Column: The family-values hypocrisy of cutting Medicaid

Los Angeles Times

27-02-2025

Hello and happy Thursday. MAGA Republicans love babies, as they are quick to claim — the more the better!
As long as they don't have to take care of them.
Fathers that 'run like water' are nothing new, as the old John Prine song says.
Neither are the looming threats to Medicaid in the current Republican budget — up to $88 billion a year in cuts for the next decade — which 186 male Republican House members (and 31 female Republicans, to be fair) just voted for. The lone GOP dissent was Kentucky Rep. Thomas Massie, whose state would be pummeled by the reductions.
The vote this week represents another cruel example of how certain conservatives have a long history of talking about family values while simultaneously abandoning actual families.
Because guess who benefits the most from Medicaid and CHIP, the Children's Health Insurance Program?
'Stripping this funding jeopardizes the safety of moms and babies,' said Joan Alker, executive director and co-founder of the Center for Children and Families at Georgetown University McCourt School of Public Policy. 'The consequences would be devastating.'
House Republicans voted Tuesday to pass a budget proposal that keeps tax cuts (especially for rich folks) from the Trump 1.0 era by cutting costs in other areas. While Medicaid isn't explicitly mentioned, it is de facto on the chopping block.
That's because the proposal instructs the House Energy and Commerce Committee to find ways to cut spending by $880 billion over 10 years. That committee oversees spending for Medicaid and Medicare among other, smaller programs. Finding that large of a sum of money to save would almost certainly require digging it out of Medicaid. (Republicans wouldn't dare touch Medicare.)
Separately, Republicans are also looking to slash food assistance. The budget instructs the House Agriculture Committee to also make cuts in programs it handles, which likely means gutting the Supplemental Nutrition Assistance Program, or SNAP. Doing so would literally take food away from kids.
Republicans are claiming that the Elon Musk-driven Department of Government Efficiency, which is not a government department at all, will find enough fraud and abuse in the system to prevent these cuts, and Trump has promised not to touch Medicaid, if you still believe in Trump promises.
'Look, Medicaid has never been on the chopping block,' House Speaker Mike Johnson (R-La.) said during a news conference, according to the Hill.
But he also recently said: 'Medicaid is hugely problematic because it has a lot of fraud, waste and abuse. Everybody knows that. We all know it intuitively.'
So far, Musk's crew has had to walk back multiple claims of saving billions of dollars after public scrutiny has found errors in its accounting and data, and it has not offered any dollar figure for fraud found specifically in Medicaid.
Actual government entities that do fight fraud haven't found the level of abuse in Medicaid that would be required to fund the tax cuts, either — although there is fraud. The Government Accountability Office, which investigates such things for Congress, found that in 2024, Medicaid made about $31 billion in 'improper payments.'
Alker points out that most of this fraud doesn't involve covered individuals running a scam, but rather provider organizations — labs, medical groups, etc.— billing too much or for services not provided.
Another option for cutting expenses would be to shift more Medicaid costs to the states, which would also be a de facto cut in services, since states, even California, likely couldn't afford to keep the plan as-is without that federal money. Or federal legislators could even try again for a work requirement to qualify for Medicaid, a beloved but flawed favorite of Republicans and Project 2025 adherents, as my colleague Michael Hiltzik aptly pointed out not long ago.
But the truth is aiming at Medicaid is really about targeting poor people, especially women, who have long been painted as unworthy 'welfare queens' by Republicans. It's a term Ronald Reagan brought to prominence during his unsuccessful primary bid in the presidential campaign in 1976, and Republicans have been leaning on its poverty-porn images of racially tinged female laziness and duplicity ever since.
'We've seen this movie before,' Alker said. 'This is the third time that I have personally seen this movie.'
So no, Medicaid cuts hitting women harder isn't an accident. It's a plan.
Medicaid and CHIP provide health insurance for about half of all American kids, according to Alker, who has worked on the issue for more than 20 years. Her numbers are slightly higher than some other statistics because they include people who are partially covered by the program.
After the Affordable Care Act opened up eligibility to more people in 2014, Medicaid has grown to cover about 28% of all Americans. In California, that number jumps to 37%.
That's about 73 million low-income or medically vulnerable people (such as those with disabilities) receiving the insurance in 2024, according to the Government Accounting Office.
'I think that reflects the reality that healthcare is increasingly unaffordable for people who are not rich,' Alker said.
For children, that coverage isn't just providing lifesaving care, but all the basic stuff that keeps kids healthy. Vaccinations, wellness checks, sports physicals that are required before joining a high school team. For many if not most of the parents that are relying on Medicaid to pay for those services, they would simply be out of reach without it.
So we're not just talking about skipping the emergency room after a fall. We're also talking about not being able to play on the football team, or catching (and spreading) measles because the shot was too expensive. Those are community harms, that go beyond a single kid and preventing them is 'absolutely essential for American's future,' Alker said.
'It's really just how you want care for children to work,' she said.
And Medicaid is increasingly paying for reproductive care, prenatal services and births for low-income women — the kind of routine visits that prevent more costly problems down the line. About 41% of all births are covered by Medicaid, Alker said.
Older women, especially elderly women, also rely on Medicaid. Medicare, the insurance that many senior citizens use, does not cover the long-term-care costs of aides at home, nursing homes or memory care facilities. Those price tags, which can run into the tens of thousands monthly, are out of reach of most Americans, frankly.
But Medicare does cover that cost, and currently is paying for nursing home care for 5 out of 8 residents. It also pays for nearly half of all long-term services and supports used by Americans, including such things as medical devices and at-home medical visits.
And guess what: Women live longer than men, so there are more women receiving those benefits.
For the insult to injury on Medicare cuts, it's not just the women receiving the benefits that would be hurt by cuts — but also the women providing them.
Because throughout the United States, women — often immigrant women — are the people who are working as caretakers, both in homes and in facilities. Cutting Medicaid would cut their employment.
So in coming weeks, when you hear the 187 Republican men (and 31 Republican women) in the House tap dancing around how cuts to Medicaid may in fact be OK, remember that it's easy for men to say.
Because it's women and children who will lose out first — and most — with this bad budget deal.
The must-read: As G.O.P. Eyes Medicaid Cuts, States Could Be Left With Vast Shortfalls The what happened: They voted for Trump, but now they're losing their U.S. government jobs The L.A. Times special: Newsom launches another podcast, teases conversations with 'MAGA' leaders
Stay Golden,Anita Chabria
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