Beyond Medicare and Social Security: Cutting Medicaid After the Pandemic Would be Political Madness

STAT News | By Arielle Kane
 
During his State of the Union address, President Biden called out Republican proposals to cut Social Security and Medicare in their quest to reduce federal spending. Republican lawmakers in the chamber protested loudly, knowing these programs are political third rails — too controversial to discuss — and they have been sparring over it ever since.
 
But the president and Democrats in Congress should not miss the opportunity to make Medicaid the third rail. If they want to capitalize on the popularity of the program and protect families’ health care, Medicaid cuts must be off the table because it:

• Covers 91 million Americans, making it the largest source of health care coverage in the country
• Covers 42% of all births
• Pays for 54% of long-term care and covers 6.9 million people ages 65 and older
  Provides coverage to more than 10 million people with disabilities who rely on Medicaid for their health care

Several Republicans have said they want to use the upcoming legislative battle over raising the debt ceiling as an opportunity to cut overall spending, particularly in programs like Medicaid.
 
But politically savvy lawmakers would be wise to remember the health care fights of 2017 — and the results of the 2018 midterm elections that followed — proving that cutting coverage for pregnancy and childbirth, for older adults, and for people with disabilities is a pathway to political collapse. Even in deep red states like South Dakota, Idaho, and Missouri, the electorate has approved Medicaid expansion even when their elected lawmakers opposed it. That’s because Medicaid is a lifesaver for millions of families.
 
That’s never been clearer than over the past three years when Medicaid protected families during an enormous public health crisis. The Covid-19 pandemic upended the economy and tripled the unemployment rate. But largely because of Medicaid, the rate of uninsured reached an all-time low in 2022. That is a stark difference from the last economic upheaval during the Great Recession of 2008-2009, when 9.3 million people lost their jobs and, subsequently, their health insurance. Millions more families now know firsthand how essential Medicaid is for their health and financial well-being and they will not look favorably if their elected representatives decide to cut that lifeline.
 
The Medicaid program faces a daunting challenge in the coming months as the process of checking the eligibility for Medicaid of its 91 million enrollees starts back up again April 1. At the same time, 1 in 4 state Medicaid programs report staff vacancy rates greater than 20%. Millions of people are likely to lose coverage because of administrative hurdles during the eligibility determination process, and they will be hard-pressed to get someone on the phone to assist with their application. It’s political madness to cut Medicaid generally, but particularly so during this herculean lift across all state Medicaid agencies.

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