Happy birthday, Medicaid

Children’s Defense Fund

“It was a generation ago that Harry Truman said, and I quote him: ‘Millions of our citizens do not now have a full measure of opportunity to achieve and to enjoy good health. Millions do not now have protection or security against the economic effects of sickness. And the time has now arrived for action to help them attain that opportunity and to help them get that protection.’ … The need for this action is plain; and it is so clear indeed that we marvel not simply at the passage of this bill, but what we marvel at is that it took so many years to pass it.”

President Lyndon B. Johnson said this July 30, 1965, as he signed the bipartisan legislation that established the federal Medicaid program and thanked former President Harry S. Truman and the members of Congress from both parties who had laid the groundwork and worked tirelessly over many years to make the Medicaid program and its protections reality. For more than a half century, Medicaid has been a shining example of the good and essential support government can provide those most in need across all ages. Over the years, we have been striving to live up to the promise of ensuring all youth a chance to reach healthy adulthood.

Today, nearly everyone in America has a family member, neighbor, coworker or classmate who has benefited from Medicaid’s critical protections. Medicaid offers health coverage to 80 million people. With the help of the Children’s Health Insurance Program and the Affordable Care Act, 95 percent of all children today have health coverage. So, all of us have millions of reasons to celebrate Medicaid’s birthday. And we can celebrate, at least for now, a rejection of the cruel, relentless and frantic effort to end Medicaid, threatening tens of millions of families terrified by an uncertain future and the loss of life giving care.

Medicaid is a lean, efficient and essential safety net program that allows millions to be healthy and productive members of society. Medicaid is the largest health insurer for our nation’s children, providing affordable, comprehensive health coverage to almost 37 million low-income children. Forty-three percent of all Medicaid enrollees are children; Medicaid serves 40 percent of children with special health care needs. It also covers more than 40 percent of all births in the U.S. and serves millions of low-income pregnant women, adults with disabilities, and the elderly. Medicaid helps two of three seniors in nursing homes.

Medicaid is a foundational part of our nation’s health insurance.

• Today, all states provide Medicaid coverage to children under 19 with family incomes under 138 percent of the federal poverty level ($33,534 for a family of four in 2016). Some states cover children up to 21 or with higher incomes.

• Medicaid is a valuable source of preventive services helping children get the well-child visits and screenings they need to support healthy development and prevent expensive health complications later.

• Medicaid is a lifeline for children with disabilities and their families. For some families with disabled children, Medicaid is often the only viable source of financing extensive and expensive health care. Medicaid also supplements private coverage to allow children access to specialized medical equipment and devices such as hearing aids and wheelchairs. It also allows children and adults with serious disabilities to be treated at home and in their own communities rather than being sent off to more costly institutional settings.

• Medicaid is especially important for children of color who are twice as likely as White children to be poor.

• The ACA’s expansion of Medicaid to 11 million low-income adults enabled them to receive services and treatment. • Without Medicaid, many children would go uninsured or underinsured, increasing short and long-term costs for states and local communities and jeopardizing children’s academic performance and futures.

Medicaid guarantees coverage to millions.

• Medicaid’s Early and Periodic Screening, Diagnostic and Treatment benefit guarantees children a full range of comprehensive primary and preventive care and access to all medically necessary health and mental health services.

• Medicaid guarantees health coverage to all eligible applicants without waiting lists or enrollment caps.

• Medicaid expands as needs grow and more who are eligible require assistance.

A smart investment.

• Research comparing children eligible for Medicaid to their non-eligible peers found Medicaid eligible children were more likely to attend college, make greater contributions as adult taxpayers and live longer than those without coverage.

• Medicaid is far more efficient and cost effective than private insurance for children.

• Medicaid funding also offers critical support to hospitals and helps prevent increases in uncompensated care and declines in their operating margins which can force some of them to close, seriously impacting their local economies.

Changes to Medicaid:

• Education. Since child health impacts educational attainment, any structural changes to Medicaid would compromise returns on other major investments in children’s education from Early Head Start to college. Medicaid not only helps ensure our nation’s most disadvantaged children are healthy and learning in school, but reimburses schools for services delivered to Medicaid-enrolled children. Schools currently receive about $4 billion in Medicaid reimbursement each year.

• Child Welfare. Medicaid helps address needs that can otherwise result in children coming to the attention of the child welfare system. It helps treat children in foster care most of whom have experienced trauma in their lives; provides continuing support for children who move from foster care to guardianship with relatives; assures children with special needs who are adopted from foster care permanent families; and continues specialized treatment for some children who transition from foster care without permanent families and face special challenges.

We have been asking a question for months: Will our president and congressional leaders preserve Medicaid as we know it and reject structural changes and cuts that undermine its critical protections for vulnerable populations? Or will we see a generation of harsh, callous congressional and presidential leadership?

Thank God there is some good news from the U.S. Senate that last week voted to preserve Medicaid as we know it, at least for now, and to reject the Health Care Freedom Act by a 51 to 49 vote. While we must be diligent and watch for proposed deep cuts and other attacks on Medicaid as Congress considers the 2018 Budget Resolution, tax reform and other reform initiatives, we all should give special thanks to those who worked so hard to make the case in their own states and communities to protect Medicaid and other critical pieces of the ACA.

We know Medicaid works and on its birthday celebrate its more than 50 years of success. And we must continue to reject any actions and any leaders who threaten the health and futures of the tens of millions of our children and vulnerable adults.

Marian Wright Edelman is the president of the Children’s Defense Fund. For more information, go to http://www.childrensdefense.org.

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