“They are trying to cut Medicaid to pay for tax breaks for the wealthy. That’s it.”
On the heels of a 24-hour Medicaid Vigil at the National Mall, Nicole Jorwic, chief program officer of organizer Caring Across Generations, discusses the fate of the program.
House Republicans released their budget plan Sunday night. What’s in there?
If this becomes law, it would be the biggest cut ever to the Medicaid program.
Are you surprised?
I’ve been saying it was time for Congress to show their work, and despite assurances from President Trump and Speaker Johnson that there would not be cuts to Medicaid in the legislation, the cuts to Medicaid are in there, to the tune of $715 billion over 10 years, which we know would result in at least 16 million people losing coverage.
How is this time different from the Republicans’ attempt repeal the Affordable Care Act in 2017?
That was about cutting Medicaid as part of repealing the Affordable Care Act, which had partisan feelings attached to it. This is a much cleaner argument. They are trying to cut Medicaid to pay for tax breaks for the wealthy. That’s it.
The resistance is more organized this time. Who came to the vigil?
This time the coalition is even bigger because we have the same aging and disability and labor groups that came together then, but we also have rural health centers, hospital associations, and patient groups. We also had broader health advocates like Planned Parenthood and Network [Lobby for Catholic Social Justice] and other groups that aren’t necessarily focused specifically on aging and disability care, such as Community Catalyst. It was 24 hours of sharing stories and bearing witness to the wide array of people who would be impacted by Medicaid cuts.
What kinds of stories did you hear?
To me, what was most powerful about the vigil is that you had those aging adults who were going to be impacted. You had disabled people who are fearful of losing their services. You had the home care worker from Southern Illinois whose wages are paid for by Medicaid. She herself gets her health care benefits from Medicaid because wages are so low from Medicaid, and she’s currently in cancer treatment. It was heavy and it was intense, but there was also power in sharing those stories together. You had our partners at Little Lobbyists sharing the fears and realities of kids with medically complex needs and disabilities, right alongside those aging adults, all who rely on the same system that’s currently at risk.
And then there are the all the people doing these care jobs.
Absolutely. I like to say that a lot of people understand Medicaid as a health care program, but it is also a workforce program. Medicaid pays for the wages of over 70% of direct care workers.
And that workforce is largely women, women of color, immigrant women.
They are most often the main breadwinners in their households.
On the employer side, from the health care organizations are talking about a workforce crisis. They can’t find the workers.
It’s a big issue for the provider groups. We had groups like ANCOR, which is a coalition of providers that provide disability and some aging supports, coming together to also highlight how this will impact their businesses, because they won’t be able to find workers. They’ll have to shut down. They’ll have to lower the amount of services that they’re providing, and that’s going to impact local economies.
When you shift the burden to states, what does that look like, especially for seniors?
There is not a state, red or blue, that can make up for cuts of this magnitude. And it’s not only that the cut of the federal share of the pie will be going down, it’s also that there’s pieces of this legislation that tie the hands of how states can even access the funding and how they can raise the funds that they put up.
What kinds of requirements are there?
They’re going to be requiring states to build these really complex systems to check people’s eligibility. I’ll use my grandmother for example. If you’re 92 and have Parkinson’s today, six months from now you’re still going to be 92 or maybe 93 and have Parkinson’s. But they’re going to be requiring constant eligibility checks, which ultimately is only to get people off of the rolls.
Aging in America News 
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