthy.

Medicaid provides health insurance to some 74 million children, pregnant women, people with disabilities, older adults, and low-wage workers. The program covers nearly half of all births and pays for half of all nursing home costs in the United States.

A large body of research shows that Medicaid yields tremendous short- and long-term health benefits for both children and adults. And Medicaid coverage is associated with increased earnings and reduced medical debt among recipients.

2. Medicaid makes work possible.

Did you know that the overwhelming majority of Medicaid recipients who can work, already do?

By ensuring that low-income men and women have access to critical healthcare, Medicaid helps people stay healthy and pursue work. Just ask recipients themselves: After Ohio and Michigan expanded Medicaid eligibility under the ACA, most who were surveyed said that their coverage made it easier to seek or sustain employment.

But recent efforts by federal and state officials to attach onerous and cruel “work requirements” to Medicaid will undermine the program as a work support. Not only are these policies legally dubious and based on racist and wrongheaded assumptions about people with low income, but, ironically, by taking healthcare away from those who are already struggling, work requirements will make finding and sustaining work more difficult. Worse, many of those who would be technically exempt or eligible for coverage will likely be snared in the endless red tape that work requirements entail.

That’s not to mention, of course, that “work requirements” do nothing to address the barriers to work — from a criminal record to caregiving responsibilities to high regional unemployment rates — that keep many people with low-income from securing gainful employment.

3. Medicaid is combating the opioid epidemic.

In recent decades, opioid addiction has swept through the country, causing thousands of deaths and hitting low-income and working communities particularly hard.

While the epidemic remains an urgent problem of national scale, states that have expanded Medicaid eligibility under the ACA have been able to combat it through various addiction treatment services. In total, the ACA expanded access to care for 2.8 million Americans with drug use disorders, while Medicaid itself covers nearly 4 in 10 adults with an opioid addiction.

4. Medicaid supports state budgets.

Medicaid is the largest single source of federal funding to state budgets and, because the program is open-ended, it can respond efficiently to economic downturns and scale back in times of less need.

Yet recent proposals to slash and cap federal funding would completely undermine the program’s flexibility. Such proposals would fiscally paralyze state governments, forcing them to choose between cutting funding for healthcare or other crucial services. And, when the next economic crisis hits and need for care expands, this would leave states in a serious lurch.

Just look at Puerto Rico. Because Puerto Rico’s Medicaid program is funded through a federally capped block grant, the American territory has struggled to ensure access to healthcare for all its residents. The recent natural disaster has badly exacerbated the issue, and serves as a cautionary tale for lawmakers who wish to replicate that policy failure on a national scale.

5. Medicaid is crucial for health equity.

Because of our country’s long-standing legacy of structural racism and discrimination, people of color face various disparities in terms of quality of life — including access to healthcare.

Medicaid, the ACA, and CHIP, however, have all helped dramatically reduce the racial coverage gap, driving the rate of uninsured Latinos and Black Americans to all-time lows.

To be sure, gaps in access to healthcare remain, but, like other flaws in our health system, they can be addressed by building on the programs that have helped move us forward — not tearing them down.

Trevor Brown contributed to this blog.