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provides health insurance for those who can’t afford coverage — and the administration is trying to gut it



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Why It Matters

  • 70 million people with low incomes depend on Medicaid for health coverage. Most of them (62%) are women.

  • Groups facing discrimination and systemic oppression in the health care system — including LGBTQ+ people, people of color, people with disabilities, and women — are more likely to have low incomes and more likely to use Medicaid. These groups would be the most hurt by losing access to Medicaid.

  • Without Medicaid, millions of people couldn’t access to a wide range of health care services, from dental care to mental health care, as well as sexual and reproductive health care — including prenatal care, birth control, and STD testing.  

Related Players

Seema Verma

Administrator for the Centers for Medicare & Medicaid Services (HHS)

Nominated by Trump: 11-29-2016
Mary Mayhew

Former Deputy Administrator & Director of Medicaid & the Children's Health Insurance Program (HHS)

Resigned: 1-4-2019
Donald Trump

President of the United States

Elected to Office: 11-8-2016
Alex Azar

Secretary of Health and Human Services (HHS)

Nominated by Trump: 11-13-2017

How We Got Here & Where We're Going

  • What to expect next:
    Changes to Medicaid could threaten health coverage for 13 million women of reproductive age
  • 1-30-2020
    CMS issues guidance encouraging states to block grant their Medicaid programs

  • 1-22-2020
    HHS decides to let Texas receive federal Medicaid funding for a state program that bars patients in the program from accessing preventive care at Planned Parenthood and other health centers that also provide abortion

  • 5-6-2019
    Proposed change to poverty calculation could cause millions to lose Medicaid

  • 10-15-2018 
    Trump picks Mary Mayhew — who undermined Medicaid in Maine — to lead Medicaid for the whole nation (she later resigns)

  • 1-19-2018 
    CMS encourages states to block Medicaid patients from care at Planned Parenthood

  • 1-11-2018 
    Administration encourages states to impose new work requirements for people with Medicaid

"I have family members who have Medicaid coverage, and the thought of them losing access to lifesaving care often kept me up at night."

What Will Happen to Medicaid Under Trump?

About 20% of reproductive-age women in the United States get health insurance through Medicaid. To put it another way: 1 in 5 reproductive-age women are covered by Medicaid. So, the Trump-Pence administration’s restrictions on Medicaid will restrict women’s access to health care.

Medicaid coverage also is critical to closing the gap in health care access for women of color. Due to systemic barriers, about one-third of Black women and a quarter of Latinas ages 15 to 44 are enrolled in Medicaid, compared to 14% of white women.

Discrimination and harassment in accessing health care also leave LGBTQ people disproportionately likely to live in poverty or without health coverage. Twenty-four percent of lesbian and bisexual women experience poverty, compared to 19% of heterosexual women. Transgender people are four times as likely as the general population to live in extreme poverty. This makes Medicaid vital for the health of LGBTQ communities.

Background on Medicaid

Trump and Medicaid: Proposing to Cut Trillions of Dollars from the Program

During his presidential campaign, Trump promised he wouldn’t cut Medicaid. However, his 2020 budget plan proposes cutting nearly $1.5 trillion from Medicaid over 10 years. That cuts roughly $1 out of every $4 the government spends on Medicaid — so, millions of Americans could lose their health insurance.

New Medicaid Rules: Adding Work Requirements for Medicaid

The administration has encouraged states to require people to work a certain number of hours and adhere to frequent, detailed reporting in order for them to obtain and keep Medicaid. The Centers for Medicaid and Medicare Services (CMS) has approved Medicaid work requirements in several states, and many more anti-Medicaid state leaders have requested permission to enforce work requirements.

Commonwealth Fund
Threatening Planned Parenthood Patients

Cuts to Medicaid would significantly affect Planned Parenthood patients, about half of whom get their health care through Medicaid.

The Problem with Medicaid Work Requirements

Many people who’d lose Medicaid because of work requirements are actually working or trying to work, but have irregular hours, can’t navigate reporting procedures (often due to lack of internet access and language barriers), or simply do not know about the new requirements.

Medicaid Block Grants

HHS is planning to let states cap Medicaid spending. Under this “block grant” system, the federal government would give states a fixed amount of funding for Medicaid, instead of picking up the slack when states go over budget on Medicaid costs (such as when there’s a natural disaster). The likely results of block grants: states limiting Medicaid by enrolling fewer people, or offering fewer services, or paying health care providers less (which, in turn, would stop some providers from taking Medicaid patients).

Risking Care for 13 Million Women of Reproductive Age

Like last year’s budget proposal, Trump’s 2020 budget proposal — including the overall cuts and work requirements — would threaten health coverage of birth control, STD testing and treatment, and pregnancy-related care for 13 million women ages 15­ to 44. About 62% of Medicaid beneficiaries are women.

NBC News
Medicaid Expansion Covered Hundreds of Thousands of LGBTQ People

States with Medicaid expansion increased Medicaid coverage for lesbian, gay and bisexual individuals from 7% in 2013 to 15% in 2016. That’s about 511,000 more LGB individuals with Medicaid coverage across the United States — but restrictions on Medicaid threaten those gains. Currently, Medicaid covers about 21% of the total U.S. population.

Kaiser Family Foundation
Greenlighting Texas’s Backdoor “Defund”

On the 47th anniversary of Roe v. Wade, HHS decided to let Texas receive federal Medicaid funding for a state program that bars patients in the program from accessing preventive care at Planned Parenthood and other health centers that also provide abortion. This move upends longstanding federal law.  In the past, the federal government has refused to fund state Medicaid programs that aim to take away the right of Medicaid users to choose whatever qualified reproductive health care provider they want.

Planned Parenthood Blog

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