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Washington DC — Yesterday, Representative Kevin Brady (R-TX) and Senator Mike Crapo (R-ID) sent a letter in opposition of the Biden administration’s efforts to fix the “family glitch” and expand affordable health coverage to millions of working families. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“Republicans’ opposition to fixing family glitch and other common sense, popular policies shows they don’t care about helping American families. While offering zero solutions to lower people’s cost of living, Republican lawmakers are simply restating their opposition to the ACA and its protections for millions of Americans. The truth is every Republican voted against the American Rescue Plan, which delivered lower premiums for millions, and they continue to block Medicare negotiation, insulin cost caps, and expanded access to affordable coverage. If the GOP gets their way, it means you pay more and you get less — greater premiums, higher prescription drug prices, and worse care at the doctor’s office.”

Throughout Medicaid Awareness Month, Protect Our Care has released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats. This week, Protect Our Care is examining the role Medicaid plays in reducing disparities and improving health care outcomes for some of our nation’s most vulnerable populations, including communities of color, people living with disabilities, seniors and older adults, women, children, and rural Americans.

Medicaid expansion has been instrumental in providing health care to America’s rural populations. Thanks to the Affordable Care Act and President Biden’s transformative American Rescue Plan, nearly 14 million Americans living in rural communities have received increased access to care and health services. Medicaid expansion has resulted in healthier people, communities and economies. 

A Closer Look At Medicaid Expansion For Rural Americans

The Affordable Care Act’s (ACA) Medicaid expansion has been a critical part of our response to the coronavirus, but Republicans in 12 states have not yet implemented the program, blocking millions from coverage and access to essential health care. Holdout states are located in the southern and midwest regions with significant rural populations with  60 million Americans residing in these areas.

By signing the American Rescue Plan into law, President Biden created historic legislation that includes the most significant health care expansion in a decade. The American Rescue Plan provided additional financial incentives for the 12 states that had not yet implemented Medicaid expansion. Since the signage of the ARP, two previous holdout states, Missouri and Oklahoma, have adopted Medicaid, expanding coverage to nearly 500,000 Americans. These measures will have profound impacts on children and their families for years to come. 

By The Numbers

• Millions Of Rural Americans Depend On Medicaid. Nearly 14 million Medicaid enrollees reside in rural areas, with an estimated 1.7 million gaining coverage through ACA expansion in 2015.

• Rural States Need Medicaid. There are 7.8 million uninsured Americans living in rural areas. Non-expansion states are disproportionately rural with over 4 million Americans eligible for Affordable Care Act premium tax credits.

• Rural Hospitals Rely On Medicaid. Since 2010, 138 rural hospitals have closed, including 20 closures in 2020 alone. One in four rural hospitals face closure without more federal funding in 2022. Rural hospitals in Medicaid expansion states are 62 percent less likely to close.

• Medicaid Strengthens Health In Rural America. Overall, rural residents have worse health outcomes and tend to be older, poorer, and sicker than those in urban areas. 
• Rural Hospitals Strengthen Local Economies. Hospitals employ six percent of all employees in rural counties that report having any hospital employment, and 41 percent of counties with hospital employment rely on hospitals for more than 10 percent of total county employment. 673 rural hospitals are at risk of closing, and estimated that if those hospitals shut down, 99,000 health care jobs in rural communities would be lost.

How Medicaid Expansion Helps Rural Americans

Nearly 14 million Medicaid enrollees reside in rural areas, with an estimated 1.7 million gaining coverage through ACA expansion in 2015. Health care for rural Americans is especially important due to higher prevalence of pre-existing conditions and barriers to accessing health care. The success of Medicaid expansion across the country demonstrates the need for the 12 holdout states to finally adopt expansion.

There are 7.8 million uninsured Americans living in rural areas. Non-expansion states are disproportionately rural with over 4 million Americans eligible for Affordable Care Act premium tax credits, including 2.2 million uninsured individuals stuck in the Medicaid coverage gap.

Medicaid Expansion Saves Lives. Medicaid expansion has been proven to increase access to care, improve financial security, and save lives. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in people aged 20 to 64 by 3.6 percent. Medicaid expansion also saved the lives of 424 individuals in high rural states, Alaska and West Virginia between 2014 and 2017.

