Why U.S. Medicaid is a Pathetic Health Care Program for the Poor
The Means-Tested Program Makes a Mockery of Universal and Competent Care
When a tired U.S. capitalist president signed Medicare and Medicaid into law in 1965, the federal-state health care insurance program for the elderly and people in poverty was attacked by rabid right-wingers as socialism.
Medicaid was and is a health insurance program for a select group of poor people in the U.S., it has never been universal and leaves tens of millions of people mired in poverty with no health care. Medicaid, which is means-tested, has become over time even more inclusive offering access to threadbare health care. (See Jacobin’s recent piece on Australia’s use of means-testing in its welfare and public services.)
Medicaid will always be attacked by right-wingers regardless of how limited in scope and funding it is, because they dislike people in poverty more than centrists. Medicaid at best covers about 77 million poor people in the U.S., a country of more than 323 million people.
Leftists in Congress if we have them, should get creative and cocky and build a new Medicaid worth caring and fighting for.
Poverty in the U.S. is deep, wide, pervasive and centers on people who have long been left behind, such as Black people. It should not stun but should dishearten that the major advocates of Medicaid are wealthy, neoliberal white people working in universities and “nonprofits” in Los Angeles, Washington, D.C., and New York City. These people and groups, such as the white gaggle of professors and researchers at Georgetown University’s Center on Children and Families (CCF), have long ignored Black people because of prejudice, elitism, and the white savior belief that tying Black people to Medicaid makes the program unpopular in national polling, thereby turning away financial supporters, especially for the state Medicaid advocates.
Neoliberals are woeful advocates for people mired in poverty and have helped conservatives in making a limited, means-tested, health insurance program even more pathetic.
Incompetent lawsuits, white papers ad nauseam, inane charts and graphs, boring spokespersons, dry communications, are the bailiwick of today’s Medicaid advocates. They should be ashamed, but no, they continue pumping out those white papers stuffed with Medicaid law inertia that puts people to sleep.
The ongoing misunderstanding of Medicaid and the widespread, massive ignorance of the program’s existence is because of inept advocacy of elite neoliberals and out-of-touch Georgetown law professors.
It’s beyond time to re-think Medicaid and Medicare for that matter, but I think we should start with poor and vulnerable populations.
Medicaid right now is riddled with such terrible means-testing policies that its service to people is suspect. Instead of pouring additional funds and supports to Medicaid, lawmakers should consider legislation to de-tach Medicaid from Medicare and create a new program that may or not may not be a state federal one, maybe just federal, and make it universal for all people in poverty. Lawmakers would also need to dump the annual federal monetary ban on abortion care, so the new law would also be inclusive of all care.
Beyond ditching means-testing, the new Medicaid would do away with other austere measures that put economics above health care. Medicaid as we know it now is stuffed with biases against the care of Black people, women, and LGBTQ persons. All these people suffer wide income inequality and health care inequity to begin with, and Medicaid fails to address these pressing matters of injustice.
Medicaid is ineffective for women in poverty who need abortion care, and persons who need medical care for gender transitioning. Because of state and federal attacks on abortion and transgender rights in general, Medicaid now is failing these people.
So, the new Medicaid must include muscle to ensure access to health care as a right for all people in poverty — civil rights protections within the new Medicaid would be designed to protect it from capitalist efforts to kill the law.
Does such legislation exist? Perhaps so on both state and federal levels. Bernie Sanders a two-time failed presidential contender did tout legislation seeking to transform health care in the U.S. I’m sure the legislation can be found on the U.S. senator’s website. There are also state lawmakers throughout the country who have proposed and moved along legislation aimed at strengthening Medicare and Medicaid. But any substantial moves to change the U.S. health care setup have stalled or floundered including California Governor Gavin Newsom’s lame effort.
This new Medicaid was needed yesterday and would be a significant step toward correcting the harm and injustices of the old, tired, and ineffective Medicaid program the nation now suffers. It would also set a grand example of collective care, of using collective funds and supports to provide people mired in poverty with universal and dependable health care, which may help them one day to escape poverty.
