How Medicaid Can Bounce Us Forward Into Equitable Healthcare

June 08, 2021|7:56 p.m.| Lindsey Browning | Program Director for Medicaid Operations at National Association of Medicaid Directors

Female healthcare worker giving encouragement to elderly patient by holding her handsIt's been found that one in three individuals who contract COVID-19 will experience lasting mental health impacts, according to a recent study. This startling discovery underscores the reality facing our nation: the challenges of this last year – the public health and economic ramifications of COVID-19, coupled with the longstanding racial and ethnic inequities that it highlighted – will be felt for years, if not decades, to come.

People are also skipping recommended preventive health services during this pandemic. Stress and loneliness are on the rise, and along with depression, substance abuse, and suicide. Symptoms of anxiety and depression are being reported at three and four times the normal rate, according to CDC data. These increases are just the beginning, and our healthcare system—still reeling from the challenges of the last year—is likely to continue to struggle with these increased mental health needs.

Given the expanse of its reach, Medicaid will be essential in the nation’s recovery from these impacts. More than 77 million Americans – roughly one in every five Americans or two in every five children – use Medicaid or the Children’s Health Insurance Program to get the healthcare they need. Nearly half of all births in the country are covered by Medicaid. In addition, Medicaid pays providers, hospitals, long term care facilities, and other components of our healthcare infrastructure $600 billion each year, making it a critical funder of the healthcare system that serves all Americans.

The good news is that Medicaid programs have the tools to respond and can be a valuable partner to achieve public health goals. As we’ve seen in NAMD’s Medicaid Forward Initiative, Medicaid programs can – and already are – contributing to the nation’s recovery, including in several areas that have faced significant pandemic-related challenges:

  • Mental health and substance abuse.
  • Access to healthcare for children.
  • Supports for special populations, like people in need of long-term care, people transitioning from prison, and people living with developmental or intellectual disabilities.

Some of the options Medicaid directors can use to respond are laid out in first of three NAMD reports, Medicaid Forward: Behavioral Health. For example, numerous Medicaid programs are making it easier for people to access needed mental health and addiction by waiving the requirement for individuals to have a diagnosis before receiving mental health services. Medicaid programs are also leveraging peers – or individuals with lived experience – to support care delivery.

The American Rescue Plan Act of 2021, enacted in March, can help Medicaid in supporting the nation’s recovery. It provides new funding for Medicaid to deliver certain mental health crisis services. This can help communities connect people in crisis to treatment and preserve law enforcement for other needs.

It also gives Medicaid programs the option to provide coverage for postpartum women from 60 days after giving birth to one year, helping ensure children have family stability and a strong start to life.

Finally, it provides time-limited funding to shore up home and community-based services, which have been battered by this crisis and are a key part of the long-term care system. This will promote the health and wellbeing of the nation’s oldest adults and people with disabilities who choose to receive these services in their community.

The challenges facing the nation are immense. No agency, organization, or level of government will be able to go at it alone. But Medicaid programs, in partnership with state/territorial public health agencies, can help states in this important work and set us on a path for recovery.


Lindsey Browning is the Program Director for Medicaid Operations at NAMD

This blog represents the views of the National Association of Medicaid Directors (NAMD). NAMD is the bi-partisan, non-profit organization providing support to Medicaid directors in administering the program in cost-effective, efficient, and visionary ways that enable more than 77 million Americans served by Medicaid to achieve their best health and to thrive in their communities. This blog brings a voice from the field based on the experiences of NAMD members.

This blog is part of ASTHO’s Bounce Forward suite of resources. This product was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as a part of a financial assistance award (cooperative agreement OT18-1802) for State Public Health Capacity Building. The contents are those of the author and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS or the U.S. government.