Medicaid Expansion Reduces Income Inequality And Medical Debt. Medicaid expansion under the ACA significantly reduced poverty and income inequality across the board. In states that have expanded Medicaid, the likelihood of falling into medical debt is 20 percent lower than in non-expansion states. Additionally, a 2018 National Bureau of Economic Research analysis found that Medicaid expansion led to a nearly $6 billion decline in unpaid medical bills and to higher credit scores. 

Medicaid Expansion Plays A Central Role In Fighting The Opioid Crisis. In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide. Among those with opioid addiction, people covered through Medicaid are more than twice as likely as those with private insurance or no insurance to receive treatment. Medicaid expansion covers an estimated four in ten people with an opioid use disorder. Recent research finds that Medicaid expansion reduced the unmet need for substance use treatment by 18.3 percent. 

Medicaid Expansion Is A Lifeline For Rural Hospitals

In states that haven’t expanded Medicaid, rural hospitals are drowning under financial pressure. 

Low occupancy rates, high levels of uncompensated care, competition with other hospitals, and struggling local economies create a financial burden that rural hospitals face all over the country. Since 2010, 138 rural hospitals have closed, including 20 closures in 2020 alone. One in four rural hospitals face closure without more federal funding in 2022. 

Medicaid Helps Rural Hospitals Stay Open. Rural hospitals in Medicaid expansion states are 62 percent less likely to close. The two most common types of supplemental Medicaid payments are disproportionate share hospital payments, that pay hospitals for uncompensated care for Medicaid and uninsured patients, and upper limit payments, which supplement the gap between fee-for-service Medicaid base payments and the amount that Medicare covers. Some states are also testing the use of global hospital budgets to increase care and improve health outcomes in rural hospitals.

Closure Of Specialized Care And Obstetrical Services. Some hospitals opt to close specific services or facilities that cause patients in rural areas to have to travel further for specialized care. On average, when a rural hospital closes patients have to travel over 20 miles further to access inpatient or emergency care. A 2021 study found that fewer than half of all rural counties in the United States had hospital-based obstetric care. When hospitals face financial hardship, obstetric services are among the first to be cut. African American and Native American women in rural areas are particularly at risk. African American and Native American women are two to three times more likely to die from pregnancy-related causes than white women.

Medicaid Expansion Boosts State Budgets. Medicaid expansion generates enough savings that it is well worth the initial cost, eventually helping boost states budgets. Expansion allows states to access federally matched funds for some people covered by traditional Medicaid. The American Rescue Plan provides states with additional funding from the federal government. From 2022 to 2025, the 12 states that haven’t expanded Medicaid yet would gain $90 billion in federal matching funds in addition to $17.6 billion in ARP bonus payments and $6.6 billion from higher state and local tax revenue.

Rural Hospitals Are Large Employers In Their Communities. For rural areas that often have high unemployment rates, hospitals contribute significantly to local economies by employing large numbers of people with relatively high-paying jobs.

Beyond just being a source of jobs, hospitals tend to pay higher wages than other rural industries. As the House of Representatives Minority Staff report on rural hospitals highlights, “The average pay of hospital employees in rural counties is 43 percent higher than the average pay of other workers in the same counties.”  As Mark Holmes, the director of the Rural Health Research Program at the University of North Carolina, emphasizes, hospital closures in rural communities can be like losing a factory: “Losing an employer of 150 people with good jobs is like losing a manufacturing plant…Hospitals are usually the largest, or the second-largest, employer in a community. That’s something that’s easy to lose sight of because we think of this from a health standpoint. But the effects are wide-ranging when a hospital closes.”

Rural Hospitals Boost Local Economies. Besides hospitals providing higher paying jobs in the health care sector, rural hospitals also stimulate the local economies of other industries. Hospitals purchase goods or services from local private businesses which helps stabilize and reinforces the local economy. In turn, strong private sector employment allows for more tax dollars for public goods, such as education and safety services.

