What’s next for Medicaid? 

Last month, we discussed the budget reconciliation process and its implications for Medicaid. I hoped to reassure you that while Medicaid was at the center of heated discussions in Congress, significant changes were far from finalized. True to those predictions, the debate rages on, and it’s important to stay informed about how these developments could impact your practice and patients.  

This follow-up dives deeper into the latest updates, what they mean for you, and how you can take action to safeguard Medicaid, for both the Americans who rely on it and the providers who serve them.  

Reconciliation update: Where we stand  

Since we last talked about the $880 billion in proposed Medicaid cuts, both the House and Senate have passed their own budget plans. These plans set the stage for reconciliation, a process that could lead to changes in government programs like Medicaid. However, the House and Senate still don’t agree on how to handle Medicaid. 

Here’s a quick breakdown of the plans:  

• House plan: The House wants to cut $880 billion over the next 10 years, mainly targeting Medicaid. They’re focusing on cracking down on fraud, adding work requirements, and doing stricter eligibility checks. Learn more here.  

• Senate plan: The Senate isn’t cutting Medicaid directly but is proposing a $5.8 trillion increase in the federal deficit to extend tax cuts. This means that while Medicaid funding isn’t being reduced now, the growing deficit could lead to future pressure to cut spending on programs like Medicaid to balance the budget. While Medicaid isn’t mentioned outright, some wording hints at potential risks down the line. Details here.  

These differences highlight ongoing debates among lawmakers. While things may move slowly, now’s not the time to sit back. Healthcare providers and organizations should get ready for possible changes, like more paperwork, lower reimbursement rates, or reduced patient access to care. More from Politico. 

What’s at stake?  

Medicaid is a lifeline for over 72 million Americans—children, seniors, and people with disabilities rely on it for essential health care. For providers, any disruption to Medicaid could have serious and lasting impacts, affecting the care so many people depend on. 

• Patient coverage loss: Tighter eligibility checks and work requirements could require more documentation from patients, potentially causing some to lose coverage. 

• Reimbursement challenges: Federal cuts could mean lower reimbursement rates for the services you provide, directly impacting revenue streams.  

• Operational strain: Compliance with new policies, such as quarterly eligibility checks, could increase administrative requirements for your team.  

These changes show why it’s so important for healthcare workers to speak up and help protect Medicaid. 

Beyond ‘business as usual’: Taking the next step  

When I shared tips for navigating uncertainty, “business as usual” made sense because Medicaid changes were speculative and distant. As Congressional negotiations move forward, there’s an opportunity to do more by getting involved and helping shape the conversation.  

Here’s a practical guide for therapists, practice owners, healthcare organizations, and concerned citizens to take action: 

1. Reach out to your representatives  

Now is the time to advocate for your patients and practice. Use platforms like Democracy.io to send a message to your Congressional representatives. Simply enter your address, and the platform will connect you with your representatives, allowing you to compose and send your message directly.  

• Share specific examples of how cuts to Medicaid would negatively affect your practice, employees, and patients. 

• Use data or anecdotes that demonstrate Medicaid’s importance to your local community. 

2. Use advocacy resources  

Check out tools and templates to make your advocacy work easier! The Modern Medicaid Alliance Advocacy Page has messaging guides, factsheets, and tips for talking about Medicaid with policymakers. As a provider, your perspective can really make an impact with legislators. 

3. Connect with peers for a unified voice  

Healthcare professionals achieve more together. Collaborate with organizations and unions in your field to strengthen advocacy efforts. Physical therapists can join the APTA, physicians the AMA, and nurses the ANA or state nursing associations. Specialty groups like the AAP or ACC provide targeted support, while unions like NNU and SEIU amplify healthcare workers’ voices. Joining these networks helps unify efforts, influence policymakers, and drive meaningful change for your industry and patients. 

4. Educate your team and patients  

Help your team stay informed about Medicaid advocacy and share updates with patients who might want to get involved. Keeping your staff up to speed on upcoming changes ensures your practice is ready for anything, like new documentation requirements. Together, we can navigate these shifts smoothly and support everyone involved. 

5. Plan ahead for policy changes  

Stay ahead of Medicaid changes with tools that make life easier for you and your patients. Practice management software can help simplify your workflows and keep your documentation in check, so you’re always prepared. If new eligibility checks or audits come your way, these tools can help you stay organized and compliant, reducing stress and keeping things running smoothly for everyone involved. 

Why providers need to act  

I ended our previous discussion by emphasizing the importance of staying informed. Now, it’s time to take the next step. Medicaid supports millions of vulnerable individuals but also forms a significant portion of reimbursement for healthcare organizations nationwide. Advocacy from providers like you—who understand Medicaid’s value firsthand—is critical to ensuring its continued success.  

Closing thoughts  

Medicaid’s future may be uncertain, but your voice can help secure it. Take the time to reach out, educate, and prepare. By using tools like Democracy.io and resources from Modern Medicaid Alliance, your efforts can protect Medicaid and the vital role it plays in patient care and provider viability.  

I’ll continue to monitor changes and share updates in upcoming blogs. Until then, stay tuned, stay prepared, and don’t hesitate to make your voice heard. Together, we can make a difference—for our patients, our practices, and the communities we serve.  

For those who missed it, check out my original post, Making Sense of the Medicaid Debate, here. 

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