Life isn’t secure for anyone if they can’t count on getting health care when they need it.
Yet the Trump administration and its fellow travelers in Congress have set out to take away health care for millions of people — people most in need of affordable health care — just to help hand over bags of money to corporations and people who already are wealthy. Their proposal to cut Medicaid includes $4.5 trillion — yes, trillion — in tax cuts geared to the rich and $2 trillion in spending cuts over the next decade.
Cruel doesn’t begin to describe what is going on. Nearly 770,000 Illinois residents could lose their health care coverage if Medicaid is cut, Gov. JB Pritzker has said.
Last week, on Feb. 25, U.S. House Republicans voted for a budget resolution that paves the way for billions in cuts to Medicaid, which provides health insurance to more than 70 million Americans, almost one-fifth of the population. Medicaid is the largest single provider of health insurance in the nation.
It was a dizzying flip-flop for President Donald J. Trump, who had just earlier that same day said Medicaid would not be touched, except for possible fraud that might be unearthed. Then, on Wednesday morning, Trump on social media endorsed the House vote.
If he was willing to flip so quickly on his vow to protect Medicaid, what are his promises not to cut Medicare and Social Security worth?
Cutting off millions of working Americans
Medicaid is a key piece of the United States health insurance system, which — along with private insurance, Medicare, the Affordable Care Act and other systems — promises to bring the cost of health care into reach for Americans. Cutting billions from Medicaid would leave many people without health insurance and no access to costly medical care, no matter how hard those people have work in their lifetimes or are working now.
About two-thirds of those using Medicaid work full- or part-time, and others are exempt because they are caregivers or students, according to the health policy nonprofit KFF. Only 8% were not working, KFF reports, including those who couldn’t find a job, were retired or for other reasons. The expansion of Medicaid under the Affordable Care Act — in dozens of states, including Illinois — means it is not just for the poor, but also for those who work but don’t earn enough to qualify for ACA subsidies.
Republican officeholders should care about this. In Illinois’ three districts represented by Republicans in Congress, about 590,000 people were using Medicaid, according to a report last September by the Association for Community Affiliated Plans. How many of those people would lose their Medicaid depends on how deeply it is cut.
Overall, some 3.4 million people in Illinois are enrolled in Medicaid, which includes people who were enrolled under the Medicaid expansion.
Let’s ask: Who are the people who would be left by the side of the road?
Children born to people who now use Medicaid. Senior citizens who have spent all their money for nursing home care and now rely on Medicaid, which pays the bills for more than 60% of nursing home residents. People who are working but have pre-existing conditions, no company health insurance and who don’t earn enough to qualify for ACA subsidies. Family, friends, loved ones.
Who would suffer indirectly? People in areas where hospitals close because they cannot remain solvent. People everywhere, as Kentucky Gov. Andy Beshear said on MSNBC, as hospitals face the need to trim staffs and services, and people no longer have the same options to go to walk-in clinics.
Some Republican House members said that, although they voted for the budget resolution, they don’t support cuts to Medicaid. That’s indefensible misdirection. What about their votes to direct the House Energy and Commerce Committee to find $880 billion worth of savings in programs under its jurisdiction, which includes Medicare and Medicaid, which account for the lion’s share of the committee’s costs. If Medicaid is not cut, where else do those Republicans think the agency can trim?
Of course, states, which share the cost of Medicaid, could spend more of their own money. But where are the states with vast surpluses that can afford it? We haven’t heard of them, either. As Pritzker said, “[N]o state in the country has the money to backfill the billions of dollars in funding.”
Illinois is one of the states that has a “trigger” law, which means if the federal government stops paying its 90% share of the expansion of Medicaid under the Affordable Care Act, Illinois will drop people covered by that.
Until the final numbers are in, it won’t be clear how many people will lose their health insurance and, therefore, their access to health care. But what will be clear is that the money will wind up in the pockets of wealthy people via an unnecessary extension of huge tax cuts.
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