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Medicaid Matters to More Americans Than You May Think

It’s not just low-income people who would be affected by cuts to Medicaid.

By Dwyer Gunn

With the Affordable Care Act’s repeal-replace-reform-repair debate crawling along, House Republicans and the White House do seem to favor one point: sharp cuts to Medicaid. Under most GOP replacement plans, including the one unveiled last week by Speaker Paul Ryan, federal spending on Medicaid, the public-health insurance program that’s most associated with low-income Americans, would be sharply curtailed and converted to either a block-grant funding formula or a capped, per-capita formula. While most of these plans have not been officially scored by the Congressional Budget Office, health-care experts overwhelmingly agree that such a change would lead to a drop in the number of Americans who receive Medicaid benefits, and in the generosity of those benefits.

This is an issue that Americans across the income spectrum should care about, because, contrary to popular perception, it’s not just low-income Americans who rely on Medicaid. It’s also non-elderly adults with disabilities, children with disabilities, and senior citizens who have run through their personal savings and thus rely on the program to supplement their Medicare coverage. These sorts of people account for a big chunk of Medicaid spending. The chart below, from a recent presentation by the Kaiser Family Foundation, illustrates Medicaid spending on different demographic groups:


(Chart: Kaiser Family Foundation)

Senior citizens would be especially affected by cuts to Medicaid. Because Medicare does not cover long-term nursing home care, countless middle-income seniors end up relying on Medicaid in their older years. As this chart, also from the KFF, demonstrates, the program is currently the largest payer for this kind of care:


(Chart: Kaiser Family Foundation)

Clearly, Medicaid reform affects more than just the poorest of the poor, a fact that Americans might want to keep in mind as the ACA reform debate rages on.