By BETSY TAYLOR
Hochman
Providence St. Joseph Health began a campaign in October to raise awareness about the 72 million children and adults who rely on Medicaid — the largest single insurance program in the country — and to allow people to share their stories of how they've been helped by Medicaid coverage.
Providence St. Joseph Health President and Chief Executive Dr. Rod Hochman thinks the biggest misconception about Medicaid has to do with who it covers. In an interview with Catholic Health World he reinforced the campaign's message that:
• Nearly 50 percent of births in the United States are covered by Medicaid.
• Nearly one in 10 veterans have Medicaid coverage.
• Medicaid pays for care for about 65 percent of seniors in nursing homes who don't have and can't afford private long-term care insurance.
• Medicaid covers more mental health services than any other insurer.
Renton, Wash.-based Providence St. Joseph Health is publishing the stories on the web, and pushing them out through social media. It also is sharing the narratives with elected and appointed officials.
Providence St. Joseph Health employees have recorded the stories of people in their own families who are insured by Medicaid, and a handful of patients have contributed their stories thus far. The system is posting those written stories, videos and photos on its "The Many Faces of Medicaid" webpage at http://www.psjhealth.org/about-us/community-benefit-report/the-many-faces-of-medicaid.
"We wanted to speak about why we think Medicaid is so important, particularly for Catholic health care systems because the poor and vulnerable are our charge," Hochman said. People need to understand who is covered by the Medicaid program. "These are our children, our parents, our aunts and uncles," he said.
About 20 million people gained coverage under the Affordable Care Act with more than half of those people insured through Medicaid, according to multiple analyses of the legislation.
Hochman, who chairs CHA's board of trustees, was the signatory on a letter to Congress in September from CHA's board opposing the Graham-Cassidy bill, which would change Medicaid from an entitlement program to a capped block grant program. Medicaid is the largest single source of federal funding to the states. Under its current structure, federal reimbursements to states increase automatically to cover valid claims. If the payment mechanism was to be changed to a capped block grant program, states would be left to make up funding shortfalls in the program or institute program cutbacks.
Hochman's letter said the bill would harm many of those covered by Medicaid: "Millions of people will lose coverage, causing pregnant women and their unborn children to go without prenatal care, parents of children with serious illnesses to be unable to afford medical care, and poor elderly to be unable to get nursing home care."
He told Catholic Health World that creating awareness about who is covered by Medicaid is "a big deal." Focusing attention on the real people it helps creates a voice for the voiceless, he said. And people need to understand the program so they understand the implications of changing the program and the consequences.
Hochman said that sharing stories of people who rely on Medicaid helps eliminate some of the stigma related to use of a government safety net program. The shared stories allow people a view into the lives of those who rely on the program, and may help them understand that many hardworking people can be hit by unexpected circumstances and health care costs.
The initiative's website also lists the names of Medicaid state programs, and includes links to data and information about coverage.
A better understanding of those who use Medicaid will help health care advocates and policy makers design and advance improvements to the program. The program insures low-income adults and children whose health status may be impacted by poverty, unsafe streets and limited education and job opportunities. In light of the health impact of social determinants of health, Hochman said Providence St. Joseph Health is analyzing and working to answer a question: "Should we be doing things differently in how we care for the Medicaid population?"
The answers might encourage health providers to view health services more broadly, such as with involvement in the promotion of safe and affordable housing and efforts to broaden access to educational opportunities.
Providence St. Joseph Health employees are adding stories to the website through mid-December. In January, the system will evaluate the response to The Many Faces of Medicaid campaign and examine next steps, said Erin Wesen, communications manager for Providence St. Joseph Health.
Nisha Morris, Providence St. Joseph Health's executive director of communications and public relations, shared the story online of her 9-year-old daughter Nathasha. Nathasha has a rare genetic condition that causes her to stop breathing when she sleeps. Nisha wrote that she and her husband Randy rely on Medi-Cal (the name of Medicaid in California) for their daughter's nursing support and medical equipment because their insurance doesn't cover these major expenses. "The cost is just too big for us — or pretty much anyone," Morris wrote.
She added, "We are not poor. But we are vulnerable."