Submitted by: Traci Gleason | Vice President, External Relations at Proyecto de presupuesto de Missouri
Note: This morning (July 1st), the U.S. Senate passed the reconciliation bill, which includes the cuts to Medicaid described below as well as major cuts to the SNAP program. The bill is currently in the House of Representatives for a vote. You can find your Representative aquí to ask them to vote against the bill.
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Medicaid helps keep Missourians and their families healthy, so they can work, succeed in school, and contribute to their communities. But Congress is rushing through a plan that will take health care away from Missourians – and in doing so, will raise costs and put health care at risk for rural communities.
At the time of this writing, the Senate is debating its version of the bill. Senate Committees did not hold hearings about the bill’s wide-ranging proposals, and it has been changing in real time since its language was introduced.
There are still many moving parts, and the Medicaid provisions may change in some ways, but the story has been fundamentally the same at each step of this process.
Congress is on the cusp of making the deepest cuts to Medicaid ever, taking away health coverage from millions of people.
There’s been a lot of rhetoric suggesting that certain groups or people will somehow be protected from cuts, and that working folks or older adults or people with disabilities won’t lose their coverage.
But there is simply no way to make billions of dollars of cuts to Medicaid without causing massive coverage losses – and taking away health care from people who ARE working or who are exempt.
The bulk of coverage losses will come about because the bill creates mountains of new red tape and administrative obstacles so steep that eligible people lose coverage.
These new rules include things like requiring people to continually prove their work activities or reasons for exemptions, as well as requiring additional verifications of eligibility.
But we know that about 9 in 10 Missourians with Medicaid health coverage are already working, caregiving, in school, or would be eligible for an exemption. These requirements are just throwing up obstacles in the way of care.
And in every single state that has enacted rules like what’s being proposed federally, large numbers of workers or people who should be exempted have lost their health care.
Again, this is not because they aren’t meeting requirements – it’s because they can’t overcome the confusing rules and red tape that often the staff in charge of implementing don’t even fully understand.
Here in Missouri, those cuts would take health care away from 170,000 Missourians, including children, older adults, patients with serious health conditions and disabilities, veterans, and low-paid workers.
But we fear coverage losses could actually be much worse.
Missourians already struggle to get and keep Medicaid because our state enrollment and eligibility systems are overwhelmed. It takes much longer for our state to process applications, and Missourians routinely lose coverage for so-called “procedural reasons,” like accidentally leaving a space blank on a form, or a typo.
Folks trying to reach someone at the state’s call centers frequently face wait times of almost an hour – that is, if they don’t have to hang up the phone to go back to work, care for kids and seniors, or cook a meal.
New red tape would multiply these challenges, and our already-strained systems will simply not be able to keep up. That means every single Missourian who has or eventually needs Medicaid will be affected.
But the ripple effects extend even further. When people lose health insurance, they delay or skip care. Chronic health conditions get worse, or a cancer spreads. When an emergency forces them to seek treatment, it’s more expensive, and often uncompensated. When hospitals or health clinics have to absorb more uncompensated care, those costs are passed on to all of us through higher health care costs and insurance premiums.
These challenges will hit rural Missouri particularly hard. Medicaid means health insurance for many rural Missourians, but it’s also the backbone of the rural health system. Rural hospitals and health clinics often operate on very thin margins, and they rely on Medicaid payments to keep their doors open.
Cuts to Medicaid could force them to shut down altogether, leaving everyone in those communities without access to care, regardless of their insurance coverage.
Congressional efforts like a rural hospital fund are like putting a band-aid on a severed artery, and are wholly inadequate to address the problems created by Medicaid cuts.
Other provisions being debated could significantly reduce Missouri’s funding for Medicaid, forcing state legislators to cut services or eligibility as well, further harming Missourians.
Congress has been rushing to pass this deeply harmful reconciliation bill before the 4th of July. This arbitrary, self-imposed deadline means that changes are being made without hearings or a real understanding of how their constituents and communities would be affected.
Congress could still put the brakes on this speeding train and abandon this bill and these harmful changes.
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