As expected, House Republicans announced on Thursday their plans to cap Medicaid as part of their broader effort to repeal and replace the Affordable Care Act. Medicaid would be transformed from an entitlement program that covers anyone who is eligible to a fixed amount of funds. This fixed amount of funds would not be sufficient to keep pace with rising health care costs or increased need for Medicaid during economic downturns, forcing states to make some combination of cuts to eligibility, covered services, and payments to health care providers.
One of the most disturbing aspects of the plan is that it pits vulnerable people against each other in a scramble for pieces of a diminishing pie. Republicans portray this as an effort to save Medicaid for “the most vulnerable,” but that’s a lie. Everyone–kids, people with disabilities, the elderly, and poor adults–would suffer as a result of these radical changes to Medicaid. Minnesota alone would face budget deficits in the billions of dollars because of these cuts and the consequences would be felt by a wide swath of my fellow citizens. Republicans aren’t really interested in “saving” medicaid for us poor cripples. They view Medicaid as a huge redistribution of wealth that must be cut as deeply as possible for the sake of free-market principles and survival of the fittest. I’m sure that they would protest this characterization, but it goes to the heart of their ideology.
Of course, this policy fight is personal for me. Medicaid has provided me with the supports I need to live an independent and productive life. If the Republican plan becomes law, I could lose some or all of my nursing care. Minnesota could eliminate the buy-in program that allows me to purchase Medicaid coverage and earn an income, forcing me to quit my job as an attorney. It’s conceivable that I could even end living in an institution. These are scary prospects for me, but millions of other people will be facing even more calamitous prospects if they lose their Medicaid coverage. As I’ve noted before, those of us who depend on Medicaid for our survival can’t allow ourselves to be divided in this fight. If that happens, we will have already lost.
This is only the opening shot in the war on Medicaid. Formal legislation has yet to be introduced and it must go through a lengthy process before it becomes law. But in the meantime, we need to tell our stories to our representatives and senators. They need to understand how Medicaid has made our lives better and how funding cuts could make our lives worse. Those stories need to be told via phone calls to congressional offices and at town hall meetings with your representatives. If enough of us tell our stories, we may be the ones who actually save Medicaid.