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Congressman Richard Neal

Representing the 1st District of Massachusetts

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Columnist Richard E. Neal: Medicare and Medicaid critical for residents of rural areas

August 29, 2017
In The News

Last month we celebrated the 52nd anniversary of Medicare and Medicaid. Given this significant milestone, it is important to reflect on what these two important programs mean for the people of rural western and central Massachusetts.

For over a half a century, Medicare has been providing health security, promoting health equality and ensuring comprehensive health coverage for millions of seniors. The 1st Congressional District alone is home to more than 90,000 Medicare beneficiaries.

Before Medicare, one in three seniors lived in poverty; today it is one in 10. While this is a remarkable achievement, we can still do better. Medicare does not cover vision, hearing or most dental care. As the ranking member of the House Ways and Means Committee, I am drawing attention to this gap, and building support for legislation to add vision, dental and hearing benefits to Medicare.

While many of my colleagues and I continue to find constructive ways to improve and strengthen Medicare, I have been disheartened by continued efforts by congressional Republicans to weaken Medicare and damage our health care system. Their plans would have devastating consequences for rural parts of Massachusetts, which is why I’m fighting hard to protect current law and stop Republican efforts to dismantle it.

Here is an important example: Anyone who has had the enormous responsibility of caring for an aging loved one probably knows that Medicare does not cover long-term care. Medicaid fills important gaps in Medicare coverage, but also is a lifeline for millions of Americans living and aging with disabilities. One in four adults with Alzheimer’s and related dementias, for example, rely on Medicaid coverage.

Middle-class Americans often rely on Medicaid for long-term services and support, such as nursing home care, where they often exhaust their personal savings. That’s why it is alarming that congressional Republicans proposed to cut nearly $800 billion from Medicaid over the next decade. This would force states to cut benefits, cut coverage, or simply not provide help any longer. I have very serious concerns about what these cuts would mean for our rural communities in western and central Massachusetts who rely on Medicaid funds for everything from fighting the opioid crisis to long-term care for our seniors.

We tend to think of health care in terms of health insurance and improving health outcomes. But it is equally true that the health care industry means jobs and positive economic activity. In many communities the largest employer is a hospital or medical facility. Our community is no different.

Health care in rural Massachusetts is a huge economic engine, providing good-paying jobs and positive economic effects. Many of our local hospitals, like Baystate Franklin Medical Center, depend on Medicare and Medicaid to keep their doors open. As it is, hospitals and other health providers in rural areas struggle to attract sufficient staffing, whether it is primary-care providers or obstetricians to deliver babies.

Tossing people off health coverage means individuals will delay care; suffer poor health, and experience economic uncertainty. Hospitals without paying customers cannot stay open for very long. Cutting Medicare and Medicaid will also exacerbate rural health care challenges and harm the more than 50,000 health care-related employees in our region.

Another issue that has sadly moved to center stage is opioid-related deaths. Massachusetts has more than 2,000 deaths per year and among the highest rates of opioid-related emergency room visits, with many hotspots in the Valley. I will continue my efforts to protect and expand funding to fight this epidemic. And I plan on holding an opioid forum in the coming months with local stakeholders to discuss this growing problem.

Rural areas in Massachusetts have significant challenges that are quite different than what people in our cities face on a daily basis. But regardless of geography, we all share a personal interest in access to affordable and quality health care.

As a member of the Democratic leadership in the U.S. House of Representatives, I look forward to hearing from you about ways that we can continue to improve the health and economic security of our rural families.

Congressman Richard E. Neal, of Springfield, represents the 1st District and is the ranking member of the House Ways and Means Committee.

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