The Coalition exists to improve access, affordability and representation for chronic disease patients. While the vast majority of our work focuses on state legislative changes, there’s little doubt that nothing is more concerning to patients in 2025 than the threatened cuts to Medicaid.
You can read our full blog here, but we know the headlines: The current goal for federal spending cuts is $880M – and Medicaid is a prime target – with serious effects on chronic disease patients of all ages. Medicaid pays for more than 40 percent of all births in the U.S. It also pays for home care, nursing homes and other essential health services for seniors, who rely on both Medicare and Medicaid for nursing home and long-term care services.
While the U.S. Senate probably won’t take up the budget until September, researchers and patient-advocacy groups are working hard to anticipate and avoid the consequences. Hot topics include:
- Work requirements (unlikely to save the program much money, as most people on Medicaid are employed already)
- Waste, fraud and abuse (again, unlikely to save the program much money as there is already a ton of oversight. It’s providers, not patients, who are most likely to commit fraud against both public and private insurers)
- Rural hospitals are incredibly vulnerable, as rural communities are highly dependent on Medicaid for health insurance. Without Medicaid, patients are forced to go to emergency departments for healthcare and may not be able to pay much of the bill. Too much unreimbursed care, and hospitals can’t stay open.
- Cuts could also force a move back to fee-for-service models, which reduce the preventive care, case management and quality improvement measures that make chronic conditions manageable.
As the federal cuts have not been made, this year’s state budgets are not affected—yet. But it is coming. While legislatures may have a little reprieve this year, next year is expected to be a much different story.
Want to send a letter to your state and federal representatives? We make that easy with a pre-written letter. Want to share your story or change the letter? You can do that, too.
Other issues related to our priorities of access, affordability and representation:
- Pharmacy Benefit Manager (PBM) Reform: PBMs have an administrative role to play, but we desperately need more price transparency and oversight. Manufacturers give discounts on drugs to help patients afford them, but those discounts should be passed on to patients, not diverted as increased profits by the PBMs. PBM reform bills are moving through legislatures quickly this year, as lawmakers seek ways to save money and maintain access to treatments for patients.
- Prior Authorization: “Gold-carding” is one of the most popular reform strategies this year, a practice which recognizes providers and hospitals who have a good record. There are also bills to keep AI from being the whole basis of a denial—in other words, if an insurance company is going to deny a patient a prescribed medication, a human being ought to be involved and make the final determination. Improvements in other states include transparency requirements, faster behavioral health referrals (especially important for people in mental health crisis, or trying to avoid one) and more options for people managing rare diseases.
- 340B Program: The 340B Program is a federal program that helps certain hospitals and clinics buy prescription drugs at lower prices so they can save patient money or improve services. Too often, providers and big corporate pharmacies— not patients— benefit by pocketing the savings. Improvements in transparency and reporting are needed.
Check out February’s blog about 340B for more insight.
- Medigap: This blog tells the story of one Texas resident in need of more affordable Medigap plans. While it’s mostly only people under-age 65 with End Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS) who are in need of Medigap plans, they are crucial for both the patients and families. Medigap options also keep people off of state Medicaid programs. Nebraska, Illinois and Nevada are just a few of the other states working on Medigap bills.
“I don’t want to take cruises and fancy vacations,” Lesley shared. “I just want to live independently, somewhere safe and comfortable. I want to be able to pay my insurance premiums and my utilities, and those are expensive. So much of my income has to go to healthcare.”
What can you do?
It would be great if we could all show up in our capitol buildings, every time a bill comes up in committee. But that’s not the only way that legislators listen to their constituents.
Be informed:
- Sign up for our newsletter and get 5 quick items to know, be inspired by, or take action on twice a month. You’ll also get occasional updates about key legislation in your state.
- Follow us on social media for a mix of patient stories, policy trends, and timely actions you can take in your state. Find us on Facebook, Instagram, LinkedIn and X.
- Visit our website to read our latest blog articles, view our policy map to see which states are working on legislation in our key areas and join Chronic University to access three mobile-friendly videos sharing basic and advanced steps for telling your story.
Be engaged:
Contact your elected leaders with our fillable letters. We have suggested language to make it easy, but you’re welcome to make edits and tell your own story.
Now is a great time to send messages about building a better healthcare system; access, affordability and representation, and flexible coverage with high-deductible healthcare plans. We also have state-specific calls to action for the great states of:
- Texas
- California
- New York
- Virginia
- Pennsylvania
- Maryland
- Florida
- Indiana
- Illinois
- Nebraska
Share Your Story and Join Us
The chronic disease community is about 1 in every 3 Americans. We are in every state, every community, and every family. If we can improve the healthcare system for chronic disease patients through better diagnostics, early and effective interventions, and affordable and accessible treatments, we all get better.
Share your story here: https://chronicdiseasecoalition.org/take-action/share-your-story.
Learn about our Ambassador program here: https://chronicdiseasecoalition.org/get-involved/ambassador-program.