How the Senate Health Care Bill Could Hurt Medicaid Recipients

Susan Lees works at least 40 to 50 hours a week as a nanny for two young kids. Recently, she started walking dogs while the kids are in school to “make ends meet.” But despite working around 50 to 60 hours a week, she relies on Medicaid to pay for her medical bills.

“It’s not like I can just go out and afford big-time insurance,” Lees said. “I get state health but I also pay into it. And if they cut it–I’m 50 years old now and I try to keep myself basically healthy–but the little things I do need would come to a stop.”

Lees, who is single and lives in Danbury, Conn., is worried about the Senate’s proposed health care bill, which calls for steep cuts to Medicaid. A vote on the Better Care Reconciliation Act was delayed until after the July 4 recess amid opposition from some Republican senators, but opponents worry that the legislation could still pass.

The most recent draft of the bill would cut Medicaid funding by $772 billion over the next decade and cause enrollment to decline by 16 percent by 2026, according to the recently released Congressional Budget Office report. Overall, the CBO says, 22 million fewer Americans would be without health care by 2026.

“We have never seen a safety net rolled back like this in American history,” said Bruce Siegel, president of America’s Essential Hospitals, an association of about 300 hospitals dedicated to providing health care to poorer Americans. “It will pull the rug out from under working people and their hospitals. It could undermine the whole insurance market for everyone.”

Medicaid was created in 1965 as an amendment to the Social Security Act. Proposed and then signed by President Lyndon Johnson, the program was created to provide health care to low-income Americans. It was expanded under the Affordable Care Act to provide coverage for more citizens. Today, over 72 million Americans rely on Medicaid to help pay for their health care bills.

The slash in Medicaid funding would help reduce the federal budget by $321 billion by 2026 and pay for tax cuts for the wealthy that are included in the bill.

Under the Senate bill, federal funding for a Medicaid expansion would stop by 2024. But Siegel says that it’s not only those who gained (or would have gained) coverage under the Medicaid expansion that would lose insurance, those who already have Medicaid–even those who got it before the Affordable Care Act–could also lose their coverage.

He added that many people think that the Senate bill will return the system to the way things were before the Affordable Care Act was passed. “That’s false,” he said. “This bill takes us to places we’ve never been before.”

The Senate bill would place constraints on Medicaid funding by adding per capita caps and tying it to the standard inflation rate instead of the much higher medical inflation rate, reducing the benefits over time.

On Sunday, Kellyanne Conway, counselor to President Trump, said on ABC’s This Week that Americans who lose their Medicaid coverage from the Senate’s proposed health care plan should instead get a job that provides them with health insurance courtesy of their employer. Conway argues that the Affordable Care Act expanded Medicaid coverage to many “able-bodied” Americans who “should probably see if there are other options.”

“If they’re able-bodied, and they want to work, then they’ll have employer sponsored benefits like you and I do,” she added.

Lees says that even though she gets her coverage through Medicaid, Conway and many fellow Republicans are correct, people are abusing the program.

“A lot of them do need to go out and get a job—I’m not going to lie,” Lees said. “There are people out there who are soaking the system. I see it. Because of where I have to go to get health care I see it. There are definitely ones that are soaking the system. I feel if you’re giving into the system then you should be able to get help.”

According to the Kaiser Family Foundation, 41 percent of enrollees who are not disabled are working full-time jobs and another 15 percent are working part-time.

For people like Josey Redder, a 22-year-old waitress who is also from Connecticut, finding a job to help pay for insurance is difficult. The restaurant where Redder is employed offers her only around 12 working hours a week. At just over $6 an hour plus shared tips, her income is “just not enough” to cover health insurance. Redder uses Medicaid to pay for 100 percent of her visits to the doctor, birth control, and to see her therapist.

“We rely on it,” she said. “I know plenty of people who are working really hard and have jobs and still are on Medicaid and without it wouldn’t be able to afford doctor’s visits, medication, everything. It’s pretty awful that they want to take it away.”