The Medicaid changes reportedly being discussed in secret by a few old Republican senators has led ten of the country’s biggest health care plans to send a letter asking the senators to get their heads out of rich billionaire asses long enough to consider what the hell they are doing.
The undersigned Managed Care Organizations represent nearly 13.5 million of our fellow citizens in 23 states across the country who rely on Medicaid for their health and well-being. We respectfully ask you to carefully consider the ramifications and consequences of altering the Medicaid related provisions of the Affordable Care Act (ACA) and the underlying financing structure of the Medicaid program so that reforms assure coverage to existing and future eligible enrollees while bending the cost curve through value-based initiatives. This year’s discussion began with a focus on the ACA’s individual insurance market, but current health care proposals go further and do not enact meaningful, needed repairs to the ACA. However, our primary concerns lie in the impacts these policies will have on the 74 million low-income, disabled and elderly Americans whose health care coverage through Medicaid rests in the hands of the Senate as you craft new legislation and policy options.
After trying to remind the Senate what Medicaid does to help citizens in the world of health care, they try to walk the senators through how fraudulent the theory of “state flexibility” being promoted by Republicans is.
While this may appear positive from an immediate budgetary perspective, these amounts spell deep cuts, not state flexibilities, in Medicaid. There are no hidden efficiencies that states can use to address gaps of this magnitude without harming beneficiaries or imposing undue burden to our health care system and all U.S. taxpayers. Reducing the federal government’s share of Medicaid in this manner is not meaningful reform to bend the cost curve. It is simply an enormous cost shift to the states. It does nothing to address underlying drivers of the cost of care, like expensive new drugs and therapies, and an aging population living longer with disability. States are already hard-pressed to meet these challenges while balancing their budgets.
Simply put, the projected shortfall in federal funding must be addressed by each state, forcing them to make difficult choices which may include: 1) making up the difference through increased state and local taxes; 2) reducing benefits; 3) cutting reimbursement to health care providers; and 4) eliminating coverage for certain categories of currently eligible beneficiaries. Unlike previous shortterm changes, policies under consideration make the reductions permanent and penalize states that have already achieved efficiencies and lowered their historical spending trend.
Everybody knows what’s happening here is catastrophic for everyone but the wealthiest few.