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Celebrate 50 Years of Medicaid by Expanding It to Cover More People

Persistence pays off. Let’s remember this as we celebrate 50 years of Medicaid on July 30.

In 1965, Medicaid entered the world as a Medicare add-on for low-income families. Now, the program provides comprehensive coverage to more people than any other insurer in the United States. Almost 70 million people in the U.S. turn to Medicaid for their health coverage.

But Medicaid is much more than the country’s top health insurer. It’s also a key battleground for the future of our country.

As we stake out this future, we have big questions to answer about who will benefit from all our country has to offer — and who will wind up excluded from those benefits. We also have big questions about how such decisions are made.

Will we be a United States where we all enjoy the security that contributes to a happy and healthy life? Or, will be a country where the economy is based on indebtedness and limited options for the majority, with snowballing enrichment of the hyper-affluent? No less important, will we be a country where billionaires answer these questions, or will we renew our democratic principles?

For 50 years, Medicaid has been doing the hard work of expanding our national community. It has provided health care to people of limited means and people of color — people who have long found themselves shut out of quality employment and, along with it, health insurance. For years, Medicaid has saved lives that the private sector didn’t find profitable enough to save.

The power of Medicaid is more than symbolic. In practical terms, Medicaid demonstrates the difference that government can make in our families and communities. According to the Commonwealth Fund, adults covered by Medicaid report getting high-quality, timely health care at — but at much lower rates of medical debt.

That’s why the billionaire-backed far right put Medicaid in its crosshairs. What could be more frightening to this bloc than a government program that invests in the lives of people of limited means and, in terms of both quality and cost-effectiveness, gives the private market a run for its money? This is also why the progressive fight for Medicaid expansion — now being waged across the country — is so important.

The battles are far from easy. Nineteen states still haven’t taken up Medicaid expansion available under the Affordable Care Act (ACA), despite effective grassroots campaigning – and despite desperate calls for expansion from those among the nearly four million shut out of the benefits of the ACA because of this refusal.

This rejection of Medicaid expansion is so cruel and callous — and so steeped in racial injustice — that it’s easy to forget how far we’ve come.

From the very start, nothing about Medicaid — or Medicare, for that matter — was fated to be. In 1965, both programs came as the fruit of cresting movements for economic and racial justice. The powerful American Medical Association threw its weight against the legislation, fearing “socialized medicine.”

Meanwhile, the National Medical Association (representing African American physicians), the NAACP, the labor movement, and many others voiced the need for a government role in health care – including taking to the streets with their demand.

From this victory, we’ve made Medicaid a keystone of our health care system — turning back three major attempts to block-grant the program between 1981 and 2004 — thanks to committed, effective grassroots organizing and activism.

We’ve had losses along the way — eligibility barriers targeting immigrants being the most significant — but our victories have been greater than the losses. Since 1965, we’ve expanded Medicaid to bring in millions more children, pregnant women, and people with disabilities. People from all walks of life now count on Medicaid to cover everything from asthma treatment for kids to assisted living services for parents and grandparents.

And let’s not forget that our current fight for Medicaid expansion is also the outcome of progress — the ACA’s historic opening of Medicaid to adults without children. This was and continues to be tremendous win. To make it possible, hundreds of thousands of community leaders marched in the streets, called their lawmakers, and raised their voices on social media and in the press. Most states have responded by picking up the Medicaid expansion.

In short, thanks to ongoing grassroots pressure, more people turn to Medicaid than could ever have been imagined back in 1965. We stand to win even more as we push for full Medicaid expansion in all 50 states — each and every one of them.

The fight is about vision and values, but we shouldn’t see it in partisan terms. Many states have adopted Medicaid with bipartisan support or under the leadership of Republican governors. Take Nevada, New Mexico, and, most recently, Montana as examples.

The Republicans who have come out in support of Medicaid expansion know that it’s right thing to do, both morally and in terms of good government. Even in states stalled on Medicaid expansion – states like Alabama, Idaho, and Mississippi — most people agree. (This includes 62 percent of residents of the Deep South.) They want Medicaid expanded.

But they face an astroturf, billionaire-funded opposition so mired in a government-is-bad ideology that its adherents would rather see people die than see a public program succeed. This opposition is fueled by Koch brothers’ dollars funneled through Americans for Prosperity (meaning prosperity for billionaires). When nervous Republicans look over their shoulders, it’s AFP suits they see, making threats.

