The Critical Role of NEMT in Medicaid and Healthcare Access

"Without NEMT Millions would face challenges in reliably accessing medical care."

The threat to Medicaid and NEMT is real and has potentially devastating effects on our healthcare system. Each year more than 100 million NEMT trips are provided through Medicaid, many of these trips taking people to and from life-sustaining medical treatments such as dialysis and chemotherapy. Even the seemingly less crucial trips for routine check-ups or to treat minor illnesses are important because, without NEMT services, many children lack adequate pediatric care, and patients overcrowd emergency rooms for routine medical appointments. Medicaid is vital for millions of Americans, ensuring that low-income individuals, children, seniors, and those with disabilities have access to essential healthcare services. Because NEMT is just a small part of Medicaid services, it can be overlooked. However, NEMT saves lives and improves health outcomes, and can reduce overall healthcare costs. Without it, millions would face immense challenges in reliably accessing medical care, leading to costly consequences for patients and taxpayers alike.

• The Medical Transportation Access Coalition (MTAC) estimated that NEMT prevents Medicaid from spending an additional $40 billion each year from avoided emergency room visits and hospitalizations.

• In Florida alone, a Florida State University study determined that this equates to a saving of $11 for every $1 spent on NEMT trips.

• Another MTAC study found that NEMT saves Medicaid $40 million a month, or $480 a year, for every 30,000 individuals who rely on NEMT for transportation to dialysis, diabetic wound care, and substance abuse disorders.

Many individuals accessing NEMT transportation do so because they have no other resources or options for getting to or from medical appointments. Taking away, or significantly curtailing Medicaid NEMT will result in these same individuals missing appointments and then resorting to ambulance rides and emergency room visits. This places a tremendous financial burden on taxpayers and diverts scarce EMT and ER resources to be used on what could have been avoided trips and visits. The Kaiser Family Foundation estimates that Medicaid spent $3 billion on NEMT trips last year, and when you divide that by the 103 million estimated Medicaid NEMT trips performed each year, it works out to about $30 a trip. These numbers represent significant savings when compared to the estimated cost for an ambulance ride of between $1,200 and $2,500, and/or the cost of an average emergency room visit of $2,000 to $3,000.

Further, the problems encountered if NEMT is eliminated, or even curtailed, extends beyond just stretching already scarce resources, but also result in longer wait times due to overcrowded emergency rooms, overworked healthcare providers, and increased medical costs for both insured and uninsured patients. When individuals can engage in even basic preventive care, they can avoid exacerbating chronic conditions. When access to that care is missing, it can result in drastically increased Medicaid expenses over their lifetime.

It should go without saying, but it does need to be said, protecting Medicaid and NEMT is not only the right thing to do, it’s a great investment. If you don’t support maintaining Medicaid because it provides much needed services for those in truly in need, then support it because it makes good financial sense. After all, isn’t that what all this talk about cuts and slashing is all about? I can’t think of a single investment where you wouldn’t spend a $1 today if it meant you would save $11 in the next year, so why is Medicaid and NEMT any different? A good investment is a good investment, and investing in Medicaid and NEMT today prevents billions in avoidable healthcare costs tomorrow.

If you can’t support Medicaid and NEMT with your heart, do it with your wallet, but the most important thing is to make your voice heard. Let your elected officials know that you want them to make the sound fiscal choice. Make sure they understand that cutting Medicaid funding or reducing and restructuring the program through block grants to the states could threaten this essential service, leading to worse health outcomes for vulnerable populations and increased financial strain on our healthcare system and the economy.

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