Medicaid – 1965 Was a Very Good Year

I admittedly don’t know much detail about Medicaid. What I do know is that much of the funding for individuals with disabilities living and working in our community are supported through this funding.

According to Wikipedia: “The Social Security Amendments of 1965 created Medicaid by adding Title XIX to the Social Security Act. Under the program, the federal government provides matching funds to states to enable them to provide medical assistance to residents who meet certain eligibility requirements. The objective is to help states provide medical assistance to residents whose incomes and resources are insufficient to meet the costs of necessary medical services. Medicaid serves as the nation’s primary source of health insurance coverage for low-income populations.” This seemed like excellent legislation in our “War on Poverty” at the time.

Since 1965 this act has been modified to include bolstering up through the Affordable Care Act (ACA).

If you want to delve into this in greater detail an excellent resource, by the way, is the Kaiser Foundation it is a “leader in health policy analysis and communications, filling the need for credible, independent information on the biggest health issues facing our nation and its people.” Their board of directors is very reputable not of any particular political or philosophical group.

From the Kaiser Foundation web page “President Donald Trump and GOP leaders in Congress have called for sweeping changes in health care policy, including the proposed American Health Care Act, which would repeal of the Affordable Care Act and its Medicaid expansion and a fundamentally change the way Medicaid is financed by establishing a per capita cap system. The Trump Administration also may consider and approve new waiver requests from state Medicaid programs. This page rounds up several of our most salient resources on Medicaid and the future of the nation’s public health insurance program for people with low income, which covers 74 million Americans. Medicaid covers a broad array of health services and limits enrollee out-of-pocket costs. The program is also the principal source of long-term care coverage for Americans. As the nation’s single largest insurer, Medicaid provides significant financing for hospitals, community health centers, physicians, and nursing homes, and jobs in the health care sector. The Medicaid program finances over 16% of all personal health care spending in the U.S.”

The latest Federal budget proposal makes a 12% reduction in this program next year. We have heard it before – states get to have more control but at a reduced federal appropriation. But what are we missing…the long term goal to cut $800,000,000,000. So when you are talking about cutting 800 Billion dollars out of the system in the next 10 years – it’s a big deal.

The problem from my perspective since I am so closely connected with people with disabilities is that while people who are seniors on this program (think long-term care in nursing homes) and individuals with disabilities make up 24% of the enrollment they consume 64% of the funding – not surprising to anyone that these demographics have complex medical and support needs. So cutting $800 billion is terrifying and causing much angst.

I don’t think this is making America Great Again.  I think this is making America Dreadful Again.  Supply-side economics, based on trickle-down theory, historically hasn’t worked. The idea is that with a lower tax burden and increased investment, business can produce (or supply) more, increasing employment and worker pay.  Lower tax for the wealthy has typically brought hardship for the poor and government programs.

Please for the sake of individuals with disabilities please understand this and get involved.


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Posted in Advocacy, Disability Policy