Medicaid Messaging
The short-term funding bill only deals with discretionary spending and won't affect spending levels for Social Security, Medicare, and Medicaid, according to GOP leadership aides.But in the GOP's separate budget reconciliation package, lawmakers have instructed the Energy and Commerce Committee to cut some $880 billion, which will be very difficult to do if they don't touch Medicaid.
The bottom line: It was unclear if Friday's Democratic demands on Medicaid apply to the CR or the bigger tax and spending package that has yet to fully take shape. But both House leaders are signaling to their rank-and-file that they expect party loyalty on next week's vote.
Dr. N. Adam Brown at MedPage Today:Medicaid serves lower-income adults, children, pregnant women, and people with disabilities, as well as dually-enrolled Medicare-Medicaid older adults. Despite the talking point that people on Medicaid "don't work," 92% of adults under 65 who are on Medicaid and don't receive other social security benefits work full or part-time.
While 80 million Americans are insured through Medicaid, many people don't think of themselves as "on Medicaid" -- even when they are.
Why? Because Medicaid is not branded as Medicaid in most states. If you tell a patient in South Carolina they might lose Medicaid, their eyes may glaze over. Tell them Healthy Connections is at risk? You have their attention. In Tennessee, Medicaid is TennCare and in Ohio it is the Buckeye Health Plan. In Florida, Medicaid sounds like an orange juice brand: Simply Healthcare. (Seriously, it feels like that moniker should have an exclamation point behind it.)
Adding to the confusion, many states offer Medicaid coverage contracted through private companies. These types of plans are state-funded, private insurance-branded programs (called managed care organizations) often featuring actual private insurance logos, a fact that further distances them from their federally funded origin. No wonder Tennesseans shrug when we talk about Medicaid recipients. They don't think, or even know, they are one. And if they do not know the issue applies to them, they may be less likely to oppose cuts.
In every state, we need to call Medicaid by its real name.
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This is why healthcare advocates need to translate the impact of cuts at the individual, family, and community level. Instead of saying "Republicans want to reduce Medicaid by $880 billion" try, "If Republicans' Medicaid plans come to fruition, you could lose your Buckeye Health Plan health insurance." Or try explaining how these cuts could erode their child's access to care. Nearly half of U.S. children rely on Medicaid and 40% of all births are covered by Medicaid. Cutting the program would destabilize pediatric practices, many of which already operate on thin margins. If parents think they already have to wait too long to get a well-child visit, just wait until these cuts take effect.
