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Republicans Eye Medicaid Cuts to Fund Tax Breaks for Their Billionaire Friends

This morning, Protect Our Care launched its multi-million dollar “Hands Off Medicaid” campaign to sound the alarm on Republicans working to slash Medicaid funding to pay for another round of tax cuts for the wealthy and big corporations. As the largest health insurance program in the country, providing health care to more than 72 million people, Medicaid covers one in five Americans, including kids, moms, seniors, people of color, rural Americans, and people with disabilities. But Republicans are targeting Medicaid for deep budget cuts, putting Americans’ health care at risk. 

Working families will lose the care they need to stay healthy, people with disabilities will lose access to the services they need, seniors will be kicked out of nursing homes and lose home-based long-term care, and millions of kids, including those with special needs and cancer, will be left behind. If Republicans get their way, hard-working Americans will have their health care ripped away from them while the ultra-rich get trillions in tax breaks.

By The Numbers

  • The GOP is putting health care at risk for more than 72 million Americans. Medicaid disproportionately serves children, older people, and people with disabilities, this includes:
  • Republicans will create at least a $50 billion hole in state budgets annually to pay for tax breaks for the wealthy and corporations.
  • 12 states have a Medicaid expansion trigger law, which means that if Republicans gut funding for Medicaid expansion, 3.7 million people would quickly lose their health care.

Who Would Lose Coverage?

Approximately half of America’s children have health care coverage through Medicaid. Over 37 million children are enrolled in Medicaid or CHIP. This represents nearly half of all people who depend on Medicaid and CHIP. Access to health care coverage allows children to stay healthy and avoid health complications when they grow older. Increasing access to Medicaid for children results in lower high school dropout rates, higher college enrollment and completion rates, and higher wages later in life. For each additional year of Medicaid eligibility as a child, adults by age 28 had higher earnings and made $533 additional cumulative tax payments due to their higher incomes.

Medicaid covers 42 percent of all births and prevents maternal mortality. As of 2020, 48 percent of maternal deaths occurred during pregnancy and delivery, but more than half, 52 percent, occurred in the year following the birth of a child. 2022 CDC data shows that 4 in 5 maternal deaths were preventable. 12 percent of maternal deaths are deemed “late,” occurring between six weeks to one year following delivery, demonstrating the immense need for continuous health access and coverage for a minimum of one year following the birth of a child. 47 states have begun offering continuous Medicaid or CHIP coverage for 12 months after pregnancy. Maternal mortality rates decreased by 10.6 deaths per 100,000 mothers between 2021, the year postpartum coverage under Medicaid was expanded, and 2022. Between 2018 and 2022, the maternal mortality rate in America was 23 deaths per 100,000 births.

Medicaid covers rural Americans. Health care for rural Americans is especially important due to the higher prevalence of pre-existing conditions and barriers to accessing health care. Medicaid expansion also reduces poverty and income inequality by helping low-income families access care without jeopardizing income that they may use for other basic living expenses, such as rent or groceries. Rural hospitals also benefit from Medicaid funding and are at risk of closing if there are cuts to the program. Rural hospitals in Medicaid expansion states are 62 percent less likely to close. In 2023, over 600 rural hospitals were at risk of closing in the near future, almost all of which were within non-expansion states. If Republicans cut Medicaid expansion, rural hospitals could be at risk.

Americans with disabilities rely on Medicaid. Medicaid is a vital source of care for people with disabilities across the country, over 10 million people with disabilities rely on Medicaid for access to health care. Half of all long-term care in the United States, which includes essential home- and community-based services for people with disabilities, is provided by Medicaid. Individuals with disabilities living in Medicaid expansion states are also more likely to be employed than those living in non-expansion states. They are able to access and maintain Medicaid coverage while earning at levels that previously would have made them ineligible. For people with disabilities in non-expansion states, health disparities may widen. Medicaid also offers essential mental health services. Nearly one in five adults struggling with mental illness have access to care through Medicaid. If Republicans have their way, millions of people with physical or mental disabilities will lose access to essential care.

Medicaid supplements coverage for seniors. The benefits of Medicaid for America’s aging population often go unnoticed but are essential to their health and well-being. For seniors and older Americans with lower incomes, Medicare premiums are paid by Medicaid, as well as deductibles and health care that requires cost-sharing. 63 percent of nursing home residents are primarily covered by Medicaid. Without Medicaid’s supplemental coverage, millions of seniors would be forced to go without needed care.

Medicaid is a lifeline for Americans of color. Generations of structural racism have resulted in people of color experiencing lower rates of health coverage, worse health outcomes, and staggering health inequities. As a result, Medicaid coverage remains a critical source of coverage, especially for Black, Latino, and Indigenous families in America who experience poverty at a higher rate than white Americans and remain less likely to have access to quality care – an important driver of health. 60.5 percent of those covered by Medicaid are people of color. Research confirms that Medicaid expansion saves lives and drastically reduces racial/ethnic 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/Latino adults.  

Key Points: The GOP Plan for Medicaid

Republicans Want to Gut Federal Funding for Medicaid, Forcing States to Cut Benefits and Kick People Off Coverage. Three proposals would dramatically reduce federal funding for Medicaid: block grants, per capita caps, and reducing Medicaid matching rates. The federal government is an essential source of funding for Medicaid programs and Republicans’ proposals to slash billions in federal funding from Medicaid would strain already tight state budgets, leave tens of millions of people uninsured, and force Governors to make the hard choices on reimbursement rates and cutting benefits and services. Any flexibilities offered to states will not offset the significant budget effects.

Republicans Want To Throw Millions Off Their Coverage By Adding Burdensome Work Reporting Requirements To Medicaid. By imposing so-called work requirements, Republicans are only seeking to cut Medicaid and kick millions of people off the rolls. Research shows that work reporting requirements cost states money and do not improve people’s ability to find work. In Georgia, a GOP alternative to Medicaid expansion emphasizing work requirements cost taxpayers $26 million, spending more than 90% of those funds on administrative and consulting costs while providing care to only 5,500 people while 359,000 Georgians would be eligible for coverage if Georgia expanded Medicaid. If Republicans succeed in enacting work requirements, up to 21 million Americans could be denied Medicaid coverage.