BY BOB HORENSTEIN
Medicaid, a longstanding safety net program that is critical to the Jewish as well as the general community, is once again under threat of severe cuts, this time in U.S. House Speaker Kevin McCarthy’s debt ceiling bill passed by the House on April 26. 
In our state, the vast majority of the Oregon Health Plan Medicaid funds go directly to health-care providers to pay for health-care services. This includes mental health-care providers, primary care providers, hospitals, nursing facilities (e.g., the Harold Schnitzer Center for Living on the campus of Cedar Sinai Park), community health workers, dental care providers, health-care interpreters and non-emergency medical transportation.
In June 2022, the Congressional Budget Office estimated that imposing work requirements on certain Medicaid enrollees ages 19-49 would cut Medicaid by $135 billion over 10 years with 2.2 million individuals losing coverage. McCarthy’s proposal goes much further by imposing work requirements on a larger population of enrollees, ages 19-55, including some of the most vulnerable individuals in our country – medically frail older adults and some people with disabilities who receive Supplemental Security Income. 
In recent years, Arkansas, to cite one example, temporarily imposed work requirements on adults as a condition of Medicaid eligibility – requirements that led to widespread coverage losses, a rise in the number of uninsured in the state and no demonstrated increase in employment. Moreover, it’s highly possible that with the House budget proposal, many people who should be able to show that they are working the requisite amount would still lose coverage due to the onerous and complex reporting requirements, language and literacy barriers, and limited internet access. 
While it’s true that states on their own technically would be allowed to maintain coverage for people who would otherwise lose coverage, they would have to give up the federal Medicaid funding that they currently receive to cover these individuals. In the case of Medicaid enrollees in the expansion population, if Oregon wanted to maintain coverage, it would lose the 90% federal matching funds. 
States, which must balance their budgets and may already be under significant financial strain, would be forced to choose between maintaining Medicaid coverage or making deep cuts to Medicaid provider reimbursement rates and optional services, such as home- and community-based services and dental care for adults. Speaker McCarthy’s proposal thus would have very serious and far-reaching consequences to Medicaid and an estimated 21million enrollees nationwide.
The Jewish Community Relations Council supports the safeguarding of Medicaid funding for Oregon’s most vulnerable populations. It is therefore imperative that we actively oppose the proposed draconian U.S. House cuts to Medicaid by contacting Senators Ron Wyden (202-224-5244) and Jeff Merkley (202-224-3753).

Bob Horenstein is the Director of Community Relations and Public Affairs for the Jewish Federation of Greater Portland.