Medicaid is the foundation of long-term services and supports (LTSS) for vulnerable Ohioans. It covers 44,000 skilled nursing facility residents, 50,000 people with intellectual and developmental disabilities, and 65,000 individuals receiving care at home through popular waiver programs like PASSPORT and assisted living. As our population ages and the number of people with disabilities grows, these figures will only increase. Medicaid ensures that Ohioans needing services and supports receive high-quality care. But as budget negotiations continue on Capitol Hill, this vital safety net is now under threat.

Among the many providers serving Medicaid recipients, LTSS providers are the most dependent on the program. Yet funding has not kept pace with costs. Medicaid only reimburses 88 cents on the dollar for skilled nursing care in Ohio. Providers that serve people with intellectual and developmental disabilities rely entirely on Medicaid — no other insurance covers their services. Without adequate funding, they cannot retain workers or continue providing care. The same applies to agencies serving seniors and people with physical disabilities in home- and community-based waiver programs.

Provider taxes — known in Ohio as franchise permit fees — are a critical source of funding for the Medicaid program. In the state budget currently under review, these fees generate $11 billion annually. Without them, Ohio would be forced to further reduce already inadequate Medicaid rates, prompting providers to limit services or close entirely.

It’s deeply frustrating that these provider taxes are being mischaracterized as waste and abuse. This could not be farther from the truth. They are legitimate taxes, authorized by federal and state law for more than 30 years, that providers pay into the state treasury. They are essential tools that allow states like Ohio to provide necessary care amid chronic underfunding.

Medicaid was created to protect our nation’s most vulnerable, including seniors and people with disabilities. It supports daily living activities such as bathing, dressing, eating and walking — services typically not covered by Medicare or private insurance. Without Medicaid, millions of Americans would be left without the care they need to live with dignity.

Medicaid also helps the caregivers who provide this essential support. In Ohio, 42% of home care aides and 22% of certified nurse aides delivering LTSS have health insurance through Medicaid. If these workers lose coverage — something proposed cuts could trigger – many will leave the field, worsening a growing care shortage. That, in turn, would force providers to reduce services or turn people away.

Congress must remember that Medicaid is not only crucial for those receiving services, it’s also supported by voters, including families of beneficiaries and hardworking Americans who rely on it for their own coverage. There are better ways to manage Medicaid spending than cutting services to those who need and qualify for them. For example, Congress could eliminate costly federal red tape and focus on preventing fraud and improper payments.

Ohio’s elected officials must do what’s best for our seniors, people with disabilities, care providers and communities. At this pivotal moment, Congress should protect Medicaid funding and preserve provider taxes, so Ohioans can continue receiving the care they need and deserve.

(Van Runkle is executive director of the Ohio Health Care Association.)