By Todd Post
Medicaid is a frequent topic of conversation, but almost no one mentions the program’s vital role in preventing hunger in the United States.
Medicaid is the nation’s largest publicly funded healthcare program. In fact, for every $5 in healthcare costs in the U.S., $1 comes from Medicaid. The program provides 71.8 million people with health insurance. Medicaid covers health insurance premiums and most out-of-pocket costs, allowing participants to spend more of their money on household food needs.
Medicaid lowers health insurance premiums for everyone. Chronic conditions and food insecurity are strongly associated with higher healthcare spending. Those additional expenditures translate into higher insurance premiums that everyone must pay. If Medicaid did not provide insurance for many lower-income Americans, the cost of food insecurity to the healthcare system would likely be an even higher percentage. This is one example of how investments in access to nutritious food, preventive medicine, and affordable treatment for illness have whole-of-country benefits.
Hunger and food insecurity can drive up healthcare costs, as shown in Bread’s 2016 Hunger Report, The Nourishing Effect: Ending Hunger, Improving Health, and Reducing Inequality. Using very conservative assumptions, researchers found that hunger cost the U.S. healthcare system at least $160 billion annually in 2016 dollars. More recently, a study published in Health Affairs found, based on nationally representative data, that “… food-insecure families had 20 percent greater total healthcare expenditures than food-secure families,” for an annual difference of $2,456.
Despite these cost savings, some members of the U.S. House and Senate have proposed cutting Medicaid funding by $880 billion over 10 years. Such budget cuts would have a devastating effect on the lives of about 20 percent of the U.S. population.
Medicaid is especially important to children, whose nutrition is the focus of Bread’s current campaign, Nourish Our Future. One-third of all Medicaid participants are children. Seventy percent of WIC participants also receive Medicaid. Of children living in households that participate in SNAP, nearly 9 in 10 receive benefits either through Medicaid or a smaller program, the Children’s Health Insurance Program (CHIP).
Households with children that participate in Medicaid showed a reduction in food insecurity of 20 percent. A subgroup, known as households with “very low food security,” had a larger improvement of 26 percent. Households with young children and households with Black and/or Hispanic children had larger improvements as well.
While all health systems could be doing more to promote nutritious food and healthy eating, Medicaid has been a leader compared with private healthcare insurers. For example, Medicaid supports screening for food insecurity during the patient intake process and piloted the use of what are known as Medicaid 1115 Demonstration Waivers, which some states have used to pilot produce prescription programs and other initiatives to treat metabolic disease.
Not all states would be affected equally by the proposed cuts. More people would lose their Medicaid benefits in states with higher percentages of Medicaid participants. Because Medicaid is one of the largest sources of federal funding to state budgets, cuts to Medicaid would also produce secondary impacts such as eliminating jobs. In Texas, which consistently has high rates of household food insecurity, researchers found that the cuts proposed by the House of Representatives would be likely to cost the state more than 54,000 jobs.
Many Congressional Republicans support work requirements for Medicaid participants. This assumes that many Medicaid recipients do not want to work, but the evidence does not support this. Ninety-two percent of working-age adults on Medicaid have jobs, while the remainder are living with an illness or disability, caring for children and/or elders, or taking classes to qualify for a better job.
Bread for the World opposes any policy changes or budget cuts to Medicaid that will decrease access to life-saving health care and increase hunger for those who are already vulnerable.
Todd Post is a former senior domestic policy advisor, Policy and Research Institute, with Bread for the World.
