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CQC to Governors: Keep Patients at the Center of Medicaid Changes

Read CQC's full letter to governors here.

Dear Governor:

States are the laboratories of our democracy, and they can provide critical leadership in addressing our nation’s health care challenges.

Unfortunately, many Governors are waging experiments with health care and Medicaid programs that threaten the most vulnerable, those most in need of coverage and those least likely to be able to absorb the impact of increased premiums and other out-of-pocket expenses.

Some of these dangerous experiments include:

  • Instituting co-pays for non-emergency or “inappropriate” use of emergency room services, putting patients in the unfair position of being their own doctors and diagnosticians;
  • Adding new monthly premium fees for low-income patients;
  • Eliminating retroactive eligibility, an important protection for patients that covers medical bills incurred in the three months before a patient’s Medicaid application;
  • Instituting work requirements as a condition of coverage;
  • Cutting screening and diagnostic benefits; and many others.

The litany of proposed changes, if approved, will increase costs and reduce access for the low-income consumers who need it most.

Unfortunately, this is happening at a time when Americans are more concerned about paying for health care than ever before. According to Consumers for Quality Care’s (CQC) Health Care Experience Study, Americans with private insurance and those who are currently enrolled in Medicare and Medicaid worry about health care costs even more than they worry about costs associated with retirement, college, housing, or child care.

Even without these proposed changes to drive costs up for low-income individuals and families, worries about costs are having a negative impact on care. A March 2018 West Health Institute/NORC at the University of Chicago survey found that a large number of people are skipping necessary medical care because of costs.

We urge you to remember that the purpose of Medicaid is to help low-income patients access quality care and ask you to carefully consider the impact your administration’s Medicaid waiver will have on the neediest patients in your state. CQC’s State Waiver Checklist can aid in that deliberation to ensure consumer care remains the focus of the any changes proposed to your state’s Medicaid program.


Consumers for Quality Care Board of Directors
Donna Christensen, M.D.
Jim Manley
Scott Mulhauser
Jason Resendez

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