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POLICY INSIGHT
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Medicaid Can Help Protect Millions From Zika

Millions of Americans risk contracting Zika this summer.  Guidance from the Obama Administration describes how Medicaid can help by paying for services that prevent the virus’ transmission and treat those who contract it. Just as Medicaid has helped states respond quickly to unanticipated crises — such as Flint, Michigan’s water contamination and Hurricane Katrina — it can help states fight Zika, too. 

While Zika’s most common symptoms — fever, rash, joint pain, and eye redness — are similar to those of other viruses, it’s potentially far more dangerous. Some women who contract Zika while pregnant can pass the virus to their fetuses, and infection during pregnancy is linked to incomplete fetal brain development.  Zika is also linked to a rare disorder that can cause temporary muscle weakness and paralysis. 

The new guidance describes how Medicaid can protect and treat people infected with Zika:

  • Medicaid can prevent Zika by covering preventive services prescribed by a health provider, including mosquito repellent.  Medicaid can also offer family planning counseling to help beneficiaries make informed decisions about their reproductive health. States must offer family planning services without cost-sharing and they receive federal funding that covers 90 percent of the cost, higher than most other services.  Many states extend family planning services to women and men not otherwise eligible for Medicaid through waivers or a new state option under health reform. 
  • Medicaid can detect Zika and prevent further infection by covering diagnostic services including scans, ultrasounds, blood and urine tests, and genetic testing. 
  • Medicaid can treat Zika through clinical services and prescription drugs needed to mitigate symptoms, case management services to coordinate care and connect people to needed social services, and physical therapy where needed.  For those with long-lasting effects, Medicaid can also provide nursing home services or home- and community-based long-term services and supports.  States must cover all medically necessary diagnostic and treatment services for children and young adults under age 21, including services to diagnose and treat Zika and its effects. 

As we’ve explained, policies to convert Medicaid into a block grant or implement a per-capita cap, such as the House Budget Committee’s recent proposal, would limit states’ ability to respond to local health care needs, including outbreaks like Zika.  Policymakers should reject such proposals and maintain the federal funding and flexibility for Medicaid that enable states to provide essential health care, including fighting Zika.