A new campaign highlights how Medicaid has transformed the lives of many people who use drugs, through medications for opioid use disorder, counseling and other treatment that they otherwise couldn’t have accessed. It’s intended to help influence lawmakers in defense of the federal health care program, which is being targeted for brutal cuts by the Republican-controlled Congress.
The campaign, “Faces of Medicaid,” was launched by the Legal Action Center (LAC), a nonprofit advocating for health equity. It features individual profiles and audio testimonies from a wide range of people to whom the program has been essential. Medicaid, which provides health insurance for people on low incomes and other vulnerable groups, is the single largest payer of substance use disorder needs in the United States.
Among other things, it pays for lifesaving medications like naloxone, buprenorphine (Suboxone) and methadone; for detox and residential substance use disorder treatment services; and for counseling, supportive housing, and re-entry services for people released from prison. Of 72 million Medicaid recipients, roughly one in five has a substance use disorder.
“I’ve seen throughout my years of advocacy that data is helpful, but seeing people’s faces, hearing their voices and stories, is what moves people.”
Teresa Miller, LAC’s national director of health initiatives, said the idea for the campaign came from her organization’s advocacy efforts on Capitol Hill.
“As we’ve been talking to members and staff on the Hill about the importance of Medicaid to millions of people across the country, one of the questions we got is to share stories of people with substance use disorder who have been helped by Medicaid,” she told Filter. “We didn’t have a lot of stories focused on substance use disorder and [our contacts on the Hill] were interested in having that.”
“I’ve seen throughout my years of advocacy that data is helpful,” she said, “but seeing people’s faces, hearing their voices and stories, is what moves people.”
One of the people featured in the campaign is Frederick Shegog (above), from Pennsylvania. He experienced substance use disorder for a decade, which included periods of homelessness. “Thankfully, through Medicaid, he was able to access SUD treatment and services, including weekly therapy to work through past trauma, once Pennsylvania expanded eligibility for the program,” the campaign website reads.
While receiving this support, Shegog went back to school and earned a graduate degree. He then started his own company. His income meant he was no longer eligible for Medicaid, and the transition to paying out-of-pocket for therapy was difficult. But he’s clear about the program’s critical value.
“Medicaid stepped in when I needed help,” he told the campaign. “So I ask everybody that is in a position of power, that signs legislation, please do not stop funding Medicaid.”
Another of the people profiled is Brittany Morris, from Louisville, Kentucky. She decided to seek treatment for opioid use disorder when she found out she was pregnant. She had no income at the time, and Medicaid was the only way she could access the medication Suboxone, which changed her life.
“Suboxone put me on the right track and it should be available to everyone whether they can afford it or not,” she told the campaign. “Everyone deserves the chance that I was given.”
Like Shegog, Morris struggled with the costs after she got a job and was no longer eligible for Medicaid. It’s a common situation, among so many that illustrate how far away the US is from health equity even with Medicaid in place. Morris had to taper off Suboxone as a result, but remains in recovery.
Asked what struck her most about the people LAC profiled, Miller said, “Just how lifesaving Medicaid has been for people. When you hear someone talk about their life, and how having access changed everything. It allowed them to get treatment for their SUD, oftentimes treatment for co-occurring mental health conditions. Because of that they were able to live exciting lives. Because they got their treatment, or their kids got treated, they were able to work full-time, rebuild relationships and go back to school.”
Medicaid was established in 1965 as part of the “Great Society” agenda of President Lyndon Johnson (D). Despite its popularity among voters accross partisan lines, it has weathered repeated attempts to undermine it over the decades. In the 1980s, President Ronald Reagan (R) proposed cutting Medicaid by billions, deploying the derogatory term “welfare queen” against people who rely on social support.
In 2006, President George W. Bush (R) signed legislation that cut Medicaid spending. And in 2011 President Barack Obama (D) offered to make historic cuts to Medicaid and other programs in exchange for higher taxes on the rich, as part of a “grand bargain” with House Republicans; the deal, ironically, was killed by Tea Party Republicans who opposed tax increases.
“Where we are right now is we will have weeks, maybe months, of discussions of potentially what levels of cuts to Medicaid are acceptable.”
In 2017, during President Donald Trump’s first term, the Republicans intoroduced a plan to repeal and replace the Affordable Care Act, targeting the ACA’s Medicaid expansion and endangering millions of recipients. The bill almost passed Congress; its failure ended Trump’s health care plans for the remainder of his term.
Now, the Republican-controlled Congress is attempting a new strategy to slash Medicaid. In a budget wishlist bill passed in March, the GOP revealed its proposal to cut at least $1.5 trillion in federal spending, and instructed the House Energy and Commerce Committee—with authority over Medicaid—to make at least $880 billion in cuts over a decade.
The result, as a Congressional Budget Office analysis of the proposal confirmed, would be a catastrophic gutting of the program.
On April 5, Senate Republicans passed their version of the budget, which targets a much lower total of $4 billion in spending cuts, in part by using what NPR describes as a “procedural gimmick” to get around the $3.8 billion cost of extending Trump’s 2017 tax cuts, as well as raising the national debt limit.
“Where we are right now is we will have weeks, maybe months, of discussions of potentially what levels of cuts to Medicaid are acceptable,” Miller said. “When you talk about an $880 billion cut to Medicaid, you’re talking about terminating people’s access to health care. You’re not just talking about cutting ‘waste, fraud and abuse.’ Even if the number ends up being less, you’re still talking about cuts to a program that operates efficiently.”
Miller urged that no compromise should be made that threatens health care for the most vulnerable members of society—including people who use drugs, formerly incarcerated people and people with criminal records.
“There are so many organizations in this fight,” she said. We have partners all over the place; I would venture hundreds of organizations are fighting to preserve Medicaid. There are people across the country and here in DC that are very focused on doing whatever we need to, to protect Medicaid.”
Top photograph (cropped) by American Life Leage via Flickr/Creative Commons 2.0. Inset photographs courtesy of the Legal Action Center.
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