How Medicaid helps mothers, caregivers and children

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Barbara Rodriguez of The 19th was the first to report on this story.Read more of their coverage of politics, gender, and policy, and meet Barbara.

According to reports, Republicans in charge of Congress are considering slashing Medicaid, the well-liked federal-state insurance program that offers millions of Americans health and long-term care. According to lawmakers, the cuts would go toward funding President Donald Trump’s tax plan, which is anticipated to contain long-term tax relief for high-income Americans.

Trump declared on January 31 that he will adore and appreciate Medicaid, Social Security, and Medicare, two programs that disproportionately support and care for older Americans.

The president declared, “Unless we can find some abuse or waste, we’re not going to do anything with that.” People will not be impacted. It will only get better and more efficient.

House Republicans formally charged members in charge of the Medicaid budget with cutting at least $880 billion in spending over a ten-year period about two weeks later.

About one in five Americans are covered by Medicaid, and proponents point out that during the 2024 presidential campaign, the major party candidates did not mention it as a crucial policy issue. People are the ones who will be affected by possible Medicaid cuts, including families, especially expectant moms, caretakers, and kids. Advocates claim that if the federal government stops providing part of its current financial support, it may have an effect on the complicated medical needs and disabilities of some of these kids.

Here is everything you need to know about how Medicaid currently provides long-term care and high-quality health care for vast populations, as the topic of Medicaid funding’s future remains a topic of national discussion.

How many people are on Medicaid, and who are they?

Medicaid is a federal-state-funded health insurance program for low-income persons, children, people with disabilities, and some older Americans. It was established by law in 1965 and currently has 72 million enrollees.Due to their financial difficulties, enrollees pay little or no in premiums or fees.

The Children’s Health Insurance Program, popularly known as CHIP, guarantees that children whose parents make too much money to be eligible for Medicaid but are also unable to buy private insurance can still receive medical care. This group accounts for little under 80 million Medicaid beneficiaries, including roughly 7.2 million children.

When Medicaid and CHIP enrollments are combined, children make up 37.6 million, or over half of all Medicaid beneficiaries.

Based on the information at hand, the following is a breakdown of other enrollees:

• Parents and other adults under 65: 27.8 million
• People with disabilities: 7.8 million
• Individuals who are 65 and over: 5.6 million

The data shows how Medicaid affects women’s health. In 2023, 19% of adult women aged 19 to 64 were enrolled in the program, compared to 14% of men. In the United States, one in five women who are not old are covered by Medicaid. Joan Alker, executive director of the Center for Children and Families at Georgetown University’s McCourt School of Public Policy, says women make up a disproportionate share of low-income parents on Medicaid.

“These kinds of proposals for broad cuts put gender, and women in particular, at risk in a lot of ways,” she said.

What services does Medicaid offer for pregnant people and new parents?

A mainstay of the program since its establishment almost 60 years ago, Medicaid offers low-income pregnant and postpartum individuals health care coverage. Pregnant women who require prenatal care can typically get vitamins, doctor visits, and ultrasounds through Medicaid, which assists moms and other caregivers.

According to Laura Harker, a senior policy analyst at the Center on Budget and Policy Priorities, people of reproductive age can truly benefit from having that consistent coverage and entering pregnancy in a healthier manner. Thus, we truly examine Medicaid throughout the reproductive process.

More than 40% of all newborns in the nation are said to have been covered by the program. Experts estimate that a person with private insurance incurs an average of nearly $19,000 in health costs related to pregnancy, childbirth, and postpartum care, which can translate to nearly $3,000 in out-of-pocket expenses. However, there are many factors that affect how much an uninsured person will actually pay for a birth.

To put it briefly, Medicaid has been helping families for many years.

The significance of Medicaid for children and families cannot be overstated, according to Maddie Twomey, director of communications for the health care advocacy group Protectt Our Care. At any time in your life, you could depend on it.

States can now offer postpartum coverage for 12 months instead of the required 60 days, which caused over 45% of postpartum individuals to lose their insurance soon after giving birth, according to a clause in former President Joe Biden’s 2021 American Rescue Plan Act.

In America, the first year following childbirth accounts for over half of all pregnancy-related deaths, and Black women are disproportionately affected by these inequities.

According to experts, the majority of governments have so far agreed to increase postpartum coverage, which could aid in addressing the health inequalities that contribute to pregnancy-related mortality. In addition to helping parents deal with medical bills and postpartum depression, which can take months to manifest, a year of postpartum coverage can also aid.

Although some policy experts advise against making firm judgments about the impact of the longer postpartum coverage period just yet, they concur that the maternal mortality rate in the United States is still obstinately high. According to a Centers for Disease Control and Prevention estimate, it will be 23 deaths per 100,000 births between 2018 and 2022, which is higher than the rate in other nations.

As they attempt to counteract the federal government’s reduction of whatever matching funds it has supplied, health activists fear that broader cuts to the Medicaid program would unavoidably affect whether as many states offer extended postpartum coverage.

What does Medicaid do for children?

Millions of children nationwide have access to a variety of health care services through Medicaid and CHIP, including emergency care and checkups, dental and vision care, laboratory and X-ray services, vaccination immunizations, mental health services, and more.

As children grow into adults, their general health improves as a result. Additional advantages include reduced high school dropout rates, increased college enrollment and completion rates, and increased earnings in later life.

“It’s a really good investment because it’s one of these things that works so well,” Twomey remarked.

Medicaid also has a significant impact on the treatment of kids with disabilities and complicated medical requirements. According to data from 2019, 13.9 million youngsters in the nation are anticipated to have special health care needs. Nearly half of them are covered by Medicaid, according to KFF, a nonprofit organization that does health policy research.

Children (and adults) with such particular health requirements could need home-based and community-based care, as well as what are known as long-term services and supports.These services, which enable children to live at home with their families rather than in institutions, can include private duty nursing, case management, assistive technology, and attendant care. While private insurance frequently does not cover many of such services, Medicaid does, depending on the state.

Unless you are independently wealthy, it is the lifeline for kids with complicated medical requirements and impairments, according to Elena Hung, executive director and co-founder of Little Lobbyists, a national advocacy group for kids with such needs.

In accordance with a federal disability legislation that addresses educational needs, school districts may also use Medicaid funds to offer qualified kids specific medically necessary services. Professionals who provide services to eligible pupils, including as school psychologists, occupational therapists, speech-language pathologists, audiologists, and school social workers, are paid for with Medicaid monies.

How else does Medicaid impact overall caregiving?

According to KFF, Medicaid pays for half of all long-term care expenses. Given that women outlive men, that care is essential. Twenty percent of women were enrolled in both Medicare and Medicaid in 2021. Medicare and Medicaid are supplemental coverage programs that assist people pay for more of their medical expenses.

More than 60% of long-term care residents in nursing homes—a predominantly female population—are covered by Medicaid. Women, particularly women of color, make up a substantial portion of the care workforce. Due to their poor incomes, many of them must rely on Medicaid to pay for their own medical treatment.

According to Alker, who pointed out that just over half of Medicaid spending goes to elderly and people with disabilities, it’s affecting a wide range of different facets of our healthcare system that are related to caregiving.

Under the Affordable Care Act, the majority of states and the District of Columbia have also increased the number of people who are eligible for their Medicaid programs over a number of years. One of the $561 billion in savings that House Republicans have suggested over the next ten years is to eliminate that expansion. Alker stated that overall program cuts would be harmful to children and would probably affect all enrollees.

By taking hundreds of billions of dollars away from the most crucial program for children’s health, they are not protecting children since states would not be able to compensate for such losses, she said. States would find themselves in a very precarious situation. So fiscally, it s a huge risk to children.

Is Medicaid popular?

Yes, it s a popular program among a majority of Americans,according to KFF pollingthat was conducted in January ahead of Trump s inauguration. The findings show 77 percent of respondents view the Medicaid program favorably. 63 percent of Republicans were among them.

The poll also found nearly half of all people say the federal government is not spending enough on Medicare and Medicaid.

Is there fraud in Medicaid?

Elon Musk has reportedly been granted access to technology and spending data on Medicare and Medicaid programs that are housed under the federal health department. Musk was appointed by Trump to reduce the size of the federal government, despite the fact that his efforts to date have included attempting to stop the flow of funds already appropriated by Congress. Musk claimed on X: Yeah, this is where the big money fraud is happening.

The scope of fraud in health careis nuancedbut is not often committed by regular people who are Medicaid enrollees. According to an estimate by the Georgetown University Center for Children and Families, 95 percent of Medicaid payments are proper payments for care. There are also already systems in place,including through the federal government, to catch and prosecute fraud and forms of mismanagement.