LANSING — Michigan healthcare advocates are sounding the alarm about proposed Medicaid cuts included in House Republicans’ budget bill, which the nonpartisan Congressional Budget Office estimates would leave more than 7 million additional Americans uninsured.
Experts are saying that the cuts could leave healthcare systems underfunded and chronic diseases untreated, likely worsening the health of individuals and communities.
Nearly two million Michigan residents are enrolled in traditional Medicaid, while about 750,000 are enrolled in the Healthy Michigan Plan, the state’s Medicaid expansion program.
Under House Republicans’ proposal, states would receive less federal funding for care reimbursement, though the specifics will still need to be worked out in the Senate.
“If there is dramatic reduction in the funding for those programs, it not only impacts those that are on Medicaid, but it impacts access to those that aren’t,” said Ed Ness, president of Munson Healthcare. ”If that match decreases by whatever amount it is, either the state’s going to have its own budget deficit to make up, or it’s going to have to cut other programs, or it’s going to have to cut reimbursement to many of its hospitals.”
The proposal also includes requirements that most able-bodied recipients work for at least 80 hours a month.
Experts say they’re concerned those provisions could lead to tens of thousands of eligible recipients losing coverage, despite meeting the requirements.
An analysis from nonpartisan healthcare researcher KFF found that 44% of adult Medicaid recipients work full-time and 20% work part-time.
It also found that about 30% aren’t working due to disability, education, or caregiving, leaving roughly 8% who could work but don’t.
“It is our understanding as well that the vast majority of people on the program already are able bodied and working, or have exemptions,” said Deidra Wilson, VP of government relations for McLaren health Care.
A report from MDHHS estimated that work requirements in an earlier form of the bill would have risked coverage for up to 500,000 beneficiaries in the first year.
“It’s because of the nature of these requirements that they may lose the coverage, not because they are not working, as they appropriately should to get that coverage,” Wilson said.
Monique Stanton, president of the Michigan League for Public Policy, says that the proposed work requirements create additional barriers that would keep otherwise eligible residents from enrolling.
“It requires an investment, so additional money that we’re paying for bureaucratic red tape to make people jump through hoops in order to get healthcare, rather than spending those dollars on things to help boost health care access,” she said.
The MDHHS report also estimates that work requirements could cost the state over $150 million in administrative costs.
Republicans have pushed the cuts to offset some of the impacts of their proposed tax cuts, which the Congressional Budget Office estimates would add more than $3.7 trillion to the national debt over the next decade.
But advocates argue that cutting investments in healthcare often lead to more severe — and more expensive — issues later in life.
“When we reduce access to Medicaid, we reduce the ability for people to treat their chronic health conditions,” Stanton said. “We end up seeing people showing up in the emergency room, seeing showing up in more emergent acute care issues because they’ve not been able to get the care that they’ve needed over the long term.”
