Does the GOP understand Medicaid’s importance to rural communities?

Medicaid is the only healthcare option for millions of rural families. What happens if you kick them off?

Medicaid plays a vital role in rural communities. In fact, 20% of rural adults, and 40% of children, in rural communities get their healthcare through Medicaid. Why? Because our healthcare system leaves many rural residents with nowhere else to get affordable coverage.

Now the GOP intends to kick many of them off. Speaker Mike Johnson says that Medicaid is too expensive. But don’t worry, Johnson tells us, the GOP is only targeting “able-bodied men” who don’t deserve to be on Medicaid anyway.

But is that really true? Here are the problems with Johnson’s argument:

First, every American needs affordable access to health insurance. Healthcare is not some luxury item, like coffee at Starbucks or a video game console, that people can simply get along without. So when Johnson suggests that some people don’t deserve health insurance, he might as well be saying that they don’t deserve water.

Second, the Medicaid reductions in the GOP bill would affect nearly 8 million Americans. But there’s more: additional GOP cuts to premium tax credits under the Affordable Care Act would take healthcare coverage away from another 7 million people. That’s a lot of people! What are they supposed to do?

Third, entire communities will be hurt by big cuts to Medicaid and the Affordable Care Act. Rural hospitals and medical providers cannot survive if many of their patients lose healthcare and can’t afford to pay their bills. Nor can rural businesses prosper when their workers and customers are grappling with unaffordable medical costs. In short, even if you don’t lose coverage yourself, chances are you will know somebody who does.

Fourth, the truth is that only the very rich can afford to pay for their own healthcare today. Johnson and his fellow Congressmen are fortunate -- they get great healthcare paid by their employer (we the taxpayers, in the case of Congress). But many people aren’t so fortunate: they may be self-employed, work for businesses that don’t offer health insurance, are going to school, or acting as a full-time caregiver for a family member. And that is especially true in rural areas. Are these Americans not just as deserving of health insurance as Speaker Johnson?

Fifth, the real healthcare crisis is that America’s healthcare industry takes more of the nation’s money (nearly 18% of GDP) than any other developed nation. That is a hidden tax on every American. And it still leaves tens of millions of Americans vulnerable to medical debt and bankruptcy. But that is a crisis that kicking people off Medicaid will only make worse.

Sixth: there is a better way to fix healthcare: Yes, we absolutely need to find smart, thoughtful ways to reduce the overall cost and eliminate systemic fraud in our healthcare. (The Rural Angle has written about these challenges before — see the links below — and will do so again in the future.). The answer, however, is not for politicians to put the blame on their voters — who just want to be able to see a doctor without going bankrupt…

The bottom line: the nation cut in half the number of uninsured Americans in the last decade thanks to the Affordable Care Act and Medicaid expansion. That was an historic win. Sadly, the GOP’s bill would undo a lot of those hard-won gains and put at risk many rural communities. And for what? To fund a tax cut that will heavily benefit the wealthy. That would be morally wrong and economically foolish.

Interested in learning more? The Rural Angle has written extensively about rural healthcare. You can find the links here:

Aug ’24: the Problem with Pharmacy Benefit Managers

Jan ’24: the Scrooge Edition (Sentara Health)

Dec ’23: The Healthcare Issue: Consolidation and Corporate Greed

Aug ’23: the Small Business Healthcare Surprise

July ’23: What’s happening to Medicaid?

March ’23: How big companies inflate drug prices