U.S. Representative Chris Pappas (D-NH-01), State Lawmakers, and Health Care Advocates Called for Protecting and Strengthening Medicaid Coverage for Millions

April is Medicaid Awareness Month, and there has never been a more urgent time to highlight Medicaid’s overwhelming importance for millions of Americans in communities across the nation. Medicaid has served as a lifeline for the past two years, providing nearly 79 million Americans with access to high-quality, affordable care when they need it most. 

In the final week of Medicaid Awareness Month, Protect Our Care examined the role Medicaid plays in reducing disparities and improving health care outcomes for some of our nation’s most vulnerable populations, including communities of color, people living with disabilities, seniors and older adults, women, rural Americans, and children.

Nearly one in four Americans is now covered by Medicaid, making it a pillar of the American health care system. Still, there is more work to be done. Between closing the Medicaid coverage gap and ensuring American families can continue to access affordable coverage, lawmakers must prioritize protecting and strengthening this vital program for years to come. 

Throughout the month, Protect Our Care released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats. 

A look back at Medicaid Awareness Month 2022 themed weeks:

• Week 1: Medicaid is Working! Week one focused on how Medicaid has improved the lives of millions even amid the COVID-19 pandemic. 
• Week 2: Close the Coverage Gap. Week two brought attention to the urgent need to close the Medicaid coverage gap. 
• Week 3: Protect Medicaid Coverage. Week three focused on how millions of Americans face losing their Medicaid coverage coverage when the COVID-19 public health emergency ends and how Republican officials across the country are waging a relentless war on Medicaid. 
• Week 4: Medicaid & Health Equity. The final week highlighted how Medicaid is our most powerful tool in fighting for health equity. 

ARIZONA

On Friday, April 22, Arizona’s health care experts and advocates joined Protect Our Care Arizona for an event highlighting how Medicaid has provided Arizonans with access to quality, affordable health care, strengthened local economies, and improved health outcomes across the state. “The provisions under the National Public Health Emergency that were in place due to COVID, that actually froze Medicaid disenrollment across the country– meaning that people wouldn’t be dropped during this period of a public health emergency, that’s all at risk right now,” said Carmen Heredia, CEO of Valle del Sol. You can watch the event here.

COVERAGE:

• KJZZ (NPR): Half a million Arizonans at risk of losing Medicaid coverage

GEORGIA

On Thursday, April 28, State Representative Rebecca Mitchell and advocates joined Protect Our Care Georgia to highlight the critical role Medicaid plays in providing Georgia’s women and mothers with access to quality, affordable health care, and urge Republican lawmakers to finally expand Medicaid and close the coverage gap in Georgia. “We know that Medicaid is a lifeline for Georgians and is an integral part of the fabric of our communities,” said State Representative Rebecca Mitchell. “But despite this, we’re seeing Georgia’s Republican leadership put politics over the health and well-being of Georgians, and refuse to fully expand Medicaid. The bottom line is Medicaid expansion is the right thing to do and is long overdue.“ You can watch the event here.

NEW HAMPSHIRE

On Wednesday, April 27, U.S. Representative Chris Pappas (D-NH-01) joined public health experts and Protect Our Care NH to highlight how Medicaid has provided Granite Staters with access to quality, affordable health care, strengthened local economies, and improved health outcomes across the state. “Nothing is more important to the folks I meet than making sure that they and their families have access to quality, affordable health care, and can access affordable prescriptions that aren’t going to break the bank,” said Congressman Pappas. “We’ve got more work to do on this issue in Washington, but I think it’s important to recognize the foresight that folks had in New Hampshire in expanding Medicaid, and making sure that more individuals in our state have access to the kind of coverage that would really be life-changing, and life-saving for tens of thousands of individuals.” You can watch the event here.

COVERAGE:

• The Tip Sheet: Roundtable Highlights Success of Medicaid in NH

OHIO

On Thursday, April 14, Protect Our Care Ohio was joined by State Senator Tina Maharath and State Representative Thomas West to discuss the importance of protecting and strengthening Medicaid. Speakers also addressed the State of Ohio’s concerning approach to determining Medicaid eligibility when the federal COVID-19 public health emergency order ends. “Having health insurance through Medicaid helps Ohioans stay healthy, get to work, care for our families, and it helps alleviate the decision of paying for medical expenses or putting food on the table,” said State Senator Tina Maharath. “Medicaid has served as a lifeline during the pandemic. It has helped ensure access to quality health coverage for Ohioans, and we have to keep that coverage going and make sure Ohioans continue to have health insurance.” You can watch the event here.

