Medicaid cuts

This year will tell North Country residents whether U.S. Rep. Pete Stauber represents the people of the Eighth District, or the interests of the nation’s billionaires.
In supporting passage of last week’s House budget resolution, Stauber has given every indication it’s the latter, but the proof will come down the road as the framework approved on a narrow party line vote is fleshed out over the next several months.
In short, the resolution calls for $2 trillion in federal cuts over ten years to help pay the $4.5 trillion cost of the extension and expansion of the Trump tax cuts, which overwhelmingly favor the wealthy.
The resolution is proof positive that none of the haphazard cuts currently being engineered by Elon Musk’s mis-named Department of Government Efficiency are intended to reduce the federal budget deficit because the revenue giveaways planned by Republicans are more than double the spending cuts they hope to achieve. As is typical whenever the GOP is in charge in Washington, the deficit will only increase under their plan.
The far larger concern for our region, however, is the fate of Medicaid, which is the federal program that is currently keeping the doors open at many of northeastern Minnesota’s health care providers. That includes the community health care clinics operated by Scenic Rivers, which are heavily dependent on Medicaid reimbursements it receives for the patient care they provide.
The House Energy and Commerce Committee, which oversees Medicaid among other programs, has been tasked with finding $880 billion in cuts over ten years and that goal is virtually impossible to meet without hefty cuts in the Medicaid program. The GOP is currently divided between those wanting to slash Medicaid to the bone and those looking for slightly less draconian cuts.
Either option looks ugly from the perspective of health care in the North Country. The Medicaid expansion included as part of the Obama-era Affordable Care Act, or ACA, enabled community health centers, like Scenic Rivers, to open new clinics, such as the one in Tower, and expand services to its patients. Cuts in Medicaid will, inevitably, lead to more patients without health coverage, which will lead to more uncompensated care for community health centers in the region. That, combined with cuts in other federal grant programs that such centers rely on, will inevitably lead to reductions in services or the closure of clinics altogether.
It will also affect our region’s hospitals for the same reasons. Those who lack health insurance can’t be refused care at emergency rooms and those places will become the provider of last resort for a growing segment of the population. Thanks to the ACA and its expansion of Medicaid, the number of uninsured Americans fell under the Biden administration to just over eight percent, the lowest in U.S. history. Before implementation of the ACA, nearly one-in-four Americans lacked health coverage, and that percentage is almost certain to rise, even before any cuts in Medicaid, because the Trump administration will cut the outreach efforts to populations that need the coverage.
The impact on nursing homes could be even worse. Fully two-thirds of the payments that most rural nursing homes receive come through Medicaid. With most rural nursing homes already facing financial crisis, any cuts to Medicaid would be disastrous and would inevitably lead to closures. That would devastate families and cost valuable jobs in our small communities.
As we noted in last week’s editorial, the cuts to the federal workforce are a veritable drop in the bucket when it comes to cutting spending. That’s why Medicaid is expected to be on the chopping block, one way or another, as the GOP pushes its perks for the wealthy.
As we have noted for years, when it comes to politics, everything comes down to priorities. For Trump and the GOP, the priority is the same as its always been: tax cuts for the wealthy, paid for by cuts to the safety net that benefit children, working families, veterans, and the elderly.
Rep. Stauber, in recent responses to constituents, has suggested that slashing the safety net and gutting the federal workforce is necessary to address the nation’s deficit. But the budget resolution Stauber voted for last week exposes that as nonsense. It’s about funding tax cuts, not addressing the deficit.
And residents, and voters, of the North Country should keep that in mind if and when their local health care options become increasingly limited due to Medicaid cuts, and their neighbors begin losing their jobs at the local clinic, hospital, or nursing home. Serving rural folks, or enriching the already wealthy? It’s all a matter of priorities.