They should look more broadly. It’s our cause that has the support of the public, of the businesses in our communities, and the doctors that keep us healthy. We — and not those who don’t care if their fellow humans die for lack of health care — offer an inclusive vision. It’s a vision that everyone can get on board with and that — with 50 years of success under our belts –we know is going to win.

Daley’s View: Why We Needed the Public Option Then…

…and Why We Need It Now

 

Remember the big debate in the Congress about whether or not the ACA needed to create a public option to private insurance in order to make the new exchanges be competitive and serve all consumers. This proposal was defeated and left to die pretty much without a whimper.

Now we are just beginning to get a look at the participation of insurance companies in the new exchanges and are seeing why the public option was so important.

One of the supposed benefits of these exchanges is that there will be lots of competition among private insurance companies and a public option was simply unnecessary. Read more

The Value(s) of Medicaid: 47 Years Later

July 30th marked the 47th anniversary of Medicaid and Medicare. It’s hard to imagine that 47 years ago, these critical programs that we have grown to love and rely on, were controversial sticking points that were hotly contested for years prior to being passed through the legislature- similar to the Affordable Care Act; passed only 2 years ago. What is the commonality between these programs? They reach communities that are left behind by the money-driven health care system that has [dominated] our country. We are seeing first hand which members of Congress and Governors will come to bat for these communities when their very lives are at stake. Read more

Insurance Companies Weaken Language Access Regulations while Getting Wealthier

A few weeks ago, the Department of Health and Human Services issued a regulation stipulating that insurance companies only have to provide language services to a person with Limited English Proficiency if 10% of people in their county speak their same language. This is a high bar – only 177 out of 3,143 counties in the United States have communities that would qualify under this guideline. Hundreds of thousands of people will be left out due to this unscrupulous regulation. For instance, Spanish speakers in Los Angeles County will be able to communicate with their insurance companies, but speakers of Asian and Pacific Island languages won’t because they don’t meet the 10% threshold, which amounts to having 355,581 people not receiving language services. Read more

Community Health Care Clinics Under Attack

Community clinics are an indispensable component of the health care infrastructure in the United States. They are widely regarded as a cost-effective way to provide basic care, saving the health care system billions of dollars every year. Clinics serve over 20 million people in America, and one out of three people in poverty rely on them for their medical needs. Community clinics are also critical for access to care for immigrants, many of whom have been shut out of health insurance coverage post-reform. Read more

Health Insurer Lobbying, Sopranos Style

It’s been public knowledge for a while now that the health insurance industry secretly funneled money to the US Chamber of Commerce to fund its smear campaign against health care reform in 2009. What we didn’t know, though, was just how much money. Now, thanks to some good investigative reporting by Bloomberg News, we do. And the magic number is… $86.2 million. Read more

Establishing State Exchanges that Serve People, Not Insurance Profits

Health care reform, if fully realized, will provide health insurance coverage for an additional 30 million people in America. One of the main ways this will happen is through the creation of centralized health insurance marketplaces, or “state exchanges.” If set up properly and well, people without insurance will be able to go to their state exchange and acquire quality health insurance at affordable prices. Members of the Health Rights Organizing Project (HROP) are engaged in implementation campaigns to make sure there is no “if” about how these exchanges are set up. Read more

A Victory for Health Care Implementation

Last week, the National Association of Insurance Commissioners (NAIC) finalized their recommendations to President Obama on how to implement a critical piece of health care reform: medical loss rations. Their recommendation is a significant victory because,  according to the Washington Post, it largely favors “the views of consumer advocates over those advanced by the insurance industry.” Read more

On Language Access, Holding HHS Accountable to People, Not Insurance Companies

The Department of Health and Human Services (HHS) is currently creating the regulations that basically put the meat on the bones of this country’s health care reform law. It is the outcome of these rule-making decisions that will determine the success, or failure, of reform. NWFCO, with the Health Rights Organizing Project, has been weighing in on key aspects of reform that have been prioritized by the communities with which we work. One key issue is addressing the linguistic barriers limited English proficient (LEP) people face when trying to access health insurance coverage and medical care in the current system. Read more