COVERAGE:

• Statehouse News Bureau: Democrats warn many Medicaid recipients in Ohio could lose coverage soon
• Gongwer: Health Emergency Extended, Leaders Urge Caution In Medicaid Redetermination
• Columbus Dispatch: More than 400,000 Ohioans at risk of losing Medicaid coverage this summer as COVID emergency ends
• Ohio Capital Journal: As pandemic ebbs, fears grow that Ohioans will be improperly forced off of Medicaid

WISCONSIN

On Thursday, April 21, State Representatives Greta Neubauer (Racine) and Kristina Shelton (Green Bay) joined Protect Our Care and Peggy M., from Tomahawk, to discuss the critical role Medicaid plays in providing Wisconsinites with access to quality, affordable health care, and urge Republican lawmakers to finally accept the federal expansion of Medicaid available under the Affordable Care Act. “Across Wisconsin, there are many stories of folks who are facing unimaginable choices when it comes to their health,” said State Rep. Neubauer. “This session, the Republican-controlled legislature missed numerous opportunities to expand Medicaid for our fellow Wisconsinites. Despite public support and federal incentives, Republicans continued to ignore the calls to expand Medicaid.” You can watch the event here.

***MEDIA ADVISORY FOR WEDNESDAY, APRIL 27 AT 10:00 AM ET***

Medicaid Is More Important Than Ever Before. Lawmakers Must Work To Strengthen the Program and Ensure Access to Quality, Affordable Care.

Manchester, NH — Today, April 27, 2022 at 10:00 AM ET, U.S. Representative Chris Pappas (D-NH-01) will join Granite State Progress and Protect Our Care New Hampshire during Medicaid Awareness Month to highlight how Medicaid expansion has provided Granite Staters with access to quality, affordable health care, strengthened local economies, and improved health outcomes across New Hampshire.

Medicaid has served as a lifeline during the pandemic, providing health coverage to a record number of Americans at a time they need it most. While the federal COVID-19 public health emergency order was extended, preventing vulnerable Granite Staters from falling off of Medicaid, speakers will discuss opportunities for lawmakers to strengthen Medicaid, and ensure ongoing access to care.

VIRTUAL PRESS CONFERENCE:

WHO:
Rep. Chris Pappas (D-NH-01)
Sandra Pratt, Bilingual Service Coordinator at Gateways
Tom Cochran Executive Director Laconia Housing
Zandra Rice-Hawkins, Granite State Progress
Protect Our Care NH

WHAT: Virtual Press Conference

WHERE: Register for the Event Here

WHEN: Wednesday, April 27, 2022 at 10:00 AM ET

Washington, D.C. – Today, Protect Our Care is kicking off the final week of Medicaid Awareness Month, which examines the critical role Medicaid has played in reducing disparities in health coverage and improving overall health outcomes for vulnerable communities. Research confirms that Medicaid expansion saves lives and drastically reduces racial health disparities. States that expanded their Medicaid programs saw a 51 percent reduction in the gap between uninsured white and Black adults after expansion, and a 45 percent reduction between white and Hispanic adults. Medicaid expansion is the single most important step Congress can take to reduce harmful inequities in our health care system, particularly for communities of color.

“Medicaid has played a vital role in improving equity in health insurance coverage and access to care. The program has increased coverage rates, reduced poverty and inequality, and boosted financial security for communities of color,” said Protect Our Care Executive Director Brad Woodhouse. “Democrats have worked hard to strengthen the program, which has resulted in record enrollment at a time it was needed most. President Biden and his allies in Congress are working hard to protect Medicaid for generations to come. Their success in the face of Republican sabotage speaks to the program’s success— Medicaid is stronger than ever.” 

Throughout the month, Protect Our Care released fact sheets and hosted nationwide events with elected officials, storytellers, and health care advocates to highlight Medicaid’s critical role in America, discuss what needs to be done to expand and strengthen the program, and raise awareness of the consequences of Republican threats.

