The U.S. House of Representatives has advanced a plan to slash about $700 billion from Medicaid over the next ten years.  Not only would major cuts to Medicaid harm the health of New Yorkers, but they would also ravage healthcare providers and undermine the state’s economy.

Every consumer who uses our healthcare system, as well as every business that provides coverage to its workers, should be deeply concerned about the implications of Congress’ proposed funding cuts.

Medicaid provides healthcare to families with modest incomes, young adults who have aged off their parents’ insurance, people with disabilities and frail elderly individuals in long-term care. The program is administered by the states and jointly funded with the federal government.   With a price tag over $600 billion a year, it is expensive.  And that is why it is a primary budget target.

Over 6.9 million New Yorkers use Medicaid, including nearly 4 million New York City residents.  It covers 43 percent of the state’s children and 72 percent of nursing home care for the frail elderly and disabled. More than half of all births in the state are covered by Medicaid.

It is also the nation’s single largest payer for behavioral health services.  With federal support, New York’s expansion of Medicaid and other low-cost insurance options under the Affordable Care Act has brought our state uninsured rate below 5 percent.

Moreover, the need and utilization does not respect political boundaries.  Patients are spread throughout the state, in both red districts and blue ones, in cities, suburbs and rural areas.

If Congress follows through on the proposed cuts and reforms, the Congressional Budget Office estimates that 7.6 million Americans will lose Medicaid coverage over the next decade.  States like New York will lose billions in federal support.  That leaves a few bad options: reduce eligibility, cut benefits, or cut provider reimbursements.

Although many congressional Republicans have stated that they won’t support cuts to beneficiaries, any of these options will do just that.  It will simply shift blame to the states.  Aside from the direct hit to healthcare services, the ripple effect is lost wages, less money spent on consumer goods, other services, and housing.  Local governments will collect less in sales and property taxes.

Among the bill’s provisions is the implementation of work requirements.  However, according to the Congressional Budget Office, while effective in moving patients off the system, work requirements are ineffective in getting people employed.  Eighty-three percent are already working, in school full time or caring for a disabled family member.

Meanwhile, cutting provider reimbursements would have the same impact on enrollees as reducing benefits and eligibility – more uninsured patients mean reductions in services for everyone.  Those kicked off coverage will put off care until they are in crisis and much more expensive to treat, the cost of which will be borne by hospital charity care policies.

The newly uninsured will avoid preventive screenings and primary care, which eventually leads to higher health costs for employers and those remaining on Medicare.  Providers will be forced to shift more costs to commercial insurers, leading to higher premiums for all consumers.

New York’s Medicaid program isn’t perfect.  More robust oversight of Medicaid managed care plans, rigorous provider screening, and enhanced data mining could help to minimize waste, fraud, and abuse.  But what Congress is considering appears focused more on undoing the ACA’s Medicaid expansion and finding dollars to offset tax cuts than improving efficiency.  The massive scope of proposed cuts will gut the program, lead to job losses, a weaker economy, and poorer health outcomes for New Yorkers.

Four of New York’s House Republicans – Reps. Andrew Garbarino, Nick LaLota, Mike Lawler and Nicole Malliotakis — joined nine additional members of their caucus to write to their leadership in opposition to Medicaid cuts, a block big enough to impact whether a bill can pass.  We urge each of them to back up this message with their votes.  Protecting Medicaid matters to families, to the stability of the healthcare system we all use, and to our economy.

 

Wendy Darwell is President & CEO of the Suburban Hospital Alliance. Michael N. Romita is President & CEO of the Westchester County Association.