The Ongoing, Vital Battle to Protect Medicaid

The Ongoing, Vital Battle to Protect Medicaid

Right-wing activists were quick to attack Medicaid and Medicare enacted by President Lyndon Baines Johnson in summer 1965 as socialism – a distasteful if not threatening term to America in the 1960s (and today). LBJ did not see it that way, nor did FDR, or Harry Truman, who was with Johnson when he signed the law establishing these public safety net programs. Those presidents had long called for law grounded in health care as a right.

President Johnson, at the signing, said few lawmakers “have the piercing and humane eye which can see beyond the words to the people that they touch. Few can see past the speeches and the political battles to the doctor over there that is tending the infirm, and to the hospital that is receiving those in anguish, or feel in their heart painful wrath at the injustice which denies the miracle of healing to the old and to the poor.”

Some people, however, were not ready for this change – government programs to ensure the elderly, people with disabilities, and some groups of low-income individuals have access to quality health care. Although the law implementing Medicare and Medicaid may have passed with bipartisan support, a growing segment of conservatives had already denounced any attempt by government to involve itself with ensuring stability for aging and vulnerable people. In 1961 actor, and future Republican president, Ronald Reagan decried any attempt to “socialize medicine.” “Write those letters now; call your friends” and tell them to write to Congress, Reagan said. “If you don’t this program, I promise you, will pass just as surely as the sun will come up tomorrow, and behind it will come other federal programs that will invade every area of freedom as we have known it in this country.” It would be Reagan’s socialist-baiting take on Medicaid that would resonate with, and galvanize future generations of Republicans in quests to destroy Medicaid.

There are individuals and groups who have pushed back against conservatives’ cramped positions on constitutional liberty and rights – during the Depression and more recently in the aftermath of the Great Recession. University of Texas at Austin Law Professors Joseph Fishkin and William Forbath argue in “The Anti-Oligarchy Constitution,” there is “broad agreement that it is important to avoid oligarchy and build a robust middle class. But we have lost sight of the idea that these are constitutional principles.” The professors in their “modest” piece detail how anti-oligarchy is a constitutional principle that likely needs to be revived if we are to avoid a “moneyed aristocracy” or “plutocrats who dominate and control our polity and government. In this way concentrated wealth could destroy the promise of equal citizenship at the foundation of democratic Constitution.”

Conservatives and libertarians, however, continue their efforts to roll back laws creating a societal foundation. They have spent massive amounts of money to discredit both Medicare and in particular Medicaid. The focus on Medicaid is due in part because low-income individuals and underserved communities do not have high-powered lobbyists working on behalf of their needs and interests. They are too often a forgotten constituency.

The right’s desire to end Medicaid intensified during Ronald Reagan’s administration, and came under attack again during Bill Clinton’s term. Republicans sought to turn Medicaid’s open-ended funding into a block grant, and Clinton would counter with a so-called per capita cap.

Both efforts – block grants and per capita caps – are conservative and neoliberal economic or austerity policies. Block grants and per capita caps would fundamentally weaken Medicaid’s funding structure, leading to more low-income individuals becoming unable to access health care.

FiveThirtyEight says conservative activists argue, “The federal government’s hundreds of billions of dollars in Medicaid payments to states show a program that is drowning the country in debt in order to provide insurance to people who should be encouraged to find work and get private insurance.”

Most Medicaid beneficiaries are working – but in jobs that provide insufficient incomes and little if any health care coverage. Too many Americans, however, are oblivious to the second Gilded Age we are living in, as Nicholas Fitz for Scientific American notes. In reality, we are a nation beset with outlandish economic inequality — regardless of what the latest U.S. Labor Department report shows about economic growth and jobs’ numbers. Research by Emmanuel Saez and Gabriel Zucman revealed in 2014 that the share of wealth “owned by the top 0.1 percent is almost the same as the bottom 90 percent.”

Therefore, proponents of old school conservatism and advocates of liberalism diverge in significant and likely insurmountable ways. Conservatives mired in the 1950s still believe in and promote unfettered capitalism, and continue to protect white privilege and racial injustices. Progressives are fighting for a just, fair and nurturing society.

Through this well-funded effort to kill the program, Medicaid has persevered to become the nation’s largest health care provider. Bustle’s Morgan Brinlee reports that in 2017 “74.6 million people were enrolled in Medicaid-supported plans. But despite the large number of people who rely on them, Medicare and Medicaid remain controversial programs.”

In light of the recent conservative effort to repeal the Affordable Care Act and decimate Medicaid funding, there is evidence of growing consensus among progressives and leftists that health care is a human right. Jacobin‘s Adam Gaffney wrote, “Even before they lost the repeal battle … Republicans had already lost the moral war. As a result, the Obamacare repeal effort — or more precisely, the response it provoked — may have inadvertently strengthened the conceptualization of health care as a basic social right.”

Here is what we need to know – a strong republic is one that recognizes the right to health care is a human right, not a privilege for the wealthy.

Medicaid is the nation’s strongest social foundation program. It is saving lives and creating stronger communities. Medicaid should be embraced and celebrated and more funding should be pumped into the program to ensure even greater coverage for people of all walks of life. More and more people realize that equality is meaningless if health care is exclusive.

As summer fades, and Congress prepares to reconvene, there is already talk of another conservative effort to repeal the ACA and cut Medicaid funding, as well as regulatory changes to sabotage the program. Progressives must gird for another battle in the ongoing and noble endeavor to preserve and strengthen Medicaid.

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For almost 50 years, the National Health Law Program has fought to expand access to quality health care to low-income individuals and underserved communities. Today we are pleased to launch a newly designed website for our future work to make health care a reality for all people. Please take time to peruse our new site, and sign up for our email updates to learn about us, watch the work we do, and become engaged.

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