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Don’t put Medicaid on the chopping block

| February 23, 2020 2:00 AM

I serve on the board for Big Sky 55+, a nonprofit social welfare organization that seeks to provide a voice for Montanans 55 and older. Today I hope to draw support for Medicaid despite rumors looming of President Trump and Sen. Daines working to cut funding for the program.

President Trump’s 2021 budget blueprint reprises the same harmful proposals we’ve seen in previous budgets, doubling down on policies that cut healthcare and services for the people who need them most including low-wage earning seniors, seniors with disabilities, veterans and many others.

Although President Trump and Sen. Daines have repeatedly claimed that health-care access and affordability has improved under their leadership, the truth is that premiums have soared since Trump took office and the number of uninsured people has risen because of his actions, particularly changes to Medicaid.

Medicaid is essential to the well being of millions of families. More than 1 in 5 of us rely on Medicaid for our health insurance, from infants to seniors. Around half of all births in an average state are covered by Medicaid and 20% of seniors on Medicare also depend on Medicaid to help them pay for their premiums. In Montana alone, there are more than 100,000 people that depend on Medicaid for their health care in some way.

For over 50 years, Medicaid has provided vital health insurance protections to seniors in nursing homes and low-income Americans of all ages. Further, Medicaid has filled the gap in funding so that the Indian Health Services can offer more consistent care to those who have been promised health care under treaties agreed upon long ago. Medicaid and Medicare are especially important in Montana, which is aging at a faster rate than most of the other States in the Union. The 2010 U.S. Census showed that Montana’s 65 and older population was at 13.4% while the United States is at 12.1%.

Medicaid is one of the most successful health care programs in the nation’s history. People insured through Medicaid have health outcomes that are virtually indistinguishable from those with private insurance, but Medicaid is far more cost effective because there are fewer profit margins or CEO pay raises to support. Plus, with much lower administrative costs than private insurance, a greater percentage of every dollar goes for actual health care--not for endless paperwork.

Research shows that Medicaid saves lives. The expansion of Medicaid in some states under the Affordable Care Act saved the lives of at least 19,200 people between 2014 to 2017. In the states that chose not to expand Medicaid, however, 15,600 older adults died prematurely because they could not access health care.

The expansion of Medicaid under ACA has not only increased coverage in the states which have fully implemented the law, but has also brought needed resources to clinics and hospitals in rural and urban areas alike, providing a huge economic boon to states. Medicaid is the single largest source of federal funding to Montana.

The dramatic cuts to Medicaid in Trump’s budget proposal would put the health of many people at risk and would drain money from our state’s budget, forcing further cuts in programs and services.

And the budget isn’t our own worry: Trump’s administration recently proposed radically altering Medicaid by changing it into a block grant program that will potentially impact millions of people. While traditionally, Medicaid has covered all federally approved prescription drugs, this new proposal will allow states to limit access to prescription drugs for most conditions. The proposal would also allow states to dramatically increase costs to patients by raising co-pays and even eliminating benefits that Medicaid patients currently have.

Nor is Medicaid the only program on the chopping block. Trump and Daines are again including the repeal of the Affordable Care Act in the budget. That would take health care away from over 400,000 Montanans and roll back critical protections for people with pre-existing conditions so that insurance companies could go back to charging them more or denying them coverage.

Pre-existing conditions are common--over 400,000 in Montana have pre-existing conditions like high blood pressure, diabetes, asthma or depression. Without the ACA, even pregnancy and domestic violence can be treated as pre-existing conditions that allow insurance companies to charge more and refuse to pay for basic services.

President Trump repeated his support for pre-existing condition protections in the recent State of the Union speech while Sen. Daines applauded. He’s also repeatedly promised to protect Medicaid, Medicare and Social Security many times in the past, but those fake promises aren’t fooling anyone given a string of actions that would hurt millions.

Maybe Trump and Daines think no one will notice that these promises don’t match up with their actions, but they are underestimating the average American. When it comes to health care, most of us are paying close attention and will take action to stop him from taking away our healthcare.

—Elizabeth Marum is a board member of Big Sky 55+.