Wherever you stand on the issue of health insurance, it’s critical that we all stay informed on the impacts of proposals to change our health care system.
According to the Congressional Budget Office, the House of Representative’s version of the proposed American Health Care Act would result in $880 billion in cuts to the Medicaid program over the next 10 years.
Unfortunately, most of us don’t really understand what Medicaid does or what the impacts of such drastic cuts would be. The Medicaid system is so complicated that most health care professionals do not even fully understand it. But I would like to take a stab at giving Herald readers a little clarity.
First of all, Medicare and Medicaid are different programs with different funding streams. (I really want to find the cruel bureaucrat who named them so similarly.) Medicare is the federally-sponsored health care system for seniors (and some people with disabilities – but don’t let that throw you off). Most working Americans fund the Medicare system through their payroll taxes and become eligible for Medicare benefits at age 65.
Medicaid is a health care program for people with low incomes. Traditionally, most of Medicaid’s beneficiaries have been children, low-income seniors (as a secondary insurance to Medicare) and people with disabilities. With the Affordable Care Act’s Medicaid expansion, some states have expanded Medicaid eligibility to offer health care to individuals who made too much income to qualify for traditional Medicaid, but too little to receive subsidies for purchasing individual health insurance. Medicaid is provided as a 50 percent match from the federal government to each state.
The Medicaid program provides services traditionally associated with health insurance, such as doctor and specialist visits, hospital care, lab work and prescriptions. Additionally, Medicaid pays for Medicare premiums and co-insurance for individuals who are eligible for both programs. Most states also use Medicaid funds to pay for long-term care options, including nursing homes and home- and community-based programs that allow people with disabilities or chronic illness to live in their homes.
Medicaid is not, as many people believe, a Cadillac health care plan for people who don’t work. It is far more like a horse and buggy than a Cadillac. Medicaid reimbursement rates are at least 20 percent below the market rates for medical care, and often are far lower. Because of this, many physicians and specialists choose not to accept Medicaid beneficiaries as patients, leaving many on Medicaid without access to care.
This also isn’t a program for people who just don’t want to work. According to the Kaiser Family Foundation, almost 60 percent of Colorado Medicaid recipients are under the age of 18. And working-age adults make up a disproportionately low percent of the actual Medicaid spending. While 20 percent of Medicaid beneficiaries are seniors or adult with disabilities, these same groups total almost 65 percent of the expenditures.
Before we eviscerate a program that supports some of our most vulnerable and worthy citizens, let’s make sure we understand what it is we are giving up. It will be too late to be sorry later.
Tara Kiene is president/CEO of Community Connections Inc.