Degrees of Separation: Medicaid This Election Season

By Rebecca Waxman

A friend called me last week to tell me she was getting laid off.  The reason?  She doesn’t have a bachelors’ degree.  This disturbing news made me wonder, how many other people are losing work for this same reason?  Furthermore, why is she losing her job and I feel secure in mine?  In 2012, what it really comes down to is changes to our country’s Medicaid program, and the fact that I have two letters that I can place after my name: B.A.

Medicaid is one of our nation’s two health insurance programs.  While each state administers and pays for the program in the best way it sees fit, the federal government finances more than half of Medicaid’s total spending.  Medicaid insures people with lower incomes, including families and children, senior citizens and people with disabilities.  This political season, I hear President Obama and Governor Romney talk a lot about Medicare, the other national health insurance program that covers people older than 65 years of age, in addition to some people under 65 who have certain disabilities.  In the upcoming debates, I want to hear more about Medicaid.  Cuts or increases to the Medicaid program do not only impact people who are poor or have disabilities.  Changes to Medicaid affect businesses and hospitals that are funded by Medicaid dollars.  Moreover, changes to Medicaid just cost my friend, and countless others, her job.

When Medicare is referenced in the media, I am reminded that our public officials are looking out for our senior citizens.  Likewise when Medicaid is mentioned in the media, I hear about Medicaid program participants.  Of the 62.6 million people directly benefiting from Medicaid, 49% are children, 25% are senior citizens and people with disabilities, and 65% are from working families.  While these are important statistics that all should know, I want our future president to talk to me about another group of people directly impacted by Medicaid.  I want to hear about the social workers, doctors, nursing home attendants and hospice nurses who also depend on the continuation of the Medicaid program.

Earlier this year, Louisiana’s Medicaid system was sold to a private company, and new rules and guidelines were set in motion.  Historically, when healthcare providers like doctors and social workers work directly with patients, the state of Louisiana paid the providers directly for any services rendered.  Today, under a new managed care arrangement, doctors are paid by a third-party organization with whom the state contracts.  Understandably, the amount employees are paid is based upon their credentials, and increase according to any degrees earned by the employee who bills for services.  Under this new managed care system, employees without a B.A. are no longer paid enough, even though there is no difference in the services received by patients.  These new reimbursement rates are making it impossible for employers to continue to pay those who may be well seasoned in the social service industry through decades of professional experience, simply because they don’t have the degree to show for it.

While 1/5 of all Americans currently participate in the Medicaid program, we cannot pretend that only 20% of Americans will be directly affected by whether or not the Affordable Care Act continues in the country, and whether or not there are more or fewer dollars placed into the federal Medicaid budget.  It affects not only our hospitals, community health centers, and our nursing homes, but every working American employed by these institutions.  We are all relying on a strong Medicaid program.

When we hear about Medicaid this election season, I hope our ears perk up not only for the 20% of Americans currently able to participate in the Medicaid program, but also for the health care providers, who like me and my friend, rely on Medicaid to provide services to individuals in need throughout our community. In the end, isn’t a better economy with healthier workers and more financial security something we can all stand behind?

Rebecca Waxman was an AVODAH’s corps member in New Orleans in 2008-2009 working at the Greater New Orleans Fair Housing Action Center. Rebecca currently works at NAMI New Orleans, the National Alliance on Mental Illness as a Case Manager where she advocates for clients living with a mental illness or addiction disorder.

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