The changes to Medicaid funding recently proposed by Republicans could have serious consequences for vulnerable populations and state budgets alike, the leaders of five national advocacy organizations said on a press call Wednesday.
Howard Bedlin, the National Council on Aging’s vice president of public policy and advocacy, said he was “shocked” that such major changes to Medicaid were included at all in the GOP’s outline of policy proposals about how to replace the Affordable Care Act, given both are separate issues.
Regardless, the two Medicaid funding options floated by the GOP—block grants and per capita caps—“would lead to unprecedented cuts in Medicaid spending,” he said.
Thus, he and the other leaders on the call said they planned to urge governors attending the National Governor’s Association Winter Meeting to push Congress to reconsider the cuts.
If such policies are enacted, governors will face a “Sophie’s choice” of whether to cut services to the elderly, children or people with disabilities, said Donna Meltzer, CEO of the National Association of Councils on Developmental Disabilities.
“There will be waiting lists again," she said, because there simply won't be enough funding to go around.
Carter Steger, vice president of state and local campaigns for the American Cancer Society Cancer Action Network, said her organization has “serious concerns” about how potential Medicaid funding changes could impact cancer patients and survivors who depend on the program. Insurance coverage is critical for cancer patients, she said, and if Medicaid funding cuts leave more people uninsured or underinsured, there could be "disastrous" consequences.
In addition, Steger said block grants for Medicaid would leave state budgets vulnerable in the event of a public health emergency like the Zika virus or an economic downturn.
One reason some governors might like the GOP’s proposals would be that they promise to give them more flexibility, Bedlin said. As the Republicans’ plan stated (PDF): “Instead of burdening states with more mandates from Washington bureaucrats, our plan empowers states to design plans that will best meet their needs and put Medicaid on sustainable financial footing.”
“But we need to ask, flexibility to do what that they don’t do now?” Bedlin added. The answer, he said, could be introducing new work requirements to qualify for Medicaid, more cost-sharing burdens on beneficiaries or the repeal of certain consumer protections.
Children could be particularly vulnerable to potential Medicaid funding cuts, according to other leaders on the call. Sasha Pudelski, assistant director of policy and advocacy of AASA, The School Superintendents Association, noted that schools receive $4 billion each year from the Medicaid program to aid children with disabilities and provide a range of diagnostic screening services—funds that could be in jeopardy with the GOP’s proposals.
And Bruce Lesley, president of the group First Focus, pointed out that Medicaid and CHIP are responsible for drastically lowering the number of uninsured children.
“We believe Congress should not gamble with the health of children,” he said.