Medicaid cuts are a common threat for hospitals across the country

You might be tempted to see the national debate on Medicaid through the same prism of political and ideological fault lines that often separate sides in healthcare policymaking: the pressure to reduce the federal footprint and curb the growth of entitlements on one side and fervent proponents of the social safety net on the other. Red state versus blue; urban versus rural.

But this time, the line is blurred and strange bedfellows have emerged with each new estimate of how the House and Senate would undermine Medicaid.

{mosads}It’s not hard to understand why lawmakers from solidly red states sound at times like their blue-state colleagues on Capitol Hill when they talk about the draconian Medicaid cuts in the House-passed American Health Care Act and the Senate’s Better Care Reconciliation Act: Medicaid expansion has produced benefits uniformly across the states that rolled it out.

Likewise, the House and Senate healthcare plans pose a common threat.

On the ground, in the hospitals that care for large numbers of uninsured and Medicaid patients, that unified front is especially evident, even across communities that seem worlds apart.

Separated by 2,400 miles, 13 million residents and distinct cultures, our hospitals — New York City Health + Hospitals and Maricopa Integrated Health System (MIHS), in Phoenix — come together here because we share a mission to care for people who face financial hardship. Medicaid is vital to that mission.

We see Medicaid improve health and home every day at our hospitals. At an NYC Health + Hospitals community health center in Queens, we regularly care for 34-year-old Marianna, who suffers from asthma, obesity, prediabetes and knee pain.

Her regular clinic visits — and Medicaid coverage — make a world of difference: She hasn’t made a trip to the emergency department in 18 months. With the Medicaid cuts Congress proposes, would Marianna stay healthy and on the job as a house cleaner to support herself and her three young children? Not likely.

For David, a 37-year-old MIHS patient, Medicaid paved the way for beating a diagnosis of two types of cancer. Medicaid let David focus on his fight — rather than how to pay his medical bills —and receive the exceptional care he needed to return to his 3-year-old son and soon-to-be-born daughter. It also gave him and his family the stability they needed to weather six months of David being out of work while he received chemotherapy.

Our stories are not unique. Medicaid helps millions of working Americans, poor elderly, the disabled, children and others in communities large and small across the country. Its benefits are well-documented and noteworthy: better health, better care, better access. Just in the past month, researchers reported that wider access to Medicaid significantly reduced the incidence of sudden cardiac deaths in Oregon. Diabetes, asthma, hypertension — all improve with the opportunities for health Medicaid provides.

Financial health improves, too. One of Medicaid expansion’s greatest benefits has been the economic stability and security it provides families — families like Marianna’s and David’s. Out-of-pocket costs and new medical debt have fallen in expansion states. Researchers even have linked expansion to better academic performance for children. Expansion is good for state budgets, too, research shows.

Beyond the health and peace of mind Medicaid gives individuals and families, it provides crucial support for hospitals like ours and the vital services we provide all people — trauma and burn care, neonatal intensive care, disaster response, physician training.

Ending expansion and capping the federal contribution to Medicaid, as Congress has proposed, puts these services at risk. And when the federal dollars — upward of $1 trillion over 10 years — go away, states and local governments will turn to taxpayers to cover the shortfall.

Everyone loses, not just Medicaid beneficiaries and their hospitals.

And what about those beneficiaries? The partisan divide on Medicaid often is widest where perceptions about the typical beneficiary frame the conversation. We saw this recently in an ABC “This Week” interview with White House counselor Kellyanne Conway, who suggested the 15 million Medicaid beneficiaries who would lose coverage under the Senate plan could find work and gain coverage that way.

But the data tell a different story: 60 percent of Medicaid beneficiaries work and 80 percent live in a working family. Many of the others are unable to work due to disability or age. Here, again, even our dissimilar states find common ground, with our percentages of working beneficiaries consistent with the national number. With all due respect to Conway, we point out that even with a job, many people still need Medicaid, as less than half of private-sector employers offer health insurance.

The ball is in the Senate’s court and the stakes couldn’t be higher: 22 million more added to the ranks of the uninsured, 1.45 million jobs lost and uncompensated costs soaring at hospitals on the front lines of care for people who have nowhere else to turn. Big city or small town, black or white, young or old, Medicaid beneficiary or not, these painful changes will touch us all.

Congress can step back and understand, like we do, that their plans to fix the shortcomings of the Affordable Care Act amount to a cure worse than the disease. If communities as different as ours can find common ground in this debate, we should expect nothing less from the lawmakers we trust with our nation’s future.

Brezenoff is interim president and CEO, NYC Health + Hospitals, New York City. Purves is president and CEO, Maricopa Integrated Health System, Phoenix, Ariz.

The views expressed by contributors are their own and not the views of The Hill.