Safety Net Under Siege

Medicare and Medicaid are essential for the security of millions of Americans.

By David Elliot

Peace of mind.

That’s what Medicare and Medicaid mean for nearly one in every three Americans.

Almost 50 million Americans have paid into, and are beneficiaries of Medicare, our national health insurance program for seniors and people with disabilities. And almost 50 million Americans — the elderly, low-income adults and their children, and people with certain disabilities — have access to Medicaid.

Six million Americans depend on both.

But now these programs are under siege. Some want to replace guaranteed Medicare benefits with a voucher. The problem with this approach is twofold. First, it would require seniors to pay significantly more for basic health care — and this would drive large numbers of our most vulnerable citizens into bankruptcy. Second, these are earned benefits that hard-working people paid for most or all of their adult lives. They are not giveaways.

Others would “block grant” Medicaid to the states, as Rep. Paul Ryan has famously proposed. Under Ryan’s plan, the federal government would give states a fixed amount of money — in lump sums known as block grants. This amount of money would not go up as more people get Medicaid services. The results would be either big cuts in health care services or big tax increases for states or both. Instead, we should keep Medicaid as a system that provides federal funding for seniors and people with disabilities — and for all the families that rely on Medicaid for their health care.

The debate over Medicare’s and Medicaid’s future is likely to continue throughout this year and for years to come.

Sometimes even the most important government functions can come off as abstractions — decimal points on a budget ledger deciding who is eligible and who isn’t, who gets cut, and who doesn’t.

So at USAction, we asked our members what Medicare and Medicaid mean to them and their families.

Their responses revealed how deeply and keenly Americans cherish and rely on the promise our nation made when we established these lifelines in 1965. We’ve kept this promise so far and Americans demand we keep it in the future.

After sorting through hundreds of stories, certain themes emerged.

Many people told us they are alive only because of Medicare or Medicaid. Many others discussed how these services have enhanced the quality of their lives. Others still talked about how it brings them retirement security and peace of mind.

We heard from young people who do not directly receive benefits, but say they are able to save money they would otherwise spend on aging parents. Debra Pekin in Wheeling, Illinois, wrote that without Medicare, she would have to quit her job to care for her 92-year-old mom — Social Security pays for her assisted community living, but Medicare covers her health care costs.

Many wrote that without Medicare, they would face financial ruin. A woman noted that the entirety of her monthly Social Security check would have to go to her health care costs — nothing left for anything else.

A number of people wrote that Medicare and Medicaid mean neighbor helping neighbor — we’re all in this together.

Finally, a large number of respondents expressed extreme outrage — outrage so extreme that some comments had to be edited — that a system they paid into all of their adult lives could be cut. These people clearly felt robbed and violated. “I paid into Medicare for 40 years,” writes Jim Brady in Rochester, Michigan. “This is my money I am getting back. It is not charity. No one has the right to steal my money.”

These are the Medicare and Medicaid stories of ordinary Americans. They are on the front lines of the Medicare and Medicaid debates. Whatever policies are adopted, they are the canaries in the coal mine — they will feel the impact first.

We made them a promise.

Will we keep it?

David Elliot is communications director of USAction. He edited the report Peace of Mind: Americans Share Their Medicare and Medicaid Stories. USaction.org
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