[SENIOR MOMENTS] Dangerous Consequences

As you are probably aware, the Affordable Care Act, or “Obamacare,” is under the nation’s microscope. Congress is deliberating on how America should deliver health care insurance to all of its citizens, impacting all facets of a comprehensive health care system, including Medicaid, which is called MediCal in California.

Medicaid was signed into law in 1965 alongside Medicare, specifically for low income people. All states, the District of Columbia, and the U.S. territories have Medicaid programs designed for poor children, pregnant women, the disabled and the elderly. The program covers 74 million people, or one in five Americans.

Although the Federal government establishes rules for all states to follow, each state administers their Medicaid program differently. In 2014, the Affordable Care Act expanded Medicaid eligibility to low-income childless adults.

The expansion covered 20 million people who previously had no insurance. The expansion was voluntary and 19 states declined the aid. California embraced it.

Long-term care services and supports for the elderly or disabled account for two-thirds of the cost of Medicaid, even though these beneficiaries are less than a quarter of the enrollees.

Beneficiaries can receive nonmedical services such as caregiving, both in the home and at community-based programs. These essential services are usually not covered by traditional health insurance, or by Medicare, and only a small segment of the population has private long-term care insurance.

Because the older population is increasing dramatically, the demands for long-term care are not going down.

The Republicans have put forth a couple of dangerous ideas placing our most vulnerable households at risk. One is to curtail Medicaid costs by changing the way it is funded.

Beginning in 2020, Congress is considering “block grants.” This is a limit on the amount of funding that each state receives regardless of need or actual costs, posing a risk that not all those eligible would be able to be enrolled.

The second questionable proposal is “per capita caps” which would freeze funding for each beneficiary. If costs exceed this cap, the state will have to make up the difference or individuals would have to forgo care.

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