
This Week, Protect Our Care Highlights the Importance of Medicaid Expansion As Part of the “Hands Off Medicaid” Campaign
As the Affordable Care Act nears its 15th anniversary this month, Donald Trump and Republicans in Congress have pledged to slash Medicaid funding by nearly $1 trillion, threatening to end Medicaid expansion in 40 states and the District of Columbia. Medicaid expansion is among the crowning achievements of the ACA, and Republican plans could rip away care from upwards of 21 million Americans who are covered through it, causing them to lose access to essential services such as nursing home care and prescription drug coverage. Many states would be unable to offer expanded Medicaid eligibility without federal funding and others would would face huge financial burdens and would be forced to seek alternative funding sources by raising taxes, cutting other parts of their budgets such as K-12 education, or making changes to Medicaid eligibility and benefits, leading to thousands of Americans losing essential health care.
Health care is on the GOP chopping block – whether it’s at the state level where Republican lawmakers in 10 states continue to refuse to expand Medicaid or in Congress where Republicans have released plan after plan after plan that would cut Medicaid expansion funding by billions. Trump has also promised to follow through on his plan to repeal the ACA entirely.
Protect Our Care is continuing its “Hands Off Medicaid” campaign with theme weeks to underscore the importance of Medicaid across the country. Alongside partners, lawmakers, and other advocates, Protect Our Care is working to defend Medicaid from the Republican-led plan to slash funding to pay for another round of tax cuts for the wealthy and big corporations. This week’s focus is the importance of Medicaid expansion. Read more here.
Medicaid Expansion Saves Lives, Lowers Costs, and Reduces Inequality
Every Year Thousands Of Lives Are Saved Thanks To The Access Medicaid Expansion Provides To Quality Health Care. According to the Center on Budget and Policy Priorities, Medicaid expansion saved the lives of 19,200 older adults aged 55 to 64 between 2014 and 2017. At the same time,15,600 older adults died prematurely as a result of their states’ decision not to expand the program. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in non-elderly adults by nearly four percent.
Cancer Is Detected Earlier And Treated Sooner In States Which Expanded Medicaid. Study after study has shown that Medicaid expansion has been proven to help detect, treat, and lower the risk of mortality of cancer when compared to non-expansion states. A September 2022 study found that states that expanded Medicaid were able to detect and treat patients with colon cancer earlier than those in non-expansion states. Similarly, a 2020 study found that patients with breast, colorectal, or lung cancers had a decreased mortality rate in states that have expanded Medicaid. Medicaid expansion has also been linked with increased rates of early cancer detection and reduced late stage cancer incidence. It is paramount that the 12 non-expansion states expand Medicaid to help the estimated 1.9 million Americans diagnosed with cancer in 2022.
Expanding Medicaid Not Only Increases Access To Care But Also Boosts Employment In States Which Have Adopted It. Reports from Ohio and Michigan found that Medicaid expansion helped enrollees hold down jobs and look for work. Relatedly, a study from the University of Kansas found that people with disabilities are much more likely to be employed in states that have expanded Medicaid coverage. Additionally, the number of people who report not working because of a disability declined in expansion states.
More Americans Are Able To Access Medical Services In States Which Have Expanded Medicaid, Leading To Better Diagnoses And Treatments. Medicaid expansion has helped patients access preventative care, including colon cancer screenings. Expansion also increased patient access to kidney transplants and made diabetes medication more affordable for low-income patients. The program was also tied to earlier diagnosis of colorectal cancer and reducing diabetes-related amputations.
Americans In States Which Have Expanded Medicaid Have Lower Medical Debt Than Those Who Don’t. Access to Medicaid means access to high quality coverage and extremely low cost sharing, without the premiums. As a result, Medicaid eliminates the types of medical costs that can lead to unpaid bills and medical debt. This also correlates to people requiring less assistance in other areas, with the adoption of expansion leading to thousands of fewer evictions annually in states according to a California study Over the past decade, research has shown the gap in medical debt between Medicaid expansion and holdout states has grown approximately 30 percent. In 2020, Americans living in holdout states carried an average of $375 more in medical debt than their counterparts in expansion states.
