Show Notes
For those of us at The 80 Million, our name represents a vital segment of the American population — nearly one-fifth of the nation — who rely on Medicaid for their health, financial security and in some cases, survival. Today, the program stands at a critical inflection point. As Medicaid faces what many policy experts consider its most significant existential threat since its inception, we are expanding our coverage to meet the moment. Starting May 6, we are launching a special eight-episode podcast series to explore the seismic changes reshaping Medicaid and health care access more broadly in our country.
Hosted by Senior Managing Director Patti Boozang, Season 1 of The 80 Million Podcast is about what's at risk at this moment in Medicaid, fiscally, operationally and politically, and where the program needs to adapt deliberately — not just to survive, but to get stronger. This is a time that demands solutions. Over the next decade, Medicaid is expected to see nearly $1 trillion in federal funding cuts from H.R. 1, new administrative hurdles that make getting and maintaining Medicaid coverage difficult, and federal policy shifts that limit the ability of states to raise revenue through state-directed payments and provider taxes.
This new series reflects the very best of what defines our health group — deep expertise, meaningful collaboration and a commitment to shaping the future of care for the 80 million Americans who rely on Medicaid. Across the season, Patti brings together colleagues from Manatt Health and nationally recognized leaders to explore the most pressing challenges and opportunities facing the program today. Produced by Amanda Eisenberg, The 80 Million Podcast digs into technological innovations, FWA, and the operational and fiscal tradeoffs states are facing right now.
Subscribe to The 80 Million here. Episodes will be available starting May 6 where you get your podcasts and, for subscribers, in your inbox each week!
This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit 80million.substack.com
More from The 80 Million Podcast
The Affordable Care Act (ACA) fundamentally changed American health care — expanding coverage, establishing consumer protections that are now broadly expected, and helping cement the idea that access to health care is a basic human need rather than a privilege tied to health status, gender or income.
High-cost therapies like cell and gene therapies could transform care for Medicaid beneficiaries with serious conditions, but their upfront prices — often $500,000 to $5 million per patient — do not fit a financing system built around predictable, chronic-care spending.
Americans are rapidly aging, which is accelerating the demand for the long-term services and supports (LTSS) necessary to their care, as well as the care of a diverse range of children and adults with disabilities. Medicaid is the primary payer for LTSS. Since the early 1980s, that coverage has included home and community-based services (HCBS), which have proven better for health, less expensive and what most people prefer over institutional care. HCBS now make up almost two-thirds of long-term services and support spending, double the rate in 2001.
The scale of federal retrenchment is no longer theoretical. In Massachusetts alone, the state is bracing for an estimated $3.5 billion annual loss in federal Medicaid funding once H.R. 1 is fully implemented, against a total Medicaid budget of over $20 billion. Even with aggressive mitigation, the state could still see about 300,000 residents lose coverage.
The evidence that addressing social needs like food and transportation improves health outcomes and reduces Medicaid costs is no longer theoretical. We’ve seen recent data from two efforts: North Carolina’s Healthy Opportunities Pilots (HOP) generated $164 in savings per member per month, according to a new, multiyear evaluation of 31,000 Medicaid enrollees by the Sheps Center at University of North Carolina. The Centers for Medicare & Medicaid Services (CMS) Accountable Health Communities model showed 3%–4% reductions in total cost of care through screening and navigation alone.