Medicaid Matters
Three Things Thursday
Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week. There has been a constant flow of news this week — the number of confirmed measles cases crossed over the 1000-case threshold this week. Last Friday, President Trump nominated Casey Means to be the next Surgeon General, which has stirred up a hornet’s nest of opposition. While she graduated from medical school, she is NOT a board-certified physician, is NOT licensed to practice medicine in the United States, and lacks experience in clinical medicine, public health, and health policy. I, along with many in the medical and public health communities, am VERY upset by this nomination. And I agree with everything former Surgeon General Dr. Richard Carmona wrote in The Hill —
“Public health is a national security imperative. We must treat it that way.
History teaches us that the most impactful surgeons general have been those who brought courage, competence and scientific clarity to the nation’s most difficult conversations. Dr. C. Everett Koop took a stand against tobacco and led a science-driven national education effort on AIDS. Dr. David Satcher confronted addiction and health disparities at a time of political polarization. They didn’t just hold office — they led with authority earned through decades of experience.
This legacy should not be diminished by placing symbolism or politics above readiness and expertise. The surgeon general is not just an advisor but a field-tested leader who must command respect, coordinate with other uniformed services and represent the nation on the global public health stage.”
On top of all of this, two important pieces of information were shared yesterday during RFK Jr’s congressional testimony. First, he announced that Matthew Buzzelli is the acting Director at the CDC. Buzzelli has NO public health or medical experience. He is a lawyer and a Trump appointee at the CDC. Additionally, according to the CDC website, Buzzelli is the chief of staff, not acting director.
And so the question remains — who is in charge at the CDC?1
The second thing that happened at yesterday’s congressional hearing is that RFK Jr admitted that Americans should NOT be taking medical advice from him.
This is concerning on so many levels — but bottom line…
RFK Jr is NOT qualified to be the Secretary of Health & Human Services.
And this is NOT political. In his own words, he is saying he is not qualified to be in the position. Because the Secretary of Health and Human Services is a member of the president’s cabinet of advisers, and is charged with advising the President about health care policy issues and public health measures.
The charge of the HHS secretary is to oversee the department’s mission: “to enhance the health and well-being of all Americans, by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health and social services.”
As Secretary of HHS, RFK Jr is also in charge of the Centers for Medicare & Medicaid Services (CMS) — and is championing huge cuts to the Medicaid program. And Medicaid is the BIG news this week, as Republicans are looking to make substantial cuts to the program (they spent 26 hours debating and discussing cutting Medicaid on Wednesday). The bill has been sent to the House Budget Committee, which will meet Friday morning.
This week’s three things are the things you need to know & do to prevent enormous cuts to Medicaid.
Medicaid cuts will impact EVERYONE (more below).
And with the proposed cuts, communities, children, the poor, and those with disabilities will face serious threats to their health.
Hoping this post helps to educate and empower you
to be healthy and create healthy communities.
Medicaid Cuts
Medicaid provides healthcare coverage for children as well as individuals who are poor (with incomes 138% or below the poverty line), pregnant, blind, or disabled. Enrollment in Medicaid surged during (and after) the COVID-19 pandemic. Since 2020, nine states have expanded their Medicaid programs to cover more low-income individuals. It is worth noting that of these nine states, six (67%) are RED/republican states. Forty percent of Medicaid recipients are children. Forty-one percent of all births in the US are covered by Medicaid. And 62 percent of all nursing home residents pay for their care through Medicaid.
Now, to be clear, the entire healthcare system in the United States, including Medicaid, is broken. We pay too much for healthcare, and our health outcomes are awful. But just cutting Medicaid by $900 billion doesn't solve any of our healthcare problems. It only momentarily balances a budget.
Short-term accounting win; devastating effects to community & public health.
The GOP proposal to cut Medicaid would require all enrollees to prove that they are working, volunteering, or studying to stay enrolled. While the GOP continues to tell the story that Medicaid enrollees are lazy and unemployed, only 8 percent of Medicaid recipients are unemployed. Most are working, but do not have private health insurance and are living below the poverty line. Asking this 8 percent of recipients to seek employment or education will not make a big budgetary difference. It will add to the administrative work and paperwork of Medicaid recipients.
According to Representative Jake Auchincloss of MA —
“These aren’t work requirements.
They are paperwork requirements.”
