An excerpt from 90.5 WESA | By Kiley Koscinski
The Pennsylvania delegation in the U.S. House voted along party lines this week to narrowly pass a GOP budget blueprint that calls for $2 trillion in spending cuts, including reductions at the federal agency that oversees Medicaid and Medicare.
While Republicans celebrated the resolution as a promise kept to voters calling for massive federal spending cuts, Democrats condemned it as a fatal blow to social services. And that concern is growing among health care advocates who worry cuts to Medicaid could be a matter of life and death for people who can’t afford private insurance.
“People are scared. They’re angry,” said Antoinette Kraus, executive director of the Pennsylvania Health Access Network. “People are [already] struggling to afford care. If you take the rug out from under them… they are going to face the tough choice of going uninsured or having to give up another necessity in their life.”
Medicaid, also known in Pennsylvania as Medical Assistance, provides free or low-cost health insurance to low-income adults, children, pregnant women, people with disabilities as well as some elderly adults who also qualify for Medicare. The program, which is jointly funded by states and the federal government, covers one in five Americans.
The budget resolution approved by the U.S. House on Tuesday does not name Medicaid or Medicare specifically, but it does call for $880 billion in spending cuts from the agency that oversees the insurance programs, the House Energy and Commerce Committee. And lawmakers would be hard pressed to cut enough elsewhere to meet that target without impacting Medicare or Medicaid.
An analysis by the New York Times found that if the committee cuts funding to everything other than health care programs, it would still be $600 billion short of the $880 billion target.
“The money is not there,” said Kati Brillhart, vice president of government and external affairs at Pennsylvania Partnerships for Children. “There are not enough programs that they could shave off a bit of funding from and then only impact Medicaid very slightly.”
Medicaid covers about 3 million people in Pennsylvania, and more than 246,000 in Allegheny County, according to state data.
That’s about 25% of the county, according to Allegheny County Department of Human Services Director Erin Dalton. She expressed concerns last week to County Council about potential cuts to the program.
“Any cut to Medicaid would be really devastating to our region,” Dalton said, noting her department receives $500 million annually in Medicaid funding. She said programs that provide mental health services and addiction treatment for those who cannot otherwise afford care could be on the chopping block.
The cuts could also impact children. About half of Pennsylvania kids under the age of 19 are insured through Medicaid or the Children’s Health Insurance Program, also known as CHIP. Nearly 100,000 kids in Allegheny County are covered under the programs.
And across Pennsylvania, Medicaid covers 1 in 3 births, which is higher than the national average. The state extended Medicaid and CHIP postpartum coverage from 60 days to a full year in 2022. That expanded access to postpartum care has been found to reduce maternal mortality rates, especially among racial and ethnic minorities.
“It's a really important coverage option for low-income, hard-working, pregnant individuals,” Kraus said.
Though many elderly are insured under Medicare, many qualify for additional coverage under Medicaid. The program is the primary payer for nursing homes nationwide, covering more than 60% of nursing home residents and about half the costs for all long term care services, according to the National Center for Assisted Living.
And others who require assisted living support rely on the program too, said Mary Hartley, president of the Arc of Greater Pittsburgh. Her organization, which is part of the Achieva Family of Organizations, supports more than 2,000 families with intellectual and developmental disabilities.
She said Medicaid could be the difference between a child with disabilities living in a medical facility or at home with their family “which is the best place for a child.”
“These are the services that allow people with disabilities to live in our communities and not in institutions or nursing homes,” she said.
Advocates said Wednesday that they are staying hopeful that the winding budgetary process will afford opportunities to convince lawmakers to keep Medicaid fully funded.