Millions of individuals and families across the country rely on Medicaid for access to quality healthcare designed to work for everyday people. Medicaid is jointly run by the Federal government and each state, and states can request permission to change how they run their Medicaid programs. These changes often make Medicaid better, but sometimes the requests negatively impact access and services.
Right now, Tennessee wants to make major changes to its Medicaid program which the Biden Administration is reviewing. These changes would make it harder to get coverage, find care, and fill vital prescriptions. The policy changes would also decrease transparency and accountability, incentivize cutting services, and weaken policies that protect people from medical bankruptcy.
These proposals could start in Tennessee and spread to other states. We need your help to stop them! Share your experience and tell the Biden Administration that we need to strengthen our healthcare system — not weaken it! You have until September 9, 2021.
Issue #1 – Medical Debt and Retroactive Eligibility
Medicaid is designed to meet the healthcare needs of low-income people across the U.S. It is also designed to shield people from massive medical debt. One way it does this is through “retroactive eligibility.” Many Medicaid-eligible people get signed up after a medical emergency – maybe a trip to the hospital. Retroactive eligibility means that Medicaid covers the cost of the care, which protects people from massive medical bills and makes sure that hospitals get paid (it’s a win-win).
Some states, like Tennessee, have found ways to get around these protections, but we’re trying to close that loophole.
- Have you or someone you know been enrolled in Medicaid after an emergency? How was the experience?
Issue #2 – Prescription Drug Coverage
Medicaid has robust prescription drug coverage and generally allows patients and their doctors to decide what prescription drugs are the best course of treatment. However, proposed changes would add extra layers of approval and move decision-making from healthcare providers to private companies. Patients would have to jump through extra hoops and navigate red tape to get lifesaving prescriptions. Medications used to treat various conditions could be harder to get without approval.
- Have you ever been denied coverage for medication your doctor said you should take? What happened?
- Have you ever had to submit additional paperwork to get approval for a prescription?
Issue #3 – Innovation, Transparency, and Accountability
Advances in medicine happen every day, and people’s healthcare needs constantly shift. Federal oversight helps ensure that Medicaid stays up-to-date and meets the needs of low-income individuals and families. However, Tennessee is trying to avoid as much oversight as possible for the next ten years through a new funding scheme! The plan would decrease transparency into decision-making and make it harder to hold the state accountable if they fail to provide access to quality care. Tennessee Medicaid enrollees have a long history of having to navigate barriers to accessing quality care, and this proposal would allow that to keep happening with even less oversight. We cannot let this mismanagement continue.