Efforts in Congress to cut Medicaid jeopardize a critical source of health coverage for veterans. Approximately 1.75 million veterans—nearly 1 in 10—have Medicaid as a source of coverage.1 This coverage ensures that veterans get the primary and specialty health care they need when they need it.

About 340,000 veterans nationally receive coverage through the Affordable Care Act’s (ACA) Medicaid expansion.2 Most of these veterans would likely lose that coverage if Congress passes the Republican proposal to slash funding for the Medicaid expansion.

Republicans in the House of Representatives have also proposed to radically change the structure of the Medicaid program by capping and cutting funding—a blow to the Medicaid program that would put the health care of 1.75 million veterans at risk.

Not all veterans can get health care through the VA

Not all veterans qualify to receive health insurance through the Department of Veterans Affairs (VA). Eligibility relates to a variety of factors, including minimum service requirements as well as disability and discharge status.3 According to the Veterans Administration, in 2014 only 40 percent of all veterans were enrolled in the VA health care system.4 Furthermore, veterans’ family members rarely qualify for VA assistance.5

Approximately 1.75 million veterans rely on Medicaid. Many of these veterans have extensive health care needs. High-cost enrollees, such as veterans who require intensive care for conditions like traumatic brain injuries and musculoskeletal disorders, are at particular risk if the program is cut. Efforts to cap and cut Medicaid risk the health and security of veterans most in need.

Additionally, not all veterans enrolled in the VA can easily use VA services. One-third of veterans enrolled in the VA did not use a VA service in 2014.6 Many enrolled veterans do not live near a VA provider. Transportation issues can make it impractical or impossible for veterans to use the VA as a source of care. This is particularly true for the millions of veterans who live in rural areas.7

Nearly 1 in 10 veterans relies on Medicaid

In 2015, roughly 1.75 million veterans (ages 18 and older)—nearly 1 in 10—had Medicaid coverage (see Table 1). In many cases, Medicaid supplemented VA or other coverage like Medicare for veterans who were older than 65. About half of Medicaid-enrolled veterans are aged 18-64 and ineligible for Medicare. Forty percent of these 913,000 working-age veterans (18-64) with Medicaid had no other source of health coverage. Without Medicaid coverage, they would be uninsured. Medicaid is their only way to reliably get access to needed care.

Medicaid is also an important source of coverage for veterans’ family members, who rarely qualify for veterans benefits to help cover health care costs. In 2015, more than 660,000 veterans’ spouses were enrolled in Medicaid.

The ACA and the Medicaid expansion have improved veterans’ access to health coverage

Since the implementation of the ACA, the number of veterans without health insurance has declined.8 The ACA’s Medicaid expansion, which extended Medicaid coverage to more working-age veterans, has helped to increase veterans’ access to health coverage.

The Medicaid expansion extended coverage to millions, including hundreds of thousands of veterans. Congressional efforts to end the expansion, whether through a freeze in enrollment or a phase-out of federal funding, pull the rug out from under veterans who gained coverage.

In 2015, more than 913,000 veterans between the ages of 18 and 64 were enrolled in Medicaid, and about 340,000 veterans received Medicaid because of the Affordable Care Act’s Medicaid expansion. That represents a significant increase in the Medicaid enrollment of working-age veteran from 2013, the year before the ACA went into effect (see Table 2). While the number of veterans covered by Medicaid increased across most states when the ACA was implemented, it was significantly greater among states that expanded Medicaid.9

Changing the structure of the Medicaid program or ending the Medicaid expansion would hurt veterans and their families

Veterans and their family members depend on Medicaid. Sometimes it supplements VA or other coverage; for many, it is their only source of coverage.

Veterans are at a higher risk than most for unique and sometimes serious or complicated health care issues as a result of their service. These health conditions might include musculoskeletal conditions, traumatic brain injuries, and post-traumatic stress disorder.

Congressional actions such as capping and cutting Medicaid or ending or phasing out the Medicaid expansion would make it harder for veterans to get the health care they need. This is a disservice to those who have served our country.

Congress should be taking steps to make it easier, not harder, for veterans to access the health care they need when they need it. Voting to end the Medicaid expansion or to cap or cut Medicaid is a vote against veterans and their families.