Federal Cuts to Medicaid Will Hurt Older Californians on Medi-Cal

Medi-Cal Is a Lifeline for Older Adults

Nationally, practically 80 million folks depend upon Medicaid for well being and long-term care, together with 13 million seniors and folks with disabilities. In California alone, over 2.3 million older adults and folks with disabilities depend on Medi-Cