Medicaid in our Homes
Harley Tabak, President & CEO, Jewish HomeLife
Rick Aranson, CEO, JF&CS
At the time of this writing, the U.S. Senate is preparing to vote on their version of the “repeal and replacement” healthcare bill shortly after their July 4th recess. One of the most controversial pieces of both the House and Senate plans is the proposed cuts to Medicaid. Through JHLC and JF&CS, we represent the two populations most affected by the Medicaid debate, the elderly and the disabled.
JF&CS and JHLC are not political organizations. As non-profit agencies we are apolitical and do not support or oppose any particular party, candidate, or person in office. That said, it is incumbent upon us to educate our community about changes that could affect people we serve.
Of the three possible results of the impending vote–pass, don’t pass or continued delay–we hope the outcome is delay so more input can be shared and potential alternatives can be considered to the Medicaid cuts that have been proposed in both the House and Senate versions.
Regardless of which side of the political aisle one might lean, it would be helpful to know that Medicaid is the largest funder of skilled nursing homes in our country. Medicaid accounts for one-sixth of all health care spending in the United States, and sixty-seven percent of that is focused on older and disabled adults — primarily through spending on long-term care services such as nursing homes and support for adults with intellectual and developmental disabilities. More than half of Georgia’s Medicaid dollars go to the elderly or people with disabilities, according to the state’s Department of Community Health.
Most of the clients in JF&CS’s Zimmerman-Horowitz Independent Living Program and in the agency’s IndependenceWORKS day and vocational programs rely on the Medicaid waiver for critical supports. Changes to Medicaid could impact participants’ ability to receive services, and negatively affecting their independence and quality of life. One such client is Evan N., a self-advocate who relies on Medicaid Waiver services to support him in his home, his job, and his community. Evan lives an independent and fulfilling life due in large part to his family and friends, as well as critical support that he relies on from the waiver.
Medicaid is growing exponentially, and our elected leaders are urgently searching for a politically palatable solution to controlling the growth. Americans want a simple answer to a very complex problem. Putting politics aside, if you don’t think the Medicaid debate impacts you, think again. Many Americans think Medicaid is only for low-income adults and their children — for people who aren’t “like them.” But Medicaid is insurance for many of our mothers and fathers and, eventually, for ourselves.
This anecdote is a very typical scenario at JHLC:
Your dad needs to move into a nursing home. It’s going to cost him almost $100,000 a year. Medicare does not cover long term nursing home or assisted living care. Very few people have private insurance to cover this. Your father will most likely run out his savings until he qualifies for Medicaid.
This is not a rare event. Roughly one in three people now turning 65 will require nursing home care at some point during his or her life. 67% of these nursing home residents will eventually be covered by Medicaid, not because of irresponsibility or not saving enough, but because of living so much longer than expected.
With longer life spans and spiraling health care costs, older adults increasingly find themselves running out of money and dependent on Medicaid. Medicaid-funded nursing home residents are not your stereotypical lower-income families. These are elderly or chronically health-impaired individuals who have exhausted their savings for care and now need the highest level of care–which is also the most expensive. At The William Breman Jewish Home, 50% of its long-term beds are reserved for Medicaid recipients.
JF&CS works with coalition partners to monitor pending legislation and to represent the voices of our clients. One such organization is the Georgia Budget and Policy Institute. They have provided JF&CS with the following guidance which we wanted to pass along to you as either an FYI or a call to action if you are so inclined.
- The Senate is trying to bring the bill to repeal the Affordable Care Act to the floor for a vote as soon as they have the votes to pass it. Medicaid funding is part of that bill.
- In the proposed Bill, Medicaid has a new per capita cap which essentially means that increased need doesn’t mean increased funding for individuals.
- States will potentially have to make up the difference between the per capita cap and the funding that people are currently getting. Georgia did not expand Medicaid, so further cuts will go to the core of services provided. If the states can’t make up the funding, reimbursements will be cut while the waiting list for the Medicaid Waiver continues to grow.
- The best strategy would be to push the bill passage back, so Congress has more time to hear from stakeholders and experts to really understand the implications of this change.
Regardless of the outcome of this healthcare debate, the number of elderly and disabled will continue to increase thanks to our country’s outstanding medical expertise and advances in research and technology. It is our hope that the delay allows for greater input into an issue that affects the most vulnerable members of our society.
Whatever your perspective is on the matter, the best way to make your voice heard as a Georgia Citizen and constituent is to call our Senators and the committees that are working on the bill.
Senate HELP Committee at 202-224-5375
Senate Finance Committee at 202-224-4515
Call Senator Isakson at 202-224-3643
Call Senator Perdue at 202-224-3521
Additional contact information can be found here.