Access To Primary Care And Family Planning Is More Available To Americans In States Which Have Expanded Medicaid. Two studies from Michigan showed that Medicaid expansion doubled low-income patients’ access to primary care and enrollees experienced improved access to birth control and family planning.
Income Inequality Is Greater In States Which Have Refused To Expand Medicaid Compared To Those Which Have. A January 2021 study found that the ACA helped reduce income inequality across the board, but much more dramatically in Medicaid expansion states. The bottom 10th percentile of earners In Medicaid expansion states saw a 22.4 percent boost in their income, compared to 11.4 percent in non-expansion states. A study in Health Affairs found that Medicaid Expansion also caused a “significant” reduction in poverty.
What’s At Risk if Republicans Succeed in Gutting Medicaid Expansion
Around 4 Million Americans Could Have Their Insurance Taken Away Immediately After Republicans Sign Medicaid Expansion Cuts Into Law. Currently there are 12 states which have a trigger law in regards to funding for Medicaid Expansion. If Republicans succeed in their plans to gut the program this will mean these states will immediately halt the program, and rip away health care from around 4 million people.
Uninsurance Rates For Children Could Potentially Double If Republicans End Medicaid Expansion. Nationally, 54 percent of American children are covered by Medicaid/CHIP, and child uninsurance rates are nearly twice as high in states which have refused to expand Medicaid. Slashing Medicaid expansion funding would see many of these children become ineligible for low-cost health insurance with no pathway to finding affordable health care.
Over 2 Million Seniors Could See Their Access To Health Care At Risk. When states are forced to cut costs, they could reduce income eligibility levels for seniors leading many to lose their coverage. The ACA’s Medicaid expansion covers 21 million people, including many older adults not yet eligible for Medicare. Eliminating the expansion would leave these seniors with few options to turn to, potentially causing them to lose their coverage entirely.
Millions of Mothers in 47 States Could Lose Extended Postpartum Coverage. With one in three pregnancy-related deaths occurring between six weeks and one year after birth, expanding postpartum coverage is an essential step toward solving our country’s maternal mortality crisis. As of September 2023, 47 states and the District of Columbia have expanded or are planning to expand full Medicaid coverage for 12 months postpartum. Three states have yet to expand postpartum care, leading to dire circumstances for birthing people further exacerbating the already existing crises of care in the states. Republican attempts to slash Medicaid will lead to national maternal mortality rates more similar to Arkansas, which has the highest maternal mortality rate in the country and the overall number of deaths per 100,000 live births has more than doubled in the past twenty years, than it would any other developed nation.
Rural Americans and the Hospitals They Go To Would Be Left Behind By Republicans Working To Make The Rich Richer. If Republicans cut Medicaid expansion, rural hospitals across the country will be at risk. Nearly 14 million Medicaid enrollees reside in rural areas. Medicaid helps fund rural hospitals, which employ six percent of all employees in rural counties that report having any hospital employment. Rural hospitals in Medicaid expansion states are 62 percent less likely to close. Nearly 750 rural hospitals are currently at risk of closure, hundreds of which are in non-expansion states. From 2010 to 2022, over 130 rural hospitals have closed.
Medicaid’s Assistance For Those With Substance Use Disorders Would Substantially Diminish. Nationally, around 12 percent of Medicaid enrollees over 18 have some kind of substance use disorder (SUD). Medicaid expansion is crucial to building a system of comprehensive substance use care, investing billions annually into substance use disorder treatment making it the primary government program on the front lines of the opioid epidemic. After expanding Medicaid in 2014, Kentucky saw a 700 percent increase in enrollees using SUD treatment services and across the board expanding Medicaid has seen medication-assisted treatment increase by 50 percent. The uninsurance rate for those experiencing opioid-related hospitalizations also fell by 78.4 percent in states after they adopted Medicaid expansion. These interventions have been vital and life saving, with one study finding that around 10,000 lives were saved from fatal opioid overdoses as a direct result of Medicaid expansion alone. Cutting Medicaid, put simply, would increase overdoses and decrease treatment options for thousands of Americans.