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Ranjani Sudarsan

Intern, Policy and Practice Improvement

Medicaid Myths: Debunking Common Misconceptions of the Medicaid Program

July 18, 2019 | Addictions | Medicaid | Mental Health | Comments
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Last week, the Partnership for Medicaid, a nonpartisan advocacy coalition including the National Council, hosted a congressional staff briefing to discuss and unravel some of the most common misconceptions about the Medicaid program and its beneficiaries. The briefing focused specifically on individuals who receive health care via Medicaid and its impact on their lives. The diverse panel of speakers provided an overview of how millions of Americans benefit from the Medicaid program and how Medicaid expansion has led to increases in coverage, access to care and improved health outcomes for beneficiaries.

The panel included: Olanrewaju Falusi, MD, FAAP, Pediatrician, Children’s National Health System; Sara Rosenbaum, JD, Harold and Jane Hirsh Professor, Milken Institute School of Public Health, George Washington University and Desmond Williams, Client Advocate, Health Care for the Homeless. The panel was moderated by Shannon Attanasio, Vice President, Government Relations and Advocacy, Medicaid Health Plans of America.


REALITY: Children make up fully half of the 72 million American receiving health care benefits from Medicaid and the Children’s Health Insurance Program.

In 2019, Medicaid covered over 34.8 million children including those who require special health care needs as well as those from low-income families. Medicaid also offers robust pediatric benefits including behavioral health services for children covered under Medicaid and the Children’s Health Insurance Program (CHIP). 10.7 million individuals are eligible for Medicaid due to a disability and over six million are dually eligible for both Medicare and Medicaid.

Dr. Falusi noted that despite years of growing numbers of individuals who have health insurance, the rate of uninsured children has been on the rise. She explained the importance of parents having health insurance and its social and emotional impact on their children and their children’s health.


REALITY: Nearly 80 percent of nonelderly adult Medicaid beneficiaries are part of working families. Statistics indicate that 33 percent of the Medicaid population are ill or disabled, 30 percent are unemployed caregivers of disabled family members and 15 percent are enrolled in school.

Professor Rosenbaum highlighted that imposing work requirements on Medicaid beneficiaries is not a viable solution as low wage workers lack control over their work schedules and may be unable to meet the state’s hour requirements. The National Council remains strongly opposed to any provisions, such as harmful work requirements, that create barriers to health coverage for individuals living with mental illness or substance use disorders.


REALITY: Medicaid coverage has positive health and social impacts on beneficiaries.

Several studies indicate that Medicaid coverage and access to high quality health services lead to improved health outcomes. Medicaid expansion has increased access to mental health and addiction treatment services and has played an integral part in addressing the opioid crisis. Medicaid financed over 20 percent of substance use disorder treatment in 2014 and is projected to cover almost one-third of all treatment services by 2020. The program also supports medication-assisted treatment programs that are provide lifesaving treatment at an affordable cost.

Client Advocate, Desmond Williams said, “if you care about ending the opioid epidemic, we need access to health insurance so we can get the health care we need like mental health.” In recovery from heroin addiction, Mr. Williams explained how he had struggled with his addiction and tried to seek treatment but did not have any insurance to cover his needed services.

Mr. Williams’ inpatient and outpatient treatment, including mental health services, were all covered by Medicaid. He is now three years in recovery from heroin addiction. “If I didn’t have Medicaid, I don’t know where I would be,” he said.