“There’s No Plan B”: Medicaid Clinics Go on Life Support

Millions of healthcare providers have been furloughed during the pandemic due to a lack of patient revenue. Like many businesses, health systems and care facilities are using federal money to stay afloat during this financially uncertain time. Even though Congress recently sent around $100 billion to healthcare providers, much of that money has gone to Medicare clinics and providers, while Medicaid providers get the cold shoulder.

Without a lifeline from the federal government, Medicaid facilities are going into debt as they try to keep their doors open during the pandemic. Many facilities that serve low-income communities might not survive, which could deprive millions of Americans access to healthcare.

The Gradual Unraveling of Medicaid

Back in March, when Congress approved $100 billion for healthcare providers, the money was designed to support healthcare systems that were struggling due to a lack of revenue. Much of it was used to purchase additional personal protection equipment (PPE) so health systems could keep up with the influx of coronavirus patients.

The money was distributed by the Department of Health and Human Services, but now Medicaid clinics and providers are calling foul. State Medicaid chiefs are calling on the federal government to approve more funding, so they can keep their doors open amid the pandemic, many of which are providing life-saving services.

This lack of emergency funding is affecting a wide range of providers, including those that accept both Medicaid and Medicare. For some clinics, Medicaid may account for just 15% of their revenue, but that’s still a lot of money these clinics could be using to keep staff members on the payroll.

Why Medicaid Needs Additional Funding

Around one in five Americans are on Medicaid, including some of the poorest and sickest individuals in the country. It covers around 75 million low-income Americans, and children account for around 40% of all enrollees. To qualify for Medicaid, individuals must make less than $16,753 a year, and a family of four must make less than $34,638 a year. Many of these individuals fall below the federal poverty line.

The pandemic has forced millions of Americans to go on unemployment, and low-income Americans seem to be suffering the most. They tend to work hourly jobs, have little savings, and do not have the luxury of working from home.

Medicaid patients already tend to have trouble accessing medical care. While around 71% of providers say they accept Medicaid patients, providers are less likely to accept Medicaid than any other type of insurance. In many cases, providers may be reimbursed at a lower rate when caring for these patients, so they may decide to focus on Medicare patients and those with private insurance.

Medicaid covers a wide range of primary and specialty care services, including urgent care, pediatrics, and long-term care. Many patients, including the young and those suffering from COVID-19, may have to go without medical care if local Medicaid facilities were to close.

Why Is Medicaid Being Left Out and Not Medicare?

Medicaid provides medical care to low-income individuals and families, while Medicare serves the elderly. Many have accused the Trump Administration of being more inclined to help older Americans than poor or low-income citizens.

The president has tried repeatedly to do away with the Affordable Care Act, which expanded Medicaid coverage for low-income adults. The administration has even floated the idea of sending block grants to states, which would put a strict cap on all Medicaid funding. The White House also proposed a rule in November of last year that would make it harder for states to pay their Medicaid costs, which could lead to sweeping spending cuts across the country if passed.

While older Americans are generally considered more susceptible to COVID-19, poor Americans often suffer from high rates of diabetes, hypertension, and asthmas as well, which can leave them just as vulnerable to the disease as the elderly.

What’s the Solution?

Back in April, a bipartisan group of Medicaid chiefs wrote a letter to the federal government asking for more Medicaid funding. They want lawmakers to start making “retainer” payments to Medicaid providers and clinics to help them weather the storm that is the pandemic.

Without these retainer payments, they warn that many clinics will close their doors, further exacerbating the national pandemic. HHS responded by saying that money should start flowing to Medicaid providers that did not receive money during the first round of emergency funding, but it did not specify when this might be.

If you have been laid off as a healthcare provider or know someone who has, a lack of Medicaid funding might be to blame. If the country is going to beat the coronavirus, all Americans should have access to affordable healthcare.

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