Jolie Lizana (pictured on right) of Slidell, Louisiana, worked as a sonographer before she got sick and lost her job. Without the medication to fight her pulmonary arterial hypertension, systemic sclerosis and heart failure, she says she would be dead.
Lizana says Medicaid – which covers the cost of her medication and hospital care – has allowed her to keep raising her child. “I cannot imagine him growing up without me, but he would’ve had to if I didn’t receive Medicaid,” she says.
Jolie was one of 34 advocates who joined PHA in May to ask Congress to protect Medicaid funding.
Medicaid is the single largest source of health insurance in the U.S. The joint federal and state program, which provides quality health coverage to nearly 80 million people, is under attack in Congress. The Pulmonary Hypertension Association opposes legislation to restrict Medicaid access or eliminate funding.
Congress is considering significant cuts to the Medicaid program. The House of Representatives passed a bill that would cut billions of dollars of funding and stop health care coverage for millions of people. The Senate Finance Committee is reviewing the bill. Speaker of the House Mike Johnson (R-La.) hopes to have the bill ready for President Trump to sign by July 4.
If enacted as written, the budget bill will end access to medical care for many everyday Americans struggling to make ends meet. The lack of funding would affect medical facilities, forcing many to close their doors and leave communities without vital health services. The bill also would force people to prove their working to qualify for Medicaid.
Covering essential health services
“Medicaid is a lifeline for many of my patients,” says Kassandra Olgers, a PHA advocate and physician assistant at West Virginia University. “Health challenges are widespread, and resources are often limited in our state. This program makes the difference between patients having access to care or going without.”
Reducing Medicaid funding would directly harm her patients, including many with PH, who can’t afford their life-saving treatment without Medicaid coverage.
About one in four people with PH receive Medicaid benefits, including many children with PH. Medicaid enrollment ranges from 9% to 53% per county, according to the 2023 American Community Survey. Federal and state administrative enrollment data typically show even higher numbers.
Medicaid helps people who otherwise would be uninsured afford doctor visits, hospital stays, prescription drug coverage, home health care, nursing facilities and other medical expenses.
Medicaid eligibility varies significantly, depending on the state. In most cases, people from vulnerable groups qualify, including children, pregnant women, people with disabilities, the elderly, and those with low incomes. Medicaid recipients must be U.S. citizens or certain qualified non-citizens, such as lawful permanent residents.
In addition to helping people thrive, Medicaid funds services at hospitals, community health centers, physicians and nursing homes. In some cases, especially in rural areas, Medicaid helps keep the doors open. Rural hospitals and clinics often serve a high percentage of people with Medicaid and already operate on razor-thin budgets. Those health centers also are major employers in their communities, creating well-paying jobs and contributing to the local economy.
Bureaucratic barriers to coverage
Another threat to Medicaid under the budget bill: work requirements. The policies, also known as work-reporting requirements, require Medicaid beneficiaries to show proof of a minimum level of employment or number of hours worked to qualify for health coverage.
People who support work reporting policies claim they would reduce spending, but real-life examples have shown that isn’t the case. During trial work-reporting requirement programs tested in Arkansas and Georgia, taxpayer costs rose significantly. And medical debt increase for many people who lost benefits.
“Work-reporting requirements are the opposite of a common-sense solution,” says Katie Kroner, PHA’s vice president of advocacy and patient engagement. “To look for and keep a job, people need to be healthy. Terminating their health insurance will not help people get and stay healthy enough to work.”
After Arkansas became the first state with work requirements in 2018, NPR interviewed people about how the program affected them. In the interview, a man with severe COPD said he learned at his pharmacy that he had lost his Medicaid coverage — because he reported his work hours incorrectly. He couldn’t fill his prescriptions, ended up in the hospital and lost his job because he missed too much work.
Arkansas’ work-reporting requirement caused more than 18,000 to lose coverage in the seven months the policy was in effect. That represents one in four people who were eligible.
In fact, more than 95% of people had met the Arkansans work requirements or should have been exempt from them, according to a 2023 Center on Budget and Policy study. Many Medicaid beneficiaries didn’t know about the policy or were confused about how to report their status to the state, the study said, suggesting bureaucratic obstacles played a large role in coverage losses.
Meanwhile, Georgia’s work-reporting requirement program continues. After the program’s first year, Medicaid enrollment fell far short of expectations and need, according to the Georgia Budget and Policy Institute. The program left many eligible Georgians uninsured, the institute found. Georgia’s program also has been expensive for taxpayers. State spending for system upgrades cost nearly five times more than traditional spending for Medicaid benefits.
Take action
PHA opposes measures to cut Medicaid funding, restrict eligibility or implement work-reporting requirements. Stand with PHA, and tell your members of Congress that Americans can’t afford cuts to Medicaid.
Subscribe to PHA’s monthly advocacy newsletter for ideas and news. Email us with questions about our advocacy efforts or call 240-485-0758.
