Millions of Older Americans Could Lose Long-Term Care Due to Proposed Medicaid Cuts
July 21, 2011
Block Grant Proposals Could Reduce Access to Care
And Eliminate Consumer Protections
Washington, D.C. – Current Congressional proposals to cut Medicaid funding or convert it to a “block grant” system would have a devastating impact on America’s growing population of older adults and their caregivers, according to a new Medicaid Issue Brief released today by the Eldercare Workforce Alliance (EWA), a coalition of 28 national organizations committed to patient-centered team care for older adults.
The Alliance urged Congress not to resolve negotiations over the budget deficit by balancing “the budget through harmful cuts to Medicaid", which would be the inevitable result of cutting Medicaid or transforming it to a block grant system.”
“The impact on the elderly receiving Long-Term Services and Supports (LTSS) would be especially severe,” said Alliance co-convener Nancy Lundebjerg. “As of 2009, Medicaid paid for approximately 62 percent of America’s long-term care costs, including nursing home and home- and community-based long-term care services. It is a vital coverage for these individuals, most of whom have multiple chronic conditions and are among the health care system’s most vulnerable patients.”
Medicaid cuts will also exacerbate the severe shortage of direct-care workers that already exists, according to the Alliance issue brief, which states that over a million new direct-care workers will be needed by 2018.
In addition to being the primary source of funding for direct-care occupations, cuts to Medicaid would do further harm to the already beleaguered workforce, as nearly 20 percent currently rely on Medicaid or other public insurance at some point during the year to provide health coverage for themselves or for their families.
“The impact of Congressional proposals to convert Medicaid to a block grant system would be equally devastating to older adults, reducing access to care for some and possibly eliminating consumer protections for nursing home residents,” noted EWA co-convener Steven Dawson. “Many states have already begun to cut Medicaid payments, due to fiscal constraints caused by the recession.”
With diminished federal support under a block grant system, many states could eliminate optional coverage under Medicaid, such as home and community-based care, which falls solely under the jurisdiction of the states.
Without optional coverage, seniors may no longer be able to afford the services that allow them to stay in their homes. The result could either lead them into nursing homes for care at much greater costs or further burden family and informal caregivers who will need to fill the service gap from the loss of paid providers.
When faced with budget constraints, the EWA issue brief asserts, states could drastically reduce Medicaid eligibility and provider payments, reduce benefits, or increase cost-sharing, limiting access to desperately needed care.
“Eliminating consumer protections could have disastrous consequences,” Lundebjerg said. “Half of all nursing home residents have dementia and many have no family caregivers equipped to provide that level of care. These individuals have no other resources to help cover the costs of their care.”