According to a recent Kaiser Family Foundation poll —
“At least three-quarters of the public oppose major cuts to funding for Social Security (84%), for Medicare (79%), and for Medicaid (76%).”
Cutting Medicaid is not a solution to our healthcare problem.
Cutting Medicaid Does NOT Prevent Disease & Illness
Cutting Medicaid does NOT mean people will stop getting sick. It will not stop cancer diagnoses, car crashes, birth defects, maternal death, or infectious diseases from spreading.
According to the Center on Budget and Policy Priorities —
“These changes would hurt not just Medicaid enrollees, but entire communities. That’s because Medicaid is a critical part of our nation’s health care ecosystem, providing coverage to millions of people at all stages of life and supporting providers that serve the broad public. Proposed Medicaid changes that take away eligible people’s coverage (such as work requirements, more frequent eligibility checks, or restrictions on retroactive coverage) would leave more people uninsured and raise hospitals’ costs for providing uncompensated care to patients whose coverage has been terminated. The downstream effects of all of the proposed federal Medicaid changes would reduce Medicaid enrollees’ access to health care, potentially affecting children, seniors, people with disabilities, and all those who need support and have no other affordable pathway to health coverage.”
Cuts to Medicaid will likely result in —
An increased number of uninsured individuals. These individuals will not seek preventative care, but instead will rely on emergency rooms when they need immediate and often costly care (that could have been prevented).
The loss of home- and community-based health services, such as in-home nursing care and programs that assist individuals who need health bathing, dressing, feeding, and managing their medications themselves. Not only will these individuals see a decrease in their quality of life, but it could result in decreased home prices (if upkeep is not maintained) and an increase in mice, rats, and bedbugs at properties.
Safetynet providers, who are committed to serving the poor and disabled, will struggle to stay open. And overall access to healthcare providers will decrease.
Hospitals, especially those in communities with large populations of Medicaid recipients (like my own community), will struggle to stay open and offer the same services, as they will be serving an increasing number of uninsured patients. Hospitals may close, or services, such as OB/GYN or emergency departments, may be eliminated.
Cuts to Medicaid will NOT simply impact recipients alone. We will all feel the impact of these Medicaid cuts. And we will see the health status of our communities — life expectancy, maternal mortality, infant mortality, incidence of cancer, diabetes, and mental health disorders — decline. Our friends and family, who have private health insurance, may not be able to find a primary care provider, or they may die on the way to the nearest emergency room that is more than an hour away (after the local community hospital closed its doors).
Call Your Elected Representatives NOW
The GOP Medicaid cuts are moving to the House Budget Committee tomorrow (Friday). There is NO TIME TO WAIT.
Use this link to find your local representative and their contact information.
Call/email them. NOW.
Your message should be short and clear. Tell them —
Your name and where you live.
You are calling to OPPOSE the proposed Medicaid cuts.
And opposing those cuts is important to you because…
Follow up and be public about your opposition — post on social media and tag your representatives.
Medicaid matters because it facilitates access to care, improves health outcomes, and provides financial protection from medical debt.
Do not wait. We all need to reach out to our elected officials.
I’ve been saying for more than five years now that Epidemiology Matters.
Medicaid Matters, too.
What else can you do?
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Epi(demiology) Matters is written by Dr. Becky Dawson, PhD MPH — an epidemiologist, teacher, mom, wife, and dedicated yogi. She is a tenured professor at Allegheny College, Research Director at a community hospital, and an exclusive contributor (all things health & medicine) at Erie News Now (NBC/CBS). Her goal is to create healthy communities for all. She writes Epi Matters — first & foremost because epidemiology does matter (to all of us), and she hopes that each post will help to educate and empower readers to be healthy and create healthy communities.
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Going to ask the obvious here — how can we aim to Make America Healthy Again when there are no health leaders in our federal health system? How can a lawyer run the nation’s public health department? It makes no sense. And if you believe that Trump is working to Make America Healthy Again, you are mistaken. This is a campaign to strip America of all of the laws and recommendations, policies, programs, interventions, and research that actually keep us healthy.
Thank you for continuing to provide this much needed information. I had already called my representatives and will continue to do so.
Becky, I’m saying a prayer for your sanity in the midst of this dystopia we’re living in. Thank you for caring so much and working so hard!