Op-Ed Urges Focusing Medicaid Debate on Improving Healthcare, not Just Cutting Costs

A recent op-ed penned by National Association of Counties Executive Director Matthew D. Chase for The Hill, urges focusing the Medicaid debate on improving health care rather than just budget impacts and cost shifts.

The National Association of Counties and county elected leaders are keenly focused on improving efficiencies and lowering costs in healthcare. We understand from personal experience — counties invest more than $80 billion in residents’ health services and another $25 billion for our 3.6 million employees’ health insurance each year — the current path is unsustainable.

Yet, we remain frustrated that the debate in Congress is fixated almost exclusively on federal budget impacts and cost shifts to state and local governments, rather than on improving people’s well-being and quality of care.

As a primary safety net provider at the community level, county leaders know all too well that someone always pays at the end of the day, and, increasingly, it is local taxpayers through county health, human and public safety services. From experience, we can predict with certainty that the proposed $830 billion reduction in federal Medicaid support will drive our residents back to high cost providers such as emergency rooms, homeless shelters and jails — or worse, the county morgue.

In response, NACo has spearheaded two signature initiatives related to healthcare in recent years. One is our partnership with the National League of Cities to address the opioid and heroin epidemic, which now kills more people than car crashes. Another initiative is a collaboration with the Council of State Governments Justice Center and the American Psychiatric Association Foundation to reverse the disturbing trend of using our jails as warehouses for people with mental illnesses and co-occurring substance abuse disorders rather than treat them with professional medical care.

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These county lessons are significant because Medicaid is the largest funder of preventive health, births/pregnancy, drug recovery and mental health treatment services. When we talk about the growing costs of Medicaid, it is prudent to remember the population being served. Of the 80 million individuals covered by Medicaid today, more than 34 million are children under 18 years old, 7.3 million are low-income elderly and 11 million are disabled. Approximately one-third are very low-income adults between ages 19 and 64, yet these same adults account for less than 16 percent of Medicaid costs. By comparison, the elderly and disabled represent 61 percent of Medicaid costs, with children at around 20 percent. In fact, 50 percent of all U.S. births are covered by Medicaid.

These numbers are sobering and represent profound challenges with real faces and families, not just numbers on a Congressional Budget Office spreadsheet.

Read the full op-ed on The Hill to learn more.

Healthcare reform will be discussed at the 2017 MACo Summer Conference session “ABCs of ACA, AHCA and Healthcare in Maryland“ on Thursday, August 17, from 3:30 pm – 4:30 pm. Read more in the brochure.

The MACo summer conference is August 16-19, 2017 at the Roland Powell Convention Center in Ocean City Maryland. This year’s theme is “You’re Hired!”.

Learn more about MACo’s Summer Conference: