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Jennifer Partyka’s son was severely anemic and underweight as a result of Crohn’s disease before he began receiving treatments that dramatically changed his life.
As the operations manager for a small nonprofit without employer-provided health insurance, Partyka’s son depends on Medicaid to pay for the costly treatments. He requires them every two months, Partyka said Wednesday during a press call organized by an advocacy group on the impact of proposed cuts to the federal safety-net insurance program.
“My son, like so many people on Medicaid, works over 40 hours a week,” said Partyka, a Lackawanna County nurse who did not identify her son to protect his privacy. “People on Medicaid are not the parasite class. What a cruel way to speak about your friends and your neighbors.”
House Republicans last week passed a federal budget blueprint that calls for $880 billion in cuts to Medicaid, with House Speaker Mike Johnson (R-Louisiana) calling the program “hugely problematic” because of fraud, waste and abuse.
“Despite what the media and the left allege, no Medicaid or Medicare benefits will be reduced—these are entirely false claims,” Rep. Dan Meuser (R-9th District) said in a statement last week. “The only reductions will be to waste, abuse, fraud, and ineligibility if found—which I believe 98% of Americans support.”
Pennsylvania advocates with Protect Our Care, a national nonprofit that advocates for the right to affordable and equitable health care for all Americans, said Wednesday that a web of safeguards ensures there is “little fraud” in the program.
The National Health Care Anti-Fraud Association estimated in 2018 that about 3% or more than $100 billion of all health care expenditures are fraudulent. The federal Department of Health and Human Services estimated that there were more than $100 billion in payment errors in the Medicare and Medicaid programs in the 2023 fiscal year.
Medicaid provides a lifeline and specialized service to a broad range of Pennsylvania residents including children, seniors and adults who have complex and debilitating conditions that prevent them from earning enough to afford private insurance.
Reducing funding by the level necessitated by the House budget resolution would cost Pennsylvanians their health, dignity and lives, advocates said.
State Rep. Arvind Venkat (D-Allegheny), who is an emergency room physician, recalled a patient who came to his ER with back pain he initially suspected to be a pulled muscle.
“I was wrong. She had widely metastatic breast cancer,” Venkat said. “What she told me was that she did not have insurance coverage … and as a result, she only saw care in the emergency department when it was, frankly, too late. That is the future that we’re looking at if these types of cuts go through.”
Gov. Josh Shapiro’s 2025-2026 budget proposal includes $63.7 billion for the Department of Human Services, an 8% increase over the current budget. The department administers Medicaid programs in Pennsylvania and receives nearly 60% of its funding from the federal government.
In a House Appropriations Committee budget hearing Tuesday, Human Services Secretary Valerie Arkoosh testified that Medicaid covers more than 3 million Pennsylvanians, more than a third of whom are children and 312,000 of whom are senior citizens.
“It’s an absolutely essential program for so many people,” Arkoosh said. “It allows people to live in their homes instead of having to go into a nursing facility. It allows people to be healthy and be productive members in the workplace. It gets our kids off to a great start.”
The increase in the budget request reflects more acute illness among Medicaid recipients along with rising hospital and drug costs. It’s a result of many people who fell back on Medicaid during the pandemic returning to the workforce, leaving those with greater medical needs on the program’s rolls, Arkoosh said. She added that many of those people avoided seeking care during the pandemic, resulting in an increased demand for services.
Theresa Miller, who served as human services secretary for four years under former Gov. Tom Wolf, said during the discussion Wednesday that Medicaid also plays a key role in fighting the opioid and suicide epidemics, which claim nearly 20 lives a day in Pennsylvania. She noted Medicaid is the single-largest funder of mental health and substance use disorder (SUD) treatment in the country.
“Medicaid expansion in Pennsylvania literally saved lives,” Miller said. “I have heard countless stories of people who do not believe that they would be alive today if it weren’t for the mental health or SUD treatment or other critical health care services that they were able to access because of Medicaid.”
Miller said claims of widespread fraud and abuse are misinformation. and that there is no way that cutting nearly a trillion dollars from Medicaid would eliminate only wasteful and fraudulent spending.
“To suggest that Congress can cut hundreds of billions of dollars from Medicaid by simply ferreting out fraud, waste and abuse, and that people won’t feel the impact of these cuts is simply disingenuous,” Miller said.
State officials are reviewing the use of Medicaid funding for programs in Pennsylvania.
In the budget hearing Tuesday, Rep. Jeff Olsommer (R-Pike) said Shapiro’s budget notes that GLP-1 treatments such as Ozempic, used to control blood sugar and promote weight loss, account for nearly $1 billion in medical assistance program spending, which falls under Medicaid. He asked whether the treatment is supported by an associated reduction in costs.
Arkoosh said that while treating diabetes with GLP-1 drugs has shown savings in treatment for associated conditions, their use to treat obesity alone is more recent and less data is available. The department is proposing new guidelines that would allow the drugs to be used for only more severe conditions.
Michael Berman of Protect Our Care Pennsylvania said Wednesday that the organization’s polling shows that Americans overwhelmingly agree that health care is important in deciding who they vote for in Congress and a vast majority, including more than two-thirds of Trump voters disapprove of the proposed Medicaid cuts.
“It is numbers like that that get a little lost, and it’s important to bring it back to the stories of the individuals here who were seeing patients every day … who are going to get hurt by these cuts,” Berman said.