EPIC Charge & Response: Medicaid Reform

Medicaid has been a focal point of the ongoing reconciliation process. These are some of the most common arguments put forward by opponents of Medicaid reform, along with responses that can help inform the public about why change is necessary.   CHARGE: Medicaid savings represent “deep cuts” or a “slashing” of spending. RESPONSE: Medicaid spending is growing so rapidly that even if Congress saves $625 billion over the next 10 fiscal years, Medicaid would still grow by at least 3% per year. Only in Washington is it a “cut” for a program to grow slightly slower.   CHARGE: Changes to Medicaid would close medical providers, including rural hospitals. RESPONSE: In addition to Medicaid growing 3% per year if Congress passes reforms, overall federal health spending would increase roughly 5% per year. Medical providers would not be struggling due to a lack of federal spending on healthcare.   CHARGE: Changes to Medicaid will hurt children, the disabled, and pregnant women. RESPONSE: In fact, it was Obamacare’s dramatic expansion of Medicaid eligibility and preferential funding of healthy working-age adults that has put vulnerable groups at a disadvantage. Reforming Medicaid would provide an opportunity to refocus the program on those who need it most.   CHARGE: To support the working class, Congress should oppose Medicaid changes. RESPONSE 1: One of the core Medicaid reforms under discussion is work requirements for healthy adults, which is perfectly in line with the values of working-class Americans. RESPONSE 2: Unless Congress reins in the unsustainable, debt-fueled spending growth of programs such as Medicaid, working-class Americans will face a bleak future with higher taxes, fewer job prospects, and slower wage growth.   CHARGE: Changes to Medicaid would push millions of people out of the program. RESPONSE 1: Not everyone deserves Medicaid benefits. Illegal immigrants and healthy adults who choose not to work should not be on Medicaid. Also, Medicaid is rife with improper payments, and part of reducing improper payments includes finding and removing ineligible people. These three groups represent the entirety of those currently on Medicaid who would leave it due to proposed reforms. RESPONSE 2: Many who would leave Medicaid would be eligible for subsidized coverage through health insurance exchanges or would receive coverage through an employer. RESPONSE 3: It is unhealthy for nearly 1/4th of Americans to be on the Medicaid dole.   CHARGE: States can't afford to have Congress adjust Medicaid subsidy rules. RESPONSE 1: Some states are abusing Medicaid to fund benefits for illegal immigrants and healthy adults who choose not to work, at the behest of special interests who profit from the extra spending. This is not a legitimate public interest. RESPONSE 2: The federal government giving states dramatically larger Medicaid subsidies for healthy adults than for pregnant women or the disabled flips the program on its head. It would not be unfair for Congress to balance the scales. RESPONSE 3: The federal government has a worse financial position than any state, and Medicaid subsidies do not give state governments access to “free” money.