At the end of July, I joined a group of Vermonters protesting and staging direct actions in Washington, D.C., to resist the national Republican congressional efforts to repeal the Affordable Care Act, make massive cuts to Medicaid and, ultimately, take away health insurance from millions of Americans and tens of thousands of Vermonters, including many of my constituents in Bennington. I traveled to D.C. with fellow Vermonters who are members of Rights & Democracy, a statewide grass-roots economic, social, health care, and environmental organization. Rights & Democracy has been fighting against the GOP’s health care plans and is working to win universal health care in our state. Thanks to the grass-roots mobilization efforts by other organizations across the country like Rights & Democracy, the various Republican proposals were defeated, and our state and our country sighed a collective breath of relief.
Unfortunately, we can not celebrate this victory for long. President Trump and the congressional GOP leadership have made it clear in recent weeks that they remain committed to implementing proposals that would severely curtail access to needed health care services for seniors, people with disabilities, and lower- and middle-income individuals, children and families. The Republican fiscal year 2018 budget resolution includes deep cuts to Medicaid and overall reduces health care funding by $1.5 trillion over the next 10 years, all while giving huge tax breaks to the wealthy and corporations.
As a Vermont state representative, I strongly oppose these cuts that will harm Vermonters, our state’s budget and our local economy. In Vermont, Medicaid is our single largest source of federal dollars. In 2015 alone, Vermont received nearly $966 million in federal Medicaid funding. If we lose this funding due to federal caps, block grants or other cuts, our state budget will bear the burden. Under a per-capita cap system, for example, our annual Medicaid funding would decrease over time, and we could be faced with even more difficult choices over resource allocation among health care, housing, economic development, public education, infrastructure and environmental initiatives.
In addition to budgetary challenges, the Republicans’ proposed cuts would directly impact the people in our state who depend most on Medicaid: seniors, children, veterans and people with disabilities. In Vermont, about 200,000 people are on Medicaid including 22,300 seniors and 25,700 people with disabilities. Eight thousand veterans in Vermont are also Medicaid beneficiaries. Finally, Medicaid provides health care for 68,800 of Vermont’s children (that’s half of the children in our state) and pays for 47 percent of births.
Seniors would be particularly affected as Medicaid is the leading payer of long-term care services for the aging and disabled at home, in the community and in nursing homes (services not covered by Medicare).
Nationally, more than 1 in 7 low-income seniors enrolled in Medicare (or 6.9 million people aged 65-plus) also rely on Medicaid for their medical services and/or long-termcare.
And this demand from seniors for Medicaid will only grow. By 2060, the number of Americans ages 65 and older is projected to more than double from 46 million today to more than 98 million resulting in increased perperson Medicaid spending. Given these demographic trends— particularly significant in Vermont, a state with one of the largest population percentages of residents over age 65 — protecting Medicare and Medicaid is crucial now more than ever.
While GOP leaders argue their plans give states more flexibility, the reality is that cutting Medicaid just leaves state lawmakers like myself and my fellow members of the Vermont House with fewer resources to address the growing health care needs of aging Vermonters as well our children, working families and people with disabilities. We need more federal funding to solve public health issues — including the substance abuse crisis in our state — not less.
Whenwe do get an influx of federal funds, health outcomes in our state improve. Under the ACA’s Medicaid expansion, for example, our state was able to provide health care coverage to 63,000 adult Vermonters, helping to reduce our uninsured rate by 40 percent from 2013 to 2015. Repeal of the ACA, including the elimination of the Medicaid expansion, would cut $2.362 million from our state budget between 2020 and 2026, and 75,000 Vermont enrollees who currently have coverage would lose it.
Gov. Phil Scott’s own budget rescission proposal — approved by the Joint Fiscal Committee — also makes cuts to Medicaid. Almost half of the “savings”in Governor Scott’s midyear plan to cut the budget by $12.6 million come from the Department of Vermont Health Access, including a $4.5 million decrease in state Medicaid spending based on a reduced projection of what we’ll spend this year, due to dropping Medicaid enrollment. And even though state officials say it will not create a cap on Medicaid enrollment or potential spending, they are relying on the wishful thinking that should Vermont enrollment or spending increase, the federal government will give states more Medicaid funding. Ultimately, like repealing the ACA, this proposal from Scott will reverse the progress we have made with our Medicaid expansion program. If we want to protect the quality of life of thousands of Vermonters, our governor and all my fellow elected leaders need to protect Medicaid, not cut it.
I became a state representative to serve my fellow Vermonters, to improve their living standards, health, economic well-being and environment. We must continue to resist the national Republican efforts to dismantle health care in the continuing resolution debate, the federal budget proposal, and CHIP re-authorization. Last month, Republicans in Congress refused even to listen to their constituents and acknowledge the devastating impact of their proposed bills on millions of Americans. I went to D.C. to stand in solidarity with so many people across our nation who will lose so much under the GOP and Trump vision for our health care system. Today, in our state, I will continue to stand with Vermonters to protect our health care.
The time is now for us to work together to build a health care system that prioritizes patients and their families instead of the profits of private insurance companies and big pharma. I look forward to engaging in this work this legislative session to realize the vision laid out in 2011’s Act 48 and making high-quality health care accessible to all Vermonters.
Kiah Morris is a Democratic House member from Bennington.