Medicaid Awareness Month 2022 theme weeks:

• Week 1: Medicaid is Working! Week one focused on how Medicaid has improved the lives of millions even amid the COVID-19 pandemic. 
• Week 2: Close the Coverage Gap. Week two is bringing attention to the urgent need to close the Medicaid coverage gap. 
• Week 3: Protect Medicaid Coverage. Week three will focus on how millions of Americans face losing their Medicaid coverage coverage when the COVID-19 public health emergency ends and how Republican officials across the country are waging a relentless war on Medicaid. 
• Week 4: Medicaid & Health Equity. The final week will highlight how Medicaid is our most powerful tool in fighting for health equity. 

FACT SHEET: Medicaid Works For Communities Of Color

Generations of structural racism have resulted in people of color experiencing lower rates of coverage, worst health outcomes, and staggering health inequities. As a result, Medicaid coverage remains a critical source of coverage, especially for Black, Hispanic, and Latino Americans who experience poverty at a higher rate than white Americans and remain less likely to have access to quality care. These groups also face higher rates of chronic conditions that make access to affordable health coverage even more essential. 

Read the full fact sheet here.

Today, President Biden is attending an event in Seattle to discuss the importance of giving Medicare the power to negotiate prescription drug prices. Recent coverage and opinion pieces confirm that the American people are counting on Congress to pass legislation to drive down prescription drug prices. Giving Medicare the power to negotiate is overwhelmingly popular among voters, as it would drive down prices at the pharmacy counter and deliver long overdue relief to working families. 

“President Biden is making clear that Democrats will deliver lower prescription drug prices,” said Protect Our Care Executive Director Brad Woodhouse. “Americans are sick and tired of choosing between paying the bills and affording the medications they need to survive. Congress must work quickly to meet the demands of American families and finally give Medicare the power to negotiate for lower drug prices. The President’s commitment to delivering lower costs for the American people is unwavering, and today’s event makes clear he won’t rest until he gets this done.”  

RECENT HEADLINES

HuffPost: This Piece Of ‘Build Back Better’ Is Still A Political No Brainer. “Under the terms of the deal, Medicare would finally have some power to negotiate drug prices with manufacturers. There would also be “inflation caps” ― financial penalties on manufacturers that raise prices substantially from year to year. People with insurance would pay no more than $35 a month for insulin, and Medicare beneficiaries would finally have a hard limit ($2,000) on their out-of-pocket drug costs.” [HuffPost, 4/20/22]

The Hill: Opinion: Congress Must Pass Comprehensive Drug Pricing Reforms That Include Medicare Negotiation. “Right now, the Senate could follow the House of Representatives’ lead and pass the comprehensive reforms to deliver relief to all Americans with high drug prices. These historic reforms already have the necessary support to pass in the Senate – a clear path through reconciliation. But the Senate is dragging its feet on reconciliation, instead focusing on passing just one component of the broad package: capping monthly insulin copays. Meanwhile, Rep. Wild and her colleagues in the House have now passed the insulin provision twice — once in the comprehensive package last Fall and again last week as standalone legislation.” [The Hill, 4/8/22]

(AZ) AZ Mirror: Covid-19 Is Causing More Type 1 Diabetes In Kids, Who Will Be Saddled With High Insulin Prices — Unless Congress Acts. ”In America, around 1 in 4 diabetics have rationed their insulin due to high costs. With nearly 60% of Americans under 17 having been infected with COVID-19, some of them may develop type 1 diabetes. It is more important than ever to do something about insulin prices. By lowering the price of insulin and passing other federal prescription drug reforms, we can help existing diabetics and prevent newly diagnosed diabetics, especially kids, from being forced to ration life-saving medication.” [AZ Mirror, 4/11/22] 

(KS) Kansas City Star: Kansas Seniors Like Me Have To Choose: My Medication Or My Mortgage? There Is A Fix. “I had eagerly anticipated the day I’d qualify for Medicare, believing I’d finally be able to afford my prescriptions. But to my surprise, the out-of-pocket cost of my medication was $3,000 a month. The price left me with few options: Skip my medication, seek donations or sacrifice my entire net worth to purchase the prescription. These should not be the only options in the American health care system. But President Joe Biden does have a solution that more than 80% of Americans agree with: Allow Medicare to negotiate drug costs and cap out-of-pocket spending on prescriptions at $2,000 a year. This would change my life. I wouldn’t have to choose between my mortgage or my medication.“ [Kansas City Star, 4/20/22] 

(NV) Las Vegas Sun: Why I Turn To Mexico To Buy My Medications. “President Joe Biden has proposed an economic agenda that would allow Medicare to negotiate the cost of prescription drugs, limit the ability of drug companies to hike prices on life-sustaining medications, and cap insulin copays at $35 per month. The House has passed the Affordable Insulin Now Act but the Senate has not. We can’t let this issue fall by the wayside. These reforms would make my daily life much less stressful. Do you know what it is like to get up and spend an extra $1,500 a month just to stay alive? I often think of all the things I could have invested in to better my life if not for the financial weight of drug costs holding me down. If my costs are reduced, I can finally begin to spend my money on other things I’ve been dreaming of, like a mortgage for my own house.” [Las Vegas Sun, 4/17/22] 

(NV) Nevada Current: Senate Dems Turn To Prescription Drug Reform Bill, But Will Need GOP Support. “U.S. Sen. Catherine Cortez Masto is optimistic the Senate could soon hear legislation on capping insulin costs and reigning in prescription drug prices, she said in Las Vegas Monday…’We should all be working to do it together,’ Cortez Masto said. ‘Nobody should be saying, ‘this doesn’t make sense.’ We all know this needs to be done. I don’t care if you’re a Republican or Democrat or independent. The focus is on lowering the costs for families and we should be doing it.’” [Nevada Current, 4/19/22] 

(PA) The Morning Call: Your View By Monroe County Kidney Donor: Give Medicare Power To Negotiate Prescription Drug Prices. “Prescription drugs don’t work if people can’t afford them. As someone who is affected by the shockingly high cost of prescription drugs that is only getting higher, I’m grateful to see Congresswoman Susan Wild speaking out about this issue… Even since Rep. Wild wrote her letter in January, the prices of hundreds of medications have gone up. Drug companies have already raised prices on 804 drugs this year alone.” [The Morning Call, 3/22/22]

(WI) Wisconsin Examiner: Cutting Prescription Drug Costs Still Priority In US Senate, Baldwin Says. “[Sen. Tammy Baldwin] said she hopes that another provision she has advocated, allowing the federal Medicare program to negotiate drug prices with pharmaceutical manufacturers, can be revived this year as well… American patients pay two, three or four times what residents of other wealthy countries pay for medicine. Medicare negotiation would produce savings for taxpayers as well as patients, Baldwin said.” [Wisconsin Examiner, 3/28/22]

***MEDIA ADVISORY FOR FRIDAY, APRIL 22 AT 1:00 PM MST // 4:00 PM EDT***

Medicaid Is More Important Than Ever Before. Lawmakers Must Work To Strengthen the Program and Ensure Access to Quality, Affordable Care.

Phoenix, AZ — Today, April 22, 2022 at 1:00 PM MST // 4:00 PM EDT, Valle del Sol CEO Carmen Heredia and David Lujan, President & CEO of Children’s Action Alliance, will join Protect Our Care Arizona to highlight how Medicaid has provided Arizonans with access to quality, affordable health care, strengthened local economies, and improved health outcomes across the state.

Medicaid has served as a lifeline during the pandemic, providing health coverage to a record number of Americans at a time they need it most. As Republicans undermine Medicaid to throw people off coverage and we look to the end of the COVID-19 public health emergency, health care coverage for millions of Americans hangs in the balance, requiring a solution to prevent widespread coverage losses. Speakers will identify opportunities for lawmakers to strengthen Medicaid, and ensure ongoing access to care.

VIRTUAL PRESS CONFERENCE:

WHO:
Carmen Heredia, CEO, Valle del Sol
David Lujan, President & CEO, Children’s Action Alliance
Protect Our Care Arizona

WHAT: Virtual Press Conference

WHERE: Register for the Event Here

WHEN: Friday, April 22, 2022 at 1:00 PM MST // 4:00 PM EDT