Medicaid cutoffs: An American horror story


April 21, 2023

The biggest threat to Americans today isn’t from a foreign power. It’s from a long-running war on the poor by out of touch politicians and their Wall Street backers.

The latest attack on working Americans even has a name: “The Unwinding.”

If that sounds like the title of a horror movie to you, you’re not far off. Starting this April, state governments and welfare offices began cutting off Medicaid coverage from some 15 million people.

Under pandemic protocols, people getting healthcare through Medicaid had enjoyed some extended protection from the constant threat of losing their care. In exchange for increased federal funds, the federal government had required states not to kick people off the program.

Before these protections, people could be cut from Medicaid for many reasons — including slight changes in income, missing paperwork, glitches in the system, mistakes by state agencies, or simply delayed mail deliveries.

The stated purpose of all this surveillance is to prevent “waste, fraud, and abuse” by those on Medicaid. But as anyone who’s dealt with the American health care system can tell you, the real fraud comes from profiteering health care corporations, not patients.

For example the Centene Corporation, which acts as an intermediary between Medicaid and private insurers, recently had to pay a $140 million penalty for overbilling taxpayers in Ohio and Mississippi. More broadly, it’s the fundamental business model of all insurance giants to collect premiums while denying care.

Still, it’s working people who pay the biggest price. Late last year, both parties in Congress agreed to “unwind” federal Medicaid protections, making it possible for states to start stripping people of their health care starting April 1.

Sadly, this was no April fool’s joke.

The health care cut-off could be a killer for people with chronic health conditions that require blood work, medication, and specialist appointments. It’s a mental and behavioral health crisis in the making. And it will mean millions of Americans losing access to the doctors and health care providers that have come to understand their situation.

As pandemic protections expire, it’s those who were hit hardest by the pandemic itself that will bear the brunt of this disaster, too.

A report from the Poor People’s Campaign: A National Call for Moral Revival found that counties with the most people living in poverty had pandemic death rates 1.5 times higher than counties with the fewest people living in poverty. These counties — both urban and rural, black and white, red and blue — will be decimated by these Medicaid cuts.

Not all of those 15 million may lose care entirely, but all will be impacted.

Some may still qualify for Medicaid if they re-apply, but that puts the burden on people who shouldn’t have been thrown off in the first place. And about half will qualify for Affordable Care Act marketplace plans. But how many people do we already know on junk plans they will never use because of high deductibles and copays?

There are more than 140 million poor or near-poor people in the U.S. today, according to the Poor People’s Campaign. Of that number, more than 90 million receive health care through Medicaid. The “unwinding” of care for 15 million people, then, is a horror story of epic proportions.

The pandemic moratorium on cut-offs was an absolute minimum measure to maintain health care coverage for working people in this country. It’s the kind of thing that shows our government is perfectly capable of serving our people — when it chooses to.

With the overlapping health care crises of hospital closures and ballooning medical debt, our national wellbeing requires the extension of this moratorium and the expansion of Medicaid — not its “unwinding.”

No elected official, community leader, or person of good conscience who claims to stand on the side of the people should make excuses for this punishing policy violence.

Medicaid cuts