Read on Riverhead Local

By Denise Civiletti

Feb 21, 2025, 12:23 pm

Major cuts to Medicaid funding would have devastating impacts on medical services for 680,000 Long Island residents who depend on Medicaid for healthcare, according to healthcare advocates who conducted a “Medicaid Equity Town Hall” at Riverhead Free Library Wednesday night.

Those Long Island residents include 103,400 seniors, four in nine children, four in nine people with disabilities, and 48% of births, according to data presented by the Healthcare Education Project during the session. Medicaid covers over $9 billion in medical services for Long Islanders.

Substantial cuts to Medicaid are a key part of congressional Republicans’ plans to provide $4.5 trillion in tax cuts, extending tax cuts that were part of the Tax Cuts and Jobs Act of 2017. The Tax Cuts and Jobs Act of 2017 made sweeping changes to federal tax law that disproportionately benefited the country’s highest-income households. 

The 2017 tax cuts expire at the end of 2025. Trump has promised to extend the cuts and House Speaker Mike Johnson has negotiated a budget bill that will do so, in part by cutting about $880 billion from Medicaid funding over the next decade.

“Americans throughout the entire USA are fearful of the potential proposed Medicaid cuts,” Marcella Dinnall of the Healthcare Education Project told the audience at Wednesday night’s presentation.  “And if you’re not affected directly, you will be affected and impacted, because these are your neighbors, your friends, your family,” Dinnall said of people who rely on Medicaid. Even if you have good private health insurance, she said, you should still join the fight for Medicaid equity, she said.

Restricting access to Medicaid will strain hospitals and healthcare workers,  Dinnall noted, because people without any healthcare coverage turn to hospital emergency rooms for care of conditions that could have been dealt with in a physician’s office or conditions left untreated and eventually require hospitalization that might have been avoided if treated sooner.

Nationally, 80 million Americans rely on Medicaid for healthcare coverage: 4 million seniors, 7 million children and 11 million adults with disabilities. 

“Can you imagine these people not having any healthcare coverage— dental, ophthalmology, you have a heart failure, any chronic illness like diabetes, and I can go on and on, but it’s very dismal,” Dinnall said. “So we’re saying, Why should these vulnerable populations have to suffer to fund tax cuts for the wealthiest Americans? Why should they suffer long waits and worse treatment — so the rich can get richer?” she asked.

“We’re asking you to call your representative, and ask ‘Whose side are you?’  Are they for the very wealthy? Or for the vulnerable?” Dinnall said. She provided contact numbers for the district offices of Rep. Nick LaLota (NY-01) 631-289-1097 and Rep. Andrew Garbarino, (NY-02) 631-541-4225.

Naquashia Bias, a homecare worker for 14 years, said of the 80 million Americans who rely on Medicaid for healthcare, about 4.5 million received home-based care. 

“Cuts affect elderly and others living in the comfort of their own homes while being cared for,” Bias said. “It affects families that depend on workers like myself to come into their parents’ or relatives’ homes every day, to assist with basic daily care and appointments,” she said. 

“These proposed cuts eventually put many home care workers out of a job, out of what they love to do, and out of the joy they get from simply hearing at home. Caregivers are essential. We help make it happen,” Bias said. 

In addition to people who receive Medicaid, New Yorkers are eligible to receive discounted health care coverage through the Affordable Care Act because New York State took advantage of the ACA’s expanded eligibility option, which currently allows residents with incomes that are 138% above the federal poverty level to access Medicaid coverage and allows low-income residents who are not Medicaid-eligible to access healthcare coverage at discounted rates.

“If we are not going to be investing in healthcare, if we’re pulling Medicaid dollars out, those are monies that are going to be gone as well,” said Vanessa Baird-Streeter, president and CEO of Health & Welfare Council of Long Island.

She urged residents to get on the phone with their congressional representatives consistently about these issues. 

“You have to be in their face about it. They have to know that their constituents care about this, because if we’re not speaking up, they don’t think we care, and therefore they go ahead and approve these cuts,” Baird-Streeter said.

Congress is talking about almost a billion dollars in cuts to Medicaid, she said. “If you cut a billion dollars from Medicaid, there are going to be very many people that are not eligible for Medicaid. You’re going to be getting subpar services…Providers are not going to want to provide, or service those who are Medicaid-eligible,” Baird-Streeter said.

Medicaid is a joint federal-state program. States receive reimbursement for Medicaid spending of between 50% and 77%.  Cuts in Medicaid funding will shift costs for health care coverage to states, putting pressure on state budgets that extends beyond healthcare, to spending for education and public safety, according to the Healthcare Education Project. 

States will be forced to cut payment rates for hospitals and other providers, according to the group’s Medicaid fact sheet.  Home- and community-based long-term care services will be “immediate targets for cuts or elimination, since states are not required to cover them, the fact sheet says.

Baird-Streeter also gave a presentation on the Social Care Network led by the Health & Welfare Council of Long Island. The Social Care Network is made possible by a waiver approved for New York by the Centers for Medicare and Medicaid Services in January 2024. The waiver is in effect until March 31, 2017.

The waiver allows states to create healthcare options or programs that typically would not be funded with federal Medicaid dollars. It allows New York to fully integrate social care into the delivery of health care under the state’s Medicaid program.

The Social Care Network allows for a holistic approach to health and well-being, Baird Streeter said. Through a network of about 120 community-based organizations, the  Social Care Network delivers health-related social care services to Medicaid members across Long Island, Baird-Streeter said. 

Social Care Network providers are all nonprofit organizations and each agrees to a uniform initial screening and agrees to use a shared portal for data entry, to make delivery of services seamless and more accessible for clients. 

The idea is for the Social Care Network providers to connect Medicaid recipients with a wide range of services they need outside of healthcare, including: ending food insecurity, housing assistance including rent, assistance with paying for heat and utilities, assistance with things like building a ramp for handicap access to their homes or mold remediation, or mental health and substance abuse counseling and treatment.

“All of these things are actually addressing and looking at your health-related social needs, because we can take care of health care, but if we’re not taking care of your social needs, your health is not going to necessarily improve. It has to be holistic and comprehensive,” Baird-Streeter said.

“These are opportunities and resources that have never been available to Medicaid members, but they are available under the Social Care Network and enhanced care management,” she said.

For more information, visit the Health Equity Alliance of Long Island.

Wednesday’s Health Equity Town Hall was presented by the Healthcare Education Project in collaboration with 1199 SEIU United Healthcare Workers East.