Medicare and Medicaid, signed into law by President Lyndon Baines Johnson on July 30th, 1965, were founded on the premise that healthcare is a right, not a privilege, for Americans over 65 and those in poverty. Over the past 53 years, Medicare and Medicaid have provided essential health services to families and individuals that likely could not afford private market insurance.
In 1965 alone, 19 million Americans signed up for Medicare. In 2017, 58.5 million Americans 65 and older or with disabilities, representing nearly one-fifth of the U.S. population, were Medicare beneficiaries. Nearly one in four Americans, 72.3 million, were enrolled in Medicaid, which provides coverage for low-income individuals including families, seniors, and persons with disabilities.
Despite their success over the past 53 years, these programs face threats to their efficacy and future existence. Neither Medicare nor Medicaid are perfect. But, instead of improving and expanding these crucial programs, the Trump administration and Republicans in Congress are working to undermine them.
Having failed in repeated attempts to repeal the Affordable Care Act (ACA), Republicans are now focused on dismantling government-sponsored health care by other means. One strategy involves restricting the number of people who are eligible for Medicaid. In January, the White House announced that it would allow states to refuse Medicaid to unemployed individuals, with certain exceptions. President Trump is the first to make medical coverage for low-income Americans conditional on work, something that would have been unthinkable in the past.
The Trump-GOP tax law codified additional tactics in this multi-pronged attack against our existing health protections. Passed in 2017, the misleadingly-named Tax Cuts and Jobs Act repealed the Affordable Care Act’s individual mandate, which required Americans to maintain a minimum level of health care coverage or seek an exemption. The individual mandate previously lowered health care costs by widening the insurance risk pool to include both healthy and unhealthy individuals.
As predicted, the repeal of the individual mandate has already begun to inflate the price of health care as healthy people leave the insurance marketplaces while sicker people maintain (or sign up for) coverage. EmblemHealth recently warned policy-makers that it plans to raise the price of insurance premiums by 25 percent because the individual mandate was eliminated. “When only sicker people buy health coverage,” an EmblemHealth representative explained, “it costs more.” EmblemHealth is only one of many insurers that have raised premiums citing Trump-GOP tax cuts. The non-partisan Congressional Budget Office (CBO) predicts that rolling back the individual mandate will increase the price of insurance premiums by 10 percent per year for the next decade
The CBO also predicts that eliminating the individual mandate will cause 13 million to lose coverage by 2027. A decline in the number of insured Americans since the tax law took effect provides early evidence of the accuracy of this grim forecast. A recent study found that 3 million more people lacked health insurance at the end of 2017 compared to the end of 2016.
Trump-GOP tax reforms also took aim at health care funding in the long term. According to CBO analysis, the tax law will increase the federal deficit by $1.9 trillion over the next decade. President Trump and House Republicans have already proposed trillions of dollars in cuts to Medicare and Medicaid to trim the budget gap.
Finally, the Trump Administration is working to roll back protections for people with pre-existing conditions. The ACA barred insurance companies from denying coverage, or charging higher premiums, to people with chronic illnesses or prior health issues. The White House has asked the Justice Department to overturn this provision—a provision supported by a majority of registered voters from both parties.
If overturned, insurance companies could refuse coverage to the approximately 130 million Americans under 65 with pre-existing conditions and a recent study estimated that 52 million of these American may be uninsurable due to their pre-existing conditions. Public outcry has so far stopped many Congressional Republicans from supporting the President’s attack on fair treatment for Americans with pre-existing conditions. However, pending legal cases on pre-existing conditions seem likely to reach the Supreme Court, which could strike down these crucial protections.
On the 53rd anniversary of Medicare and Medicaid’s creation, expanding, not dismantling, public healthcare is the solution and Medicare-for-All is the next step. Call your Member of the House of Representatives at 202-224-3121 to tell them to join the Medicare for All Caucus and support the Expanded and Improved Medicare for All Act (H.R.676).