A little more than a year ago, 11-year-old Marcelas Owens stood next to President Obama for the signing of federal health reform, the Patient Protection and Affordable Care Act. A grassroots leader with the Washington Community Action Network, Marcelas had fought hard for the bill, telling his family's story to senators, national reporters and people gathered at rallies in support of reform. His story is tough, but all too common: when he was only seven, his mother died because she was uninsured and couldn't get treatment for her pulmonary hypertension.
Fortunately, Marcelas does have health coverage – through Medicaid. But now Medicaid is up for grabs, caught up in the latest DC budget negotiation showdown. So far, the fight for Medicare is getting all the press, but Medicaid needs and deserves just as strong a defense.
Medicaid touches the lives of many, many people, not just the 58 million people it covers, but their family members, too. This includes the hundreds of thousands of grassroots leaders active in the organizations that form the Alliance for a Just Society's network. Step into forgotten places from Maine to Montana and you'll see the difference Medicaid makes. Mary Jane, a toddler whose mother was laid off, receives vaccinations so she can start school. Sixty-six-year-old Karen gets help to stay at home in Boise, where she enjoys scrapbooking, instead of having to move into a nursing home due to disability. And Sade, from Pennsylvania, can receive treatment for kidney stones that have sent her to the hospital in debilitating pain.
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With wrenching unemployment and the housing market still in the tank, this may be the worst possible time to think about gutting Medicaid. Yet, the program still faces a slew of threats.
Medicaid provides comprehensive health insurance, with low-income children accounting for nearly half its enrollees. Another quarter consists of seniors and people with disabilities, who, thanks to Medicaid, can receive home health or nursing home care they otherwise couldn't afford. Under the Ryan House Republican budget, Medicaid would be turned into a lump-sum program – a block grant – that would mean waiting lists, higher costs and lots of people losing out on health care they need.
But it's not just the House Republicans who've put Medicaid in its sights. Earlier this year, Sens. Claire McCaskill and Bob Corker introduced a spending cap proposal that would achieve the same results, but more stealthily – in the way a time bomb is stealthy. And there's also legislation to remove Medicaid's stability requirements, which ensure that states keep people covered while health reform goes into effect. Removing those requirements would open up the floodgates to all sorts of cuts.
Gutting Medicaid will mean that people lose their lives. If that's not enough, there's another set of reasons progressives should be fighting for Medicaid:
- Millions of seniors receive nursing home care thanks to Medicaid. Removing this support will be disastrous for families, including many who consider themselves middle class and want to stay that way.
- Health reform didn't include a public option, but it does include a significant expansion of public coverage, with Medicaid expected to take on 16 million new people by 2014. This expansion – by removing categorical barriers to coverage – can help transform public coverage from a benefit only for the “deserving” poor to an established element of the social contract.
- Medicaid is especially important for people of color. Racial disparities in coverage would be even worse if not for Medicaid, without which an additional 25 million people of color would likely be uninsured. Gutting Medicaid would send – and actualize – the message that our country values the lives of people of color less than the lives of white people.
- In towns like Burley, Idaho, and Greeley, Colorado, and small towns across the country – places progressives should pay attention to – Medicaid is a real economic engine, generating jobs and keeping small businesses open.
As important as it is to defend and expand Medicaid, the budget fight is about more than a single program. It's also about what and who we value in our country. With Congress fixated solely on cutting spending – and letting many corporations get away without contributing a dime – lawmakers are telling us who matters and who they answer to. And, from coast to coast, people are getting the message.
Of course, there are alternatives. We can protect and build on Medicaid and raise revenue at the same time. The Congressional Progressive Caucus and Our Fiscal Security have put out budget proposals that reinvest in Medicaid while requiring corporations and the rich to pay their fair share. This includes making Wall Street contribute to economic recovery and reversing the Bush-era tax cuts for the wealthiest among us.
It's been more than a year since Marcelas Owens and a wave of other grassroots leaders achieved an incredible victory. With health reform, our country affirmed the value of investing in a healthy society. Let's act on that value and defend Medicaid.