Consumer Advocate's Guide to the Medicaid Report Card

(Last Updated: September 19, 2011)

State policymakers across the country are considering harmful Medicaid cuts in order to balance their budgets: eliminating coverage for vulnerable Americans, restricting critical benefits like prescription drug coverage, imposing premiums on those who can't afford them, and slashing already-low provider reimbursement rates.

To protect Medicaid against these types of cuts, advocates must first and foremost persuade policymakers that cutting eligibility, benefits or rates, or creating barriers to enrollment are bad ideas. But in the current fiscal environment, that's often not enough. A successful Medicaid-defense campaign may also need to make the case that there are better ways to find savings in Medicaid without harming care for vulnerable families. 

This report card is intended to help advocates with that second strategy: proposing a consumer-friendly cost-containment agenda as an alternative to the more harmful cuts. The policies we highlight underscore that it's possible to make Medicaid more sustainable without harming - and often by improving - care for the millions of vulnerable seniors, people with disabilities, children and low-income parents that rely on Medicaid.

Advocates can use this Medicaid Report Card to:

1. Identify state level cost-saving policies to advocate for as alternatives to more harmful Medicaid cuts

• Click on your state to get information about which cost-savings policies your state has and hasn't yet implemented.
• Click on the links for policies your state has yet to implement to read more about them. Each includes key considerations to help you decide whether it makes sense to purse the policy given the political environment in your state.
• Incorporate these consumer-friendly cost-containment ideas into your broader Medicaid defense work. See our Medicaid Defense toolkit for resources to help persuade policymakers that cutting eligibility, benefits or rates, or creating barriers to enrollment are harmful. Then promote your consumer-friendly cost-containment agenda as a better way of saving money.

2. Develop materials for state policymakers in support of a consumer-friendly alternative to harmful Medicaid cuts

• Once you've identified policies that your state could enact to save money in Medicaid without harming beneficiaries, frame these policies as clear alternatives to other cuts. Emphasize their documented potential to save the state money in the short run. Each policy page includes evidence of cost-savings and quality improvement.
• Example: Advocates in Ohio developed this fact sheet to urge their policymakers to adopt consumer-friendly cost-containment agenda instead of harmful Medicaid cuts.

3. Use proposed Medicaid cuts to get press on consumer-friendly alternatives

• Highlight these policies in responses to news-worthy hooks, such as your Governor proposing harmful Medicaid cuts in his budget address. You can contrast the savings potential and quality improvement from these policies with the harmful effects of the other cuts on the table.
• Resources:
  • Sample media materials (including op-ed, letters to the editor, media advisory)
  • Messaging tips and sample talking points for how to talk with the public and media about delivery system (coordinated care) and payment reform (quality care pricing).