OPINION | SCHAUER: NEW MEDICAID RULE WOULD UPEND HEALTHCARE ACCESS
By Mark Schauer
The Detroit News
August 31, 2023
Michigan has a Medicaid problem. It has for a long time, and now a federal healthcare agency called the Centers for Medicare and Medicaid Services (CMS) seems poised to worsen it.
CMS recently proposed a new rule that would restrict how we can fund our state Medicaid program. The agency’s proposal will cut Medicaid spending as intended, but it will also upend healthcare access for thousands of Michiganians at the same time.
CMS issued its draft Medicaid rule in May, but it’s not new. It’s just a reincarnation of a failed, unpopular policy from years past.
In 2019, CMS proposed a nearly identical policy, called the Medicaid Fiscal Accountability Rule (MFAR), that would have done the same thing if enacted into law — cut Medicaid spending to plug holes in the federal deficit. After Michigan Sen. Gary Peters worked with then-presidential candidate Joe Biden, then-Senator Kamala Harris, and a coalition of more than 20 of his Senate colleagues to push CMS to reconsider the MFAR, the agency pulled it back.
Why CMS is resurrecting it now is beyond me. Cutting Medicaid funding now and under these conditions would be catastrophic for our state.
After temporarily expanding Medicaid during COVID, the government now finds itself re-evaluating more than three million Michigan residents’ enrollment qualifications. That means tens of thousands of our vulnerable friends and neighbors are already at risk of losing their healthcare coverage. The last thing they need is for the government to finalize a rule that will make it even more difficult to keep them on the program.
This is especially true considering that Michigan already has a significant healthcare access problem. According to the Millbank Memorial Fund, as many as 20% of Michigan’s adults and 8% of its children don’t have a primary care physician because of the state’s doctor shortage. The cuts would fall the hardest on Black and Brown Michiganians, devastating equity in our state.
Underserved residents need more healthcare options, not less. CMS’ new Medicaid rule will give them the latter by making it harder financially for healthcare professionals to operate in our state, especially in rural communities where access to care is the most challenging.
Since 2005, nearly 200 U.S. rural hospitals have closed due to financial issues, including Michigan’s Leelanau Memorial Health Center and Cheboygan Memorial Hospital. More than a dozen state hospitals are at risk of soon joining this list. The more uncompensated care these facilities are forced to undertake, the worse this problem will get.
Is that what we want? To breed a healthcare environment where parents struggle to bring their kids to the hospital due to costs? To make grandma drive hours to find a hospital in a pinch when there’s no time to waste?
It doesn’t have to be this way. We need to do a better job of balancing the federal budget, but we shouldn’t be doing it by playing politics with Medicaid. Doing so is as dangerously irresponsible as it is cold and impractical.
Sen. Gary Peters’ advocacy efforts were instrumental in killing MFAR the first time CMS proposed it. He was right then when he warned that MFAR “would have disastrous consequences for the Medicaid program and the millions of individuals it serves.” Here’s to hoping he continues to fight the Medicaid rule with bipartisan support from his Senate colleagues. Tens of thousands of his constituents’ livelihoods depend on it.
Schauer is a former Democratic member of Congress from Michigan. Schauer was also previously a member of the Michigan House of Representatives and Michigan Senate, where he served as the minority leader.