State advocates have a critical role to play in the two fights looming over Medicaid - protecting existing Medicaid coverage against devastating budget cuts, and ensuring the implementation of the Affordable Care Act's (ACA) Medicaid expansion.
The recession has worn on state budgets for nearly five years, and states continue to face budget shortfalls in fiscal year 2013, placing extraordinary pressure on state policymakers to cut public spending and close budget gaps. As a result, many states are considering harmful Medicaid cuts: eliminating coverage, restricting critical benefits, and imposing premiums on those who can't afford them.
The ACA expands Medicaid coverage to 16 million new enrollees starting in 2014, but the Supreme Court's decision gave states the option of rejecting the expansion, putting the health of millions of vulnerable Americans in the hands of state government.
Whether they're trying to prevent Medicaid cuts or ensure that states expand Medicaid, state advocates will need to:
Advocates can use this Medicaid campaign planning guide to help develop their Medicaid campaigns in addition to this toolkit, which provides best practices and lessons from a number of states. Advocates can tailor the tactics, tools and resources in this guide to reflect specific expansion campaigns, strategies, or states' political environments when building the case for protecting and expanding Medicaid.
Make the case Medicaid helps people and is popular
Tactic: Create a table of potential partners, allies, and stakeholders who can help build the case for Medicaid
New Mexico advocates' YouTube video highlighting that Medicaid rocks
The Insuring our Future partnership's YouTube video highlighting that Medicaid matters in Colorado
Other helpful toolkits
Arkansas Advocates for Children and Families Medicaid toolkit-including great resources, videos, and infographics
Tennessee Justice Center resource page with several factsheets on the Medicaid expansion and populations that will be helped
Savings and Revenue Options for Policymakers
Costs - whether they're perceived or real - are often the barrier to expanding Medicaid or protecting it against harmful cuts. Advocates have an opportunity to change the way policymakers think about Medicaid costs. First, many of the perceived costs associated with the Medicaid expansion are outweighed by the savings the state would see in reduced uncompensated care and other expenses associated with the uninsured. Second, advocates can help policymakers move to a rational, progressive approach to sustaining the Medicaid program over the long term.
Strategies to support sustainable Medicaid funding include: