In 1965 — 50 years ago this coming Thursday — President Lyndon B. Johnson signed the landmark legislation that created Medicaid. In so many ways, it was a different world then. Televisions had antennas and broadcast just a few channels in black and white. Gas cost 31 cents a gallon and the Dow was at 969. Tobacco had only just been declared a hazard. The Governor of Iowa was Harold Hughes.
Health care treatments and the way we deliver and pay for them have also changed dramatically in the past five decades — largely for the better. But one thing that has not changed since 1965 is the fact that there are times in people’s lives when they will face medical challenges — sometimes serious ones. And it often happens when we least expect it. Fortunately when people need help, Medicaid is there for them. Nearly two-thirds of Americans have either benefited directly from Medicaid or have a family member or friend who has. And for many folks with disabilities, Medicaid allows them the ability to live independently at a much lower cost.
Here in Linn County, Medicaid is a lifeline for people who otherwise lack coverage for their health care needs. We take seriously our responsibility for protecting the health and well-being of all of our 215,000 residents, and the Medicaid program helps make that possible.
Nationally, counties invest $70 billion on health care services. We run 1,000 hospitals and 700 nursing homes. At least 16 states require counties to contribute to the non-federal share of Medicaid, and the majority of states require counties to provide health care for low-income, uninsured or underinsured residents. Until recent changes in the mental health system in Iowa counties paid a portion of the Medicaid match.
Linn County delivers Medicaid eligible services through the regional mental health system, and through the Linn County Public Health.
Over the past half century, Medicaid has had a positive and lasting impact on the many families it serves, providing health care to one in every five Americans from all walks of life. Half the babies born in this country had their births covered by Medicaid. The program fills gaps in people’s health coverage and helps them transition through life events that would otherwise leave them uninsured and more vulnerable.
The average adult using Medicaid spends only a portion of any given year enrolled in the program, and health care outcomes and economic security are much better for those in Medicaid compared with the uninsured. Children with Medicaid coverage live healthier, more productive lives as adults than similarly disadvantaged children without access to the program.
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Medicaid supports our most vulnerable citizens — including the disabled, seniors and their families — who account for two-thirds of Medicaid’s budget. One in five people with Medicare also rely on Medicaid to cover the things that Medicare doesn’t like nursing home care, dental treatment and vision care.
Medicaid does more than just care for our residents. It has been a source of innovation in American health care benefiting our local economy. Medicaid reduces the frequency of uncompensated care provided by local hospitals and health centers, lessening the strain on our county budget. It provides patient revenue that helps communities retain doctors and other health professionals, especially in underserved and rural areas. The Eastern Iowa Health Center is a federally qualified health center which provides medical homes for people by using resident doctors and many of its patients receive Medicaid.
There will always be a need to treat illnesses in our community, and Medicaid should always be there to help. Linn County is working with the National Association of Counties to preserve a strong federal-state-local partnership for financing and delivering Medicaid services.
As we celebrate Medicaid’s 50th anniversary, we must also stand together to protect this vital program from cuts proposed by members of Congress. Funding reductions, caps or block grants would further shift federal and state Medicaid costs to counties, placing a greater burden on local property owners. When we all work together, when all of our citizens thrive, we help foster a resilient and healthy community.
In the past half century, much has changed and Medicaid has been there throughout, proving its value to patients and taxpayers in Linn County. Let’s ensure it can continue to do so for the next 50 years.
• Linda Langston is a Linn County Supervisor. Comments: Linda.firstname.lastname@example.org