An Expert Explains: Medicaid Cuts Will Hurt Us All

Transcript

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Cynthia : And what I want to stress is, it's not an issue of red versus blue. It's an issue of billionaires versus you.

Natieka : Hello and welcome to School Me, the National Education Association's podcast dedicated to helping educators thrive at every stage of their careers. I'm your host, Natieka Samuels. Today we're talking about something that might not always make headlines in the education world, but absolutely should, which is Medicaid. Medicaid is a lifeline for [00:00:30] millions of Americans including students, families, and school employees, but right now it's under serious threat. New proposals in Congress aim to slash Medicaid funding and the consequences could be devastating. To help us understand what's at stake, I'm joined by Cynthia Blankenship, NEA's senior policy advisor for health policy and benefits. She'll explain what these proposed cuts mean, how they could impact students in schools and what educators can do to help protect Medicaid at the state and national level. [00:01:00] Thank you for joining us today, Cynthia.

Cynthia : Thank you for having me, Natieka. Pleasure to be here.

Natieka : Let's start off with a little bit about you and your current role at NEA.

Cynthia : I am the senior policy advisor for all health policy and benefits on the federal as well as state levels. And so what I mean by that is, I work to review legislation, amendments, draft for Congress with our amazing government [00:01:30] relations team, and I work with the agencies to submit comments here on a federal level. And then I work with all of our incredible state affiliates on all state healthcare issues and reform efforts that are going on in the state.

So here at NEA, just for a structure, I am in the Collective Bargaining and Members' Advocacy Department. And also, we have a brilliant team that assist on all bargaining efforts nationwide as well.

Natieka : I think there's a lot to cover. So I want to start [00:02:00] with a foundational question to this discussion, which is, what is Medicaid?

Cynthia : Medicaid has many, many roles, but I think at its core, Medicaid provides healthcare to almost 80 million people. And some of the things that we may not think about that Medicaid does, because it's so vast, is that it's also the largest federal revenue stream to all of our states. That's our state budgets and all of our state programs [00:02:30] as well.

It keeps our hospitals and long-term care facilities open. It also decreases our uncompensated care, which we know, that keeps employer-sponsored healthcare lower. When we have less uncompensated care, we have lower employer-sponsored healthcare as well.

It's a major revenue stream for all of our schools. So we talk about that hit on the state budget that Medicaid is the largest federal revenue stream. In addition to that, [00:03:00] it also provides 7.5 billion for school-based services under that Medicaid billing stream. So Medicaid certainly touches all of our lives, and it impacts all of us on a daily basis as well.

Natieka : Medicaid is the name that, I think pops up the most often when people are talking about state-related or government-related healthcare. But I understand that there are a lot of different names that [00:03:30] Medicaid programs could go under in different states. So can you talk a little bit about why the naming of Medicaid programs is important?

Cynthia : We started, here at NEA, efforts just within a few days of the election. So we've been working on a massive education effort for months and months on these Medicaid cuts. And when we initially started our work, we did initial polling. What we did, we took a name of a program within a state and we asked a person, is this program Medicaid? And predominantly we heard, [00:04:00] no.

And it was so there's this disconnect between what the programs are called in the states and that they are actually Medicaid. And what I mean by that is that all these states have a program that they name it their own in that state for traditional Medicaid program. And then there may be an additional program with a different name for the population that was added to Medicaid after the passage of the Affordable Care Act. We call them the [00:04:30] expansion population.

So those that came after the ACA went into effect, they're in a different program with a different name, and then states can have even additional programs when they add services to their state Medicaid programs. They may add vision, they may add overdose and rehabilitation efforts, they may add some surgeries or oral care. Postpartum is a large one that's being expanded.

When they add these services, they may give [00:05:00] names to each of these service expansion populations as well. So when you look at a state program, not only Medicaid may not be in the name at all, but there may be many different programs in that state that are actually operating under that umbrella of Medicaid. And when we start to connect those dots and when we have conversations with family members and friends and we start to explain, all of these programs are Medicaid, that's when we really start to get glimpses of how vast Medicaid cuts [00:05:30] would really impact our lives.

Natieka : And I can see how that would be an issue with people not recognizing so many things that people rely on, is actually Medicaid, especially when we're talking about the political popularity of cuts in all of this. So speaking of cuts, why are cuts being proposed to Medicaid right now?

Cynthia : When I go into a room and I'm talking to people, what I like to tell them is that unless you are Elon Musk [00:06:00] or one of his billionaire friends, these cuts are not going to benefit you. And what I want to stress is, it's not an issue of red versus blue, it's an issue of billionaires versus you.

And so these Medicaid cuts are being taken for the billionaire tax cuts. And the reality is the billionaire tax cuts are expiring, and if they are going to extend those billionaire tax cuts like they have been very publicly [00:06:30] vocal that they are, they have to pay for those tax cuts and that means they're willing to cut other programs in order to find the money for the billionaire tax cuts.

Just to reiterate, when I used to work for Congress, I was a congressional staffer and I would have people come and they would say to me, I want to cut programs so that the money goes back to the Treasury.

And I tried to be clear then, and I want to be very clear here. This is not about money going back to the Treasury. We see those talking points. It's not [00:07:00] about money going back. In fact, the nonpartisan Congressional budget office has scored this and the initial preliminary scoring are coming back that this actually will add 3.3 trillion to the deficit. That is add, not subtract.

And if these billionaire cuts are made permanent, it's almost 6 trillion will be added to the national deficit. So the question is not, do we want money to go back [00:07:30] to the Treasury? That is not what's happening when we're talking about Medicaid cuts and these devastating losses to our programs. The question is really, what programs do you want that money to be used for? Do you want that money to be used for billionaire tax cuts, even when that means that your taxes increase and that you're bearing the burden of paying for those tax cuts to billionaires? Or do you want this money to be used to support [00:08:00] programs that have long been the backbone of this country?

So I think that's the question Natieka that's out there, and really I guess why these cuts are being proposed and what the money is actually going to be used to pay for.

Natieka : What are these billionaire tax cuts that we're talking about? I feel like they're mentioned a lot. And it's in the name, they're tax cuts for billionaires, but I'm sure that that's not what they're officially called. So how should we think of the billionaire tax cuts [00:08:30] beyond just those three words?

Cynthia : When you look at all of these bills that really come under this reconciliation bill, there's a lot of wording on tax credits. And that's really what we're talking about here is who can file for tax credits, meaning tax cuts.

And so these are very targeted to only certain income brackets, and those income brackets will receive tax credits or tax cuts that the rest of us as middle-class, lower class are never [00:09:00] going to see. And so these aren't broad tax cuts that they're proposing for all Americans. These are very targeted to the top 1% of the income brackets here in the United States. Those are the only individuals that will receive those types of tax credits and essentially tax cuts.

Natieka : Just to connect the dots in order to replace the money that is lost through giving billionaires and a 1% less taxes to pay. [00:09:30] They want to make up that money somehow, and in order to do that, they are talking about cutting, what we might consider essential services such as Medicaid in order to make up that money.

Cynthia : Every time we give a tax credit and cut that is less money coming in to the federal, what I say coffers, to the federal programs to provide them down to the state budgets. And so we have to find a revenue stream to pay for those types of tax credits if you're going to do them there, of course is the option on the table that [00:10:00] they could just not extend the billionaire tax credits and then we wouldn't have to be having this conversation at all about Medicaid cuts, because that is the sole reason for the program cuts that we're talking about, is solely to pay for those tax credits to billionaires.

And so the option would still be on the table. We don't have to do any of these cuts at all. But if you do and they are choosing to at this point, then you have to pay for them. And that's why we're having conversations [00:10:30] about cutting these very, very critical and important programs.

Natieka : There are a couple of proposals out there as to how to make these cuts. Can you review the current proposals and explain what we think of them?

Cynthia : The reconciliation process that we're seeing in Congress and that we turn on our TVs and watch is really a two-step process. The first step is done. The first step was where they come up with top line amounts, [00:11:00] and they assign those amounts to specific committees.

So each committee gets an amount of a directive to make cuts in a specific amount. When that step was completed and we watched as the targeted amount was $880 billion, that amount was assigned to the House Energy and Commerce Committee. The House Energy and Commerce Committee doesn't have jurisdiction over enough revenue raisers. So we know those cuts are [00:11:30] going to have to be made from Medicaid.

Now as we enter step two, step two is for each of these committees then to take the amount they're given and draft a bill that proposes how those cuts will be made. And what the nonpartisan Congressional budget office told House Energy and Commerce is exactly what we've been saying all along, which is that the only thing you have jurisdiction over for those cuts is Medicaid. You only have about 200 billion in everything else you have jurisdiction over. And so Medicaid [00:12:00] we knew was on the chopping block.

The House Energy and Commerce bill was just released as of us recording this, Natieka. And now we're moving through voting on the Energy and Commerce Committee, which we just had happen late the other night and we're watching the Budget Committee in this process. That bill is devastating on the Medicaid cuts. And I'll walk through just a few of the proposals briefly and talk about why the [00:12:30] talking points that we're hearing are not what's happening in this bill and what really this bill means.

So the first big proposal in this bill is a decrease in the federal monies that goes to states. Now, if you're looking at the bill, you're going to see this called FMAP, F-M-A-P, all the way through it. That's just the federal match that the federal government pays.

And prior to the Affordable Care Act, the federal government provided up to about 50% [00:13:00] of the federal monies for the Medicaid program to all the states. If you were a state that didn't expand your Medicaid population, like a lot of our rural and southern states did not expand until after the Affordable Care Act, the Affordable Care Act, what it required is that the federal government pays 90% of federal monies to states for that expansion population. So that is massive.

And what the proposal in this bill does is [00:13:30] decrease that federal match down. So it's a shift of the burden to pay from the federal government to the states and the states will have to pick up those funds. Now that is devastating for all states, but I want to be clear, it's particularly devastating for states in rural areas, and states with trigger laws, and states with the coverage in their constitution like Missouri, South Dakota, and Oklahoma.

So that's the first proposal we're going to hit states and we're going to shift the cost to them and decrease [00:14:00] that federal match. The second element in this proposal is a national requirement for a work requirement. And what that means is that they're requiring those that obtain coverage under Medicaid to show proof of employment. The problem with that, and what I always like to say when we're talking about work requirements, is that we're proposing a solution to a problem that does not exist.

What we know is that the majority of those [00:14:30] on Medicaid are actually working. We know that. The small population that is not working are caregivers. They're in school or they're disabled themselves.

We also know that Medicaid helps people actually seek employment and stay employed because access to Medicaid is essential for seeking and maintaining a job. So we know that as well.

We also know [00:15:00] that the Nonpartisan Congressional Budget Office estimated that implementing these work requirements will lead to 1.5 million people losing their healthcare coverage and over 15,000 people dying. So we ask ourselves, if these individuals are working, why does a work requirement have that result? And the answer lies into the way that they're having to prove their employment, the massive hurdles of paperwork [00:15:30] and verification processes.

And so prior to our states adopting work requirements, work requirements was just a theory. It's hard to read about a theory, and now we have real examples in our states that show how big of a failure that work requirements will be. So if we look at Georgia, Georgia has implemented a work requirement. Initially they designated almost $40 million, and the governor has had to come back and announce millions and millions more in funding. And that funding [00:16:00] solely goes to administrative costs and vendors. That is it.

There is not a penny of all of those millions of dollars that has went to providing an individual with healthcare and there's not a penny of it that has increased work in Georgia. And so this money, the millions and millions were spending, I think it's estimated now that Georgia has spent double the amount, many of they would have just provided healthcare under Medicaid to people.

We look at Arkansas, Arkansas is the same thing. [00:16:30] The first seven months of disenrollment, they disenrolled millions of people in the first seven months. They didn't increase the single job or work in Arkansas. So it's about the administrative cost, the vendor cost, when we really don't have a problem in the Medicaid space of those that are working.

And the third element that you're going to see in this reconciliation bill that's targeting Medicaid is called the Eliminating of the Provider Tax.

So that's a provider tax and that [00:17:00] can get really complicated. So to keep it very simple, here's all we got to know, states tax providers within the state, they tax them in order to pay their portion of the state match under the Medicaid program. So states use those provider tax funds to pay so that they don't have to reach into their state budgets, and essentially then it increases their federal match as well. It means more money.

So anytime we're talking [00:17:30] about eliminating provider taxes, we're talking about one more attack on state budgets as well. So we're hearing a whole lot of information about this being fraud, waste, and abuse, and that it is, this is not about targeting fraud, waste and abuse. I hope as I've outlined these proposals, what is this is really about is that it's $715 billion in cuts to the Medicaid program, and it's going to disenroll almost 14 [00:18:00] million people.

So while they may tell us they're decreasing fraud, waste, and abuse, I think it's really important that what we are communicating when we're talking to our friends, our families, our neighbors, when we're talking to our state decision makers and our governors, is that it doesn't matter what you actually call the cuts, or the terminology on these specific actions.

If we're talking about work requirement or provider tax or what we're talking about, all of these proposals lead to massive [00:18:30] disenrollment from Medicaid. It leads to drastic cuts to our state budgets and our programs, massive increases in uncompensated care, which will absolutely and certainly drive up all employer-sponsored healthcare and all of our members will pay more for healthcare. It will close our hospitals and long-term care facilities, particularly in rural areas, but all hospitals are at risk. And it will force our schools to eliminate school- [00:19:00] based services, positions and services for our students. And so that's what these proposals do.

Natieka : Thanks for listening to School Me and a quick thank you to all of the NEA members listening. If you're not an NEA member yet, visit nea.org/whyjoin to learn more about member benefits.

Okay, that's quite bleak. I have a couple of questions that I think you touched on. Let's talk about schools and students more specifically. Can you go over [00:19:30] how this will affect schools and students if Medicaid is cut in any of these ways?

Cynthia : So let's look at schools first and kind of zoom that lens out a little bit. When we look at our schools, we have now just incredibly tragic, when I share this data, we have almost 10% of our ESPs obtain coverage under Medicaid now. We have over half of our students that obtain coverage [00:20:00] under Medicaid as well. So there's 37 million children that are on Medicaid and CHIP, and that's almost right at half of all the children in the United States.

And so we know they're going to be vastly impacted by these Medicaid cuts. Also, when I talked about our school budgets, there's two ways that Medicaid plays a role in our school budgets. And the first is that Medicaid provides the fourth-largest stream of federal education funding. And I just like to emphasize [00:20:30] that, because I think we think about funding coming from all different sources, grants, sources, and we don't often recognize that it's actually Medicaid. That is the fourth-largest education funding to our schools.

On top of that, if a has amended their state plan to allow a school to bill for Medicaid services, so to offer the screenings and speech pathologists and occupational therapists within a school setting and are wonderful school [00:21:00] nurses, then if that school can bill for those school-based services under the Medicaid program.

So in addition to being the fourth-largest revenue stream for education, Medicaid also provides 7.5 billion with a B, to our schools directly through that billing service as well. So there's two avenues that our budgets are going to be drastically impacted. One being when the state budget is drastically cut, because now the state is forced [00:21:30] to pick up all of these costs, so they're going to have to cut education and transportation and infrastructure and everything is on the table, then our schools are going to feel the cuts that way.

The other way that our schools will feel the cuts is that when they're not able to seek reimbursement under that direct billing. And when I say direct billing, I mean direct services and administrative billing, both of those, will be cut off from receiving those Medicaid funds. So that's devastating on a school budget.

And then let's [00:22:00] zoom that out and let's look at our students. So we know over half of our students have Medicaid, and what does that mean? That means that it allows our students to not only seek the preventative care, but it also allows our schools to identify the barriers to success through a lot of this earlier screening and early intervention that we are required to provide in a school setting.

And what we know really specifically is that we [00:22:30] know, and we have the many, many data sources that show us that all of this screening and identifying of healthcare barriers and providing healthcare for preventative care, it leads to fewer missed days in schools, it leads to higher high school and college graduation rates, and it leads to higher earnings as adults.

We have a specific study that increasing Medicaid eligibility at birth led to improved reading scores in fourth and eighth grade. So it is clear. Every data point [00:23:00] shows that Medicaid means more success for children.

And I think then when we zoom that lens out just a little bit further and we look at all of their families and how this will impact their home settings and their families, our families, half the population in the United States has someone in their families that is actually on one of these Medicaid programs. As I mentioned, it may have a different name, but it actually is a Medicaid program.

And so here's what we know about how it will impact families. [00:23:30] Medicaid supports 1.5 million births within the United States. And I talked a little bit about how the impact will be greater on rural here. 41% of births are nationwide, but in rural areas, Medicaid covers almost half, it's at 47%.

And what we know from the data is that families that are covered by Medicaid, they have less risk of medical debt. And this is massive right now. Medical debt is a huge problem in our country that is leading people to [00:24:00] choose between getting the prescription drugs, their life-saving medications, and actually buying groceries. That's a choice that no one should ever have to make.

And so we know that Medicaid drives down the medical debt so that it allows people to buy groceries, pay their rent, and contribute positively to our economy. All of us benefit from that. We know that an estimated 888,000 people in these families will lose their jobs if these Medicaid cuts [00:24:30] go into effect. We know millions of our workers will lose their healthcare. And I want to be clear, I am talking about union-administered health plans will encounter increased costs due to uncompensated care.

That means increased premiums and out-of-pocket costs for all of our members, all workers across the United States. And another area these families will be impacted, and one I don't know that we always think about Natieka, is that 13 million of our seniors [00:25:00] and retirees use Medicaid to pay for their Medicare premiums. So Medicaid pays Medicare premiums. That is just essential and we will lose that as well.

And we've been talking a lot about how we're in the midst of a youth mental health crisis and all the efforts that we're undertaking. And so we need to talk and mention that Medicaid is actually the largest payer for mental health [00:25:30] services in the United States.

So we can't afford to lose Medicaid on the mental health side, particularly in the crisis that we're in on mental health care. The level of impact to our schools, to our students, to our families, is just massive.

Natieka : It sounds like pretty much no one wins with Medicaid cuts except of course the billionaires that we were talking about earlier and their tax credits or cuts, however you want to put [00:26:00] it. So a lot of this that we've been talking about is about states and how states would be able to handle it because everyone pretty much lives in the states. So that is how the money is produced for all of these programs. So how would states feel the economic impact of Medicaid cuts?

Cynthia : All states are going to feel this impact, and I want to keep stressing that. Because again, this isn't red versus blue issue. As I mentioned, all states will feel the impact, but there are states that may feel [00:26:30] it's even more have an increased impact.

And so states altogether, Medicaid represents 56% of our federal funding for states. So massive amount there. Without Medicaid states would be forced to deplete other resources to cover this amount. So they would have to cut their programs. Education, transportation, infrastructure, healthcare programs all across the board, everything would be on the table.

We have numbers that show that the Medicaid [00:27:00] cuts would shrink a state, what we call GDPs, meaning the state amounts, by an estimated 95 billion just in next year alone and eliminate jobs and increase taxes. So they would lose those tax revenues of about 7 billion and be forced to increase those taxes.

Those are massive numbers. So this isn't about reducing, it's just about shifting the burden from the federal support to the states. As I mentioned, we do have states that will fill it more. When I talk about states [00:27:30] with trigger laws, we have 12 states with a trigger law. When I talked about that federal match going down, decreasing, the moment that federal amount decreases from that 90% that I talked about earlier. The moment a bill goes into effect that decreases the federal money that goes to the states, 12 states in this country have automatic trigger laws. Nine of them automatically disenroll the entire Medicaid expansion population. Three of them set up reviews to determine how to go about [00:28:00] those disenrollments. All told, immediate disenrollment and you lose all federal funds.

Three additional states, South Dakota, Missouri, and Oklahoma, have constitutional amendments that mandate they cover Medicaid. They don't have a choice, which means when that federal money decreases, those three states have to take it out of their state budgets.

So to give you an idea what that means. For 2025, Missouri allotted $18.2 billion towards Medicaid. The federal [00:28:30] government picked up almost $13 billion of that. That means for next year, if this goes into effect, Missouri will have a hole in its budget of 1.7 billion with a B, 1.7 billion for just next year. That's a yearly, that's an annually hole that they're going to have to make up.

And that's why you see we've got a Republican member of Congress in Missouri who has just crafted an op-ed in the New York Times and has been very, very vocal [00:29:00] in opposing these. That may be an unusual ally that we have not worked with in the past. That's why he's connecting the dots and he understands the economic impact of this. I want to quote in the article, he says, this is morally wrong and it's also political suicide as well.

So these states will be impacted the most. And then just to mention rural areas briefly, if you're in a rural state, you have additional unique barriers that are going to increase this impact. Those are your travel barriers, [00:29:30] your provider shortages, your increased chronic diseases, and your decrease of employer-sponsored healthcare. So all states impacted, but these states it will be absolutely devastating, or those rural areas as well, in particular.

Just to reiterate two things here. When I say hospitals are closing, we have the data that shows that they're closing. Since 2010, 74% of rural hospitals that have closed have been in areas that didn't expand Medicaid. [00:30:00] There is no cleaner evidence of when Medicaid doesn't exist. Hospitals close long-term care, half is paid by Medicaid.

And so that's why you see the Kentucky governor, the Children's Hospital Association, the hospital CEOs, AARP, all of them we have worked with and wonderful allies and building our coalitions, they've come out with very strong letters opposing these cuts that are really, will just be heartbreaking when you read them about what this means for people [00:30:30] in these areas when you lose access to hospitals and long-term care facilities and it increases your provider shortages, and you can't travel and get the care you need and the care that you deserve.

Natieka : Again, I think the key word of this podcast is bleak. It sounds very scary that this could become a reality when it sounds like Medicaid is essentially the backbone of almost every part of American public life that we can think of. So [00:31:00] have we ever had success in fighting off Medicaid cuts in the past? I can't imagine that this is the first time that Medicaid cuts have ever come up, but sounds like this is one of the scarier times in recent history.

Cynthia : It is devastating and we want to make sure we're understanding the devastating impact, but there is hope. And so what I like to remind everyone is that we were in this exact same spot in 2017. And through an incredible work of our members [00:31:30] and they are amazing state affiliates and this messaging and education campaign, through you raising your voices to your neighbors and your family members and your decision makers in your state, your governors, your state legislatures, calling your members of Congress, in 2017, we defeated these cuts.

And just to show you how far we've came over the last many months with our incredible members, when we started just few days after the election, when we started [00:32:00] building massive coalitions and alliances and we started to implement a massive education and call on our members to raise their voices. When we polled, we only had just lower double digits of people that were opposed to the Medicaid cuts, particularly when we talk about Trump supporters.

And now what we know. We just got data. We've been polling this entire time, we've been doing nonpartisan polling, and just about a week and a half ago we did a Republican polling from a firm that Trump [00:32:30] uses as a pollster that polls for him. And what they came back with, is it shows Trump supporters 78% now oppose the Medicaid cuts. 78% from a Republican polling firm.

And so it's working. Your efforts matter, your voices matter. We have to continue to hold this line and push it forward. But I just want to reiterate to everybody, now that I've brought you so far down and we've talked about how devastating this is going to be, that [00:33:00] your voices matter, and we have defeated these cuts before, in 2017. So thank you for that question. So we can offer a little bit of hope and make sure we're holding this line.

Natieka : What in particular do we encourage people to do to fight off these attacks,' and what is NEA and other unions' role in this to help the individual voice get out there too?

Cynthia : I want to encourage people to never underestimate their voice [00:33:30] and the impact that you have on your voice. As a former congressional staffer, I can tell you with certainty, your voice matters. Your calls matter, your visits matter, your events and protests matter. It makes a massive impact. Make sure your voice is heard.

If you're at home, talk to your neighbors, your friends, your family, make sure they know that these cuts impact all of us. [00:34:00] And share this information about the economic impact. Tell them how it will impact the state budget and all of our programs, close our hospitals, cause us higher provider shortages, impact our schools, and take away services from our students.

So raise your voice in your neighborhoods and in your everyday lives. And then on top of that, if I can encourage you, we have a congressional alert. Our amazing government relations team has developed an alert that allows you to go on our website, send an email [00:34:30] to your member of Congress, make your voice heard on how devastating these cuts would be and how it would impact. This is cuts to your state budget and your communities and your children and your school and your hospitals, and so make sure they know that this will impact your life.

I think at this time we've got 26 districts that we are firing up events for. We've got some happening this weekend when we're recording this, Natieka. We've got events happening all around the country that we are organizing. Please [00:35:00] come out, join us, hold the line with us and make your voice heard.

We also have a story bank. We're collecting all stories. Please share your stories on how this impacts you and we make certain those get to your members of Congress and that we're elevating those up to everybody here in D.C.

We also have started a calling campaign. We have a one 800 number. We worked with our national partners on this and so they have designed a 1-800 number that we are pointing people to, to really share our story. [00:35:30] If there's something that our members need and that is listening to this, we have it and we've developed it.

Please use the resources that are in your toolkit and tell us how we can help you even further. We've held up huge events like Hands Off Medicaid. We're right now in the midst of our May Day events and as I mentioned, our Medicaid vigil. We have our call days coming and we're collecting stories.

And stay tuned because in addition to this podcast, we're about to have a lot of communications [00:36:00] articles and efforts that are around the corner. Let's leave with hope and let's shine some light because I think it was pretty bleak in the beginning. And so if I can lead you with hope, it's that there is way too much at stake. There are way too many people's lives on the line. So let's hold the line like we have before. Let's come back with the win like we did in 2017 and for all of our members out there and our incredible state affiliates, thank you for all [00:36:30] of your work and please continue the fight.

Natieka : Thank you so much for joining us today, Cynthia.

Cynthia : Thank you so much for having me, Natieka. This has been a true pleasure and I thank you for elevating this message and helping us hold the line on this critical issue.

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