Advocating Coast-to-Coast for Medicaid

President's Message: The impacts of losing access to care are real and dangerous.

By Adam Dougherty, MD, MPH

We knew that Medicaid, better known as Medi-Cal in California, would be threatened under the new Administration. The devastating impacts of proposed cuts across our communities cannot be overstated, because Medicaid is not just a safety net program anymore. Since the Affordable Care Act became law, Medicaid and its expansion programs have become a pillar of our state and nation for health care access, health system operations, and reliable health care jobs in our communities. The vast majority of Medicaid patients are employed and the program remains a vital resource for seniors, persons with disabilities, and veterans. This is why every single touch point of our health care system is sounding the alarm.

And our efforts are working.

For the past three months, we have met with Congressional representatives from across the state, particularly those from districts with the highest proportion of Medicaid, to tell the stories of our patients and our community physicians. We all know the very real impacts to losing access to care, including delayed diagnoses, decompensated chronic disease, and overcrowding of emergency departments that are already stretched thin. We have produced numerous district-level reports on the impacts in our communities under threat, including significant increases in the uninsured population, the direct threat of hospital and clinic closures, and the resulting economic losses in those communities because of job and wage loss. These cuts would ripple beyond the program itself, limiting access to ambulances and emergency care for everyone, and would continue to increase cost sharing to the commercially insured.

Op-eds explaining these very real impacts, and multi-state coalitions including Protect Our Care and Physicians For Medicaid, have amplified our messages. Your SSVMS leadership was a critical part of the Cap-to-Cap health care delegation in Washington D.C., where we dedicated the majority of energy and expertise to protecting Medicaid. I had the opportunity to speak in front of that delegation and provide insights from the front line as an emergency physician, as well as to participate in a press conference with our very own Rep. Dr. Ami Bera.

While the many meetings and discussions amidst the current political climate can feel demoralizing, our message is being heard. The worst proposals are off the table because of these many efforts, yet the proposed cuts that remain are still destructive. The health care package approved by the House Energy and Commerce Committee will move along to a full House vote (along with the slew of other spending reductions and tax cuts) in a larger budget resolution before entering the Reconciliation process where a unified bill that resolves any differences between the two houses would only need a majority approval in the Senate. The razor-thin majority in both houses leaves ample opportunity for continued direct advocacy on behalf of our patients and colleagues. The fight continues!