Dr. Jim Misak’s Remarks from Cleveland March for Health: Medicaid Works!

Dr. Jim Misak, Family Physician

I am a family physician who has the great privilege of caring for patients participating in the Medicaid program.  Based on my professional experience, I can say with absolute certainty: Medicaid works.

Medicaid is the federal-state public health insurance program for the poor and near-poor.  It largely escaped notice when it was created along with Medicare in 1965.  Since then, Medicaid has grown to become the nation’s single largest insurance program.  74 million Americans are covered by Medicaid, including 1 in every 4 Ohioans.  Medicaid pays for every other Ohio birth.  Medicaid pays for more mental health and substance abuse treatment in Ohio than any other program.  And, Medicaid is the most efficient health insurer in the country, spending more of its health care dollar than anyone else on the actual delivery of health care.

Medicaid works for my patient Mary, a diabetic who lost her job, became uninsured, and could no longer afford her diabetes medications and testing supplies.  After repeated trips to the emergency room when a diabetic crisis would arise, she became eligible for the Medicaid expansion which began in Ohio in 2014.  After working with my medical team and having access to needed medications, Mary’s diabetes is now under control, she is back at work, and she says she’s never felt better.

Medicaid works for my patient Joe, who went to the emergency room with a cough and was told that a chest x-ray showed a spot on his lungs.  Uninsured, Joe went without medical care for months until the Medicaid expansion provided coverage.  After seeing me and getting the appropriate testing, Joe was diagnosed with early stage lung cancer, which thankfully was treated while still curable.

Due largely to the Medicaid expansion, the number of uninsured in Ohio has been cut nearly in half.  The costs of care for the uninsured borne by hospitals in Medicaid expansion states, like Ohio, have decreased by more than one-third.  Because of this, many of Ohio’s smaller and more rural hospitals, often the largest and best employers in their regions, have become more financially stable and better able to serve their communities.

Medicaid is funded by both the federal government and the states.  It is funded as an entitlement, which ensures that the federal government covers its share of the cost of all eligible enrollees.  This makes the program responsive and flexible.  It allows Medicaid to respond to changing needs at the state level caused by events such as a recession, an epidemic, or an aging population.

The most recent health care bill proposed a change in how Medicaid is funded, to a per-person allotment or to a federal block grant.  If enacted, such a change would not give states more flexibility, as some have claimed.  Rather, it would remove the critical flexibility already built into the program.  It would take away health care from hundreds of thousands of Ohioans.  It would force Ohio into making impossible choices between decreasing the number of people covered, decreasing covered services, or cutting payments to doctors and hospitals, making access to care much more difficult.  And, such a change would cost Ohio between 19 and 26 billion dollars by year 2025.  That money goes to pay people, nurses and nurses’ aides and housekeeping staff, who spend their money in their communities and contribute to their local economies.

We cannot let this happen.  We cannot let this vital program die a death of a thousand cuts.  Medicaid works for our patients.  Medicaid works for our hospitals.  Medicaid works for our communities.  Medicaid works for our state.  Medicaid works!