The Feminist Majority strongly supports Medicaid and its Expansion under the Affordable Care Act and the Children’s Health Insurance Program. Medicaid and CHIP are critical health care programs which provide health care for over 73.6 million Americans according to the May 2018 Medicaid report, including a large portion of all nursing home and long-term care expenses.
Only about a third of all Medicaid dollars go to low-income dependent children and their parents, and low-income pregnant women. The remainder, nearly two-thirds of all Medicaid expenditures go to people with disabilities and the elderly. The Medicaid Expansion provided, if their state approves of the Medicaid expansion, for the first time coverage to low income individuals (138% of the federal poverty rate or $16,753 for an individual in 2018) not just pregnant women, the elderly and the disabled. Under the ACA, over 16 million poor adults became eligible for basic health care. The expansion to low-income abled body adults has already reduced the mortality rate. Most low-income adults are working but have no employer coverage and prior to the ACA could not afford health insurance coverage because of their low income. Remember the federal minimum wage of $7.25 is about $15,000 a year.
Medicaid is jointly funded by the federal and state governments. Overall the federal government pays a minimum of 50% and nearly 75% to poorer states. The federal government paid for 100% of the Medicaid expansion initially. It is schedule to pay 94% of expansion in 2018 and 90% in 2020. In the long run Medicaid saves money for federal and state governments by reducing the amount of more expensive emergency coverage and by providing other longer term benefits to the nation’s health and workforce.
Feminist Majority opposed the Ryan budget, passed by the U.S. House of Representatives in March 2012, which would turn over the Medicaid program to the individual states by block-granting a set amount of federal dollars to each state and supply grants that would not cover the need. Experts say this action would inevitably result in deep cuts to the program as the cost of care rises and states are unable or unwilling to pay those increased costs. An estimated 44,000 elderly would almost immediately lose coverage of their nursing home care, and many long-term care facilities would close their doors as well as rural and other hospital facilities.
The Republican House budget of 2018 and 2019 would also block grant Medicaid funds and cut massively the funds provided to the states and limit or cap annual payments to individuals despite their need. It would also install work requirements for some recipients. The Trump administration, through executive action, is implementing work requirements for individuals receiving funds by issuing waivers to states that allow them to establish such work requirements.
The Feminist majority opposes the 2018 and 2019 Trump Administration budget that models the House cuts in Medicaid. The Trump budgets for this and other reasons have been largely dead upon arrival in the Congress.
The House cuts to Medicaid have little or no chance of passing because of lack of votes in the Senate but show the priorities of the Republican Leadership.
A federal judge on August 10, 2018 ruled that Kentucky cannot require some Medicaid recipients to get jobs or lose Medicaid. Some 12 states have requested waivers for installing work requirements for Medicaid and were granted them by the Trump Administration. Kentucky was the first state to implement the work mandate for some (working age, non-disabled person without dependents) Medicaid recipients.