Letter to Congressional Leadership on Medicaid, CHIP and the Budget

April 17, 2023


The Honorable Charles Schumer
Majority Leader
United States Senate
Washington, D.C.  20510

The Honorable Mitch McConnell
Minority Leader
United States Senate
Washington, D.C.  20510

​​The Honorable Kevin McCarthy
United States House of Representatives
Washington, D.C.  20515

The Honorable Hakeem Jeffries
Minority Leader
United States House of Representatives
Washington, D.C.  20515


Dear Majority Leader Schumer, Minority Leader McConnell, Speaker McCarthy, and Minority Leader Jeffries,

The undersigned organizations urge you to protect Medicaid during upcoming federal budget negotiations. Medicaid is a life-saving program for millions of individuals, and its importance cannot be overstated. It provides high-quality, essential health coverage to those who need it most – low-income people, children, birthing individuals, older adults, and people with disabilities. The program also supports states in providing vital services and health coverage in a cost-effective manner.

Forty-one politically diverse states have taken up the Affordable Care Act’s Medicaid expansion, demonstrating the strong support it has among the American public. Medicaid improves health outcomes, access to care, and the financial security of individuals and families, and supports jobs and state economies. Reductions in federal Medicaid spending would be highly counter-productive at a time when our nation is still emerging from an unprecedented public health crisis.

We are grateful for the remarkable steps that Congress has taken over the last several years and especially in late 2022 to improve Medicaid for the millions of families it serves. The undersigned organizations believe that the Consolidated Appropriations Act, 2023 (CAA) – which ensures that 44 million children on Medicaid and CHIP will no longer experience dangerous gaps in coverage and care, that postpartum individuals across the nation have access to a full year of Medicaid and CHIP coverage, and that juvenile inmates have access to key Medicaid services before transitioning out of institutions – represents a significant and equitable step forward for our health care system. We urge Congress not to retreat from these gains.


Children are especially vulnerable to cuts in Medicaid funding, as the program is the primary source of health coverage for nearly half of all children in the United States, covers about 42 percent of all births in the United States, and plays a major role in the provision of behavioral health care for children. Medicaid also provides security to adults, allowing parents to better support their families. A survey of people on Medicaid in Michigan demonstrated that individuals were better able to seek and maintain employment while covered by Medicaid. Budget cuts that would reduce or eliminate coverage of health care services would impose untenable financial burdens on parents and their children, limiting access to the care they need. 

In addition, as the “unwinding” of the three-year Medicaid continuous eligibility protection begins this month, it is even more important to maintain a strong Medicaid program for children. The Department of Health and Human Services anticipates that approximately 15 million people will lose Medicaid coverage during the unwinding period and that 6.7 million of these beneficiaries will be children. Research suggests that 73.6 percent of children who lose coverage will still be eligible, but will be disenrolled due to administrative issues. State Medicaid agencies that are already resource-strapped will fare far worse in their efforts to ensure continuity of coverage for children if federal funding is taken away. 

Older Adults and People with Disabilities
Medicaid is also critically important for seniors and people with disabilities who rely on Medicaid-funded long-term services and supports to live independently, such as home health care and personal assistance. Forty-five percent of non-elderly individuals with disabilities receive Medicaid, as do 60 percent of nursing home residents.  

By providing access to trained professionals who help with bathing, dressing, and feeding, as well as a broad array of preventive and other services, Medicaid offers critical support to help these individuals remain in their homes and communities and retain quality of life, rather than having to be institutionalized. Reductions in federal Medicaid funding would have a devastating impact on seniors and people with disabilities, reducing access to essential care.


Behavioral Health
According to the Commonwealth Fund, “Medicaid is the largest public payer of behavioral health care, with the bulk of spending on care for children, youth, and birthing individuals during the perinatal period.” As such, Medicaid plays an essential role in providing access to behavioral health services, particularly for individuals with serious mental illness and substance use disorders. The program provides support for both treatment and prevention services, helping to reduce the burden of these conditions on our nation’s health care system. As the need for behavioral health services grows, we fear that any reductions in Medicaid spending would place additional strain on already-stretched behavioral health systems, making it harder for individuals to access care.

Given the importance of this life-saving program to our nation’s health care system, the economy, and the millions of families it serves, Medicaid should not be on the table during federal budget and debt ceiling negotiations. We strongly urge you to prioritize the program and maintain funding levels that support a strong Medicaid program for all Americans. Medicaid is too important for our nation’s most vulnerable citizens, and any cuts could have devastating effects.

Thank you for your consideration and we look forward to working with you on this important issue. 



American Academy of Pediatrics
Association for Community Affiliated Plans
Children’s Hospital Association
Community Catalyst
Families USA
First Focus Campaign for Children
National Alliance on Mental Illness