We’re hearing a lot these days about entitlement reform — a lot of talk about Medicare, for example, and we’ll get to that in a latter show. But today, we want to take a look at what entitlement reform may mean to folks who use Medicaid and the Children’s Health Insurance Program, also known as “CHIP,” for their basic healthcare needs. The two programs serve 60 million Americans, over 13 million African-Americans.
Now, who qualifies for Medicaid and CHIP? Well, because it’s a federal program run in conjunction with the states, the requirements vary.
MR. MARTIN: We’re hearing a lot these days about entitlement reform – a lot of talk about Medicare, for example, and we’ll get to that in a latter show. But today, we want to take a look at what entitlement reform may mean to folks who use Medicaid and the Children’s Health Insurance Program, also known as “CHIP,” for their basic healthcare needs. The two programs serve 60 million Americans, over 13 million African-Americans.
Now, who qualifies for Medicaid and CHIP? Well, because it’s a federal program run in conjunction with the states, the requirements vary. As an example, a family of four with an income of less than $44,500 qualifies. Pregnant women whose children qualify for CHIP can get Medicaid. Disabled senior citizens automatically qualify for the program. Plus, seniors who are deemed needy and don’t qualify for Medicare are also eligible for Medicaid. Now, what [do] Medicaid and CHIP provide? Well, basic healthcare for all recipients, as well as nursing home care for over 1½ million seniors. Now, folks, that’s how it is now.
What will change if the GOP takes over Congress and the White House?
The entitlement reform budget pushed by Congressman Paul Ryan, Mitt Romney’s vice presidential nominee, passed the House of Representatives – of course, dominated by the Republican Party. [It is] endorsed by Mitt Romney and the Republican Party platform. It cuts $801 billion over the next ten years out of Medicaid and CHIP. States will be free to determine what they would cover, who they would cover, and how they cover these vulnerable populations. More than 50 percent of African-Americans live in southern states. Those states are led by Republican governors, and so the net effect is those Republican governors who support the Paul Ryan budget will determine the healthcare of more than half of African-Americans in this country.
If the Democrats maintain control of either the Senate or the presidency, they will continue to stop these Republican cutbacks. Due to the Affordable Care Act, Medicaid and CHIP will be expanded to cover another 32 million uninsured Americans over the next ten years. Among that group [are] 6 million African-Americans.
Here to talk about how these radically different visions of healthcare will affect you are Dr. Walter Faggett, speaker of the House of Delegates of the National Medical Association; and Dr. Brian Smedley, vice president and director of the Health Policy Institute for the Joint Center for Political and Economic Studies.
Gentlemen, welcome to the show.
DR. WALTER FAGGETT: Thank you.
DR. BRIAN SMEDLEY: Thank you.
MR. MARTIN: We – we laid this whole vision out, if you will, so people can understand the differences. And what immediately jumps out when you talk about Medicare, Medicaid and CHIP and really the effect that it has on African-Americans and their health?
DR. FAGGETT: Well, really, in D.C., we’ve had a very positive effect with the expansion of Medicaid. Ninety-seven percent of the children, 94 percent of adults are covered in D.C.
MR. MARTIN: All –
DR. FAGGETT: Second –
MR. MARTIN: — adults?
DR. FAGGETT: — 94 percent of all adults. We – we’re close to universal healthcare in D.C., and this is what can happen. Romneycare is the only program that’s better than D.C. at this point. So, I think right now, we in the National Medical Association see a need – we have taken a very strong position that Medicaid needs to be expanded in order to have viability of the Affordable Care Act. And also, we oppose any block granting of – we ca- — you know, to me – to us, to have those governors and state legislators who are opposing [the] Affordable Care Act in a position to block grant –
MR. MARTIN: Now, I’m glad you brought that up because, again, folks at home – they hear these phrases, “block grants” – things along those lines.
OFF CAMERA: Right.
MR. MARTIN: Over the last 30 or 40 years, Republicans have been able to use that notion of block grants to say, “Hey, let’s take the federal government out of this. Let’s just simply send the money to the states so they can decide what they want to do with it.”
Dr. Smedley, you study underserved communities. And so when you look at the population trends for African-Americans, more folks are moving from the Midwest and the North back South. So, you’re talking about Georgia, Tennessee, Alabama, Mississippi, Louisiana, Arkansas. And in every, single one of those states, they have Republican governors who say, “Look. We will decide how we choose to use these dollars.” What will be the impact for those folks living in those states, who also have some of the worst healthcare stats across the country?
DR. SMEDLEY: That’s absolutely right. [In] many of these regions of the country, you see terrible health statistics relative to the rest of the country – the “Stroke Belt,” for example. So, here’s the challenge. You don’t get more by spending less on a vitally important program like Medicaid. Of the 50 million uninsured, about half are people of color, disproportionately in regions like the South.
The thing about the South – many of the sou- — southern states, eligibility requirements for Medicaid right now are so restrictive, that you’re probably making about 20, 25 percent of poverty to be eligible. ’S about 5 to $6,000. If you make a penny over that, you’re not eligible for Medicaid.
MR. MARTIN: And – and let me make this point, Doc, for – for our – for our audience. I’m talking about, obviously – because of our audience – those states where [there’re] so many African-Americans there. But you have a significant number of Whites who live in those states who often vote for Republican candidates, and when you look at the healthcare stats, they, too, have deplorable healthcare.
DR. SMEDLEY: That’s right. Absolutely. And so we see once again that the folks whose best interests are served by supporting politicians and platforms that expand public insurance programs are not fully understanding how they benefit. Most of the folks who’re on Medicaid and other forms of public assistance are, in fact, low-income Whites. The problem has been that, politically, folks have associated with – public assistance programs with people of color, and that diminishes political support for these programs, when everybody benefits from many of these programs.
MR. MARTIN: Well, Dr[s]. Faggett and Smedley, we certainly appreciate it – you coming here and breaking this down for us. And, of course, we will continue to have this conversation, because it’s not going away.
DR. SMEDLEY: Absolutely.
DR. FAGGETT: Okay.
DR. SMEDLEY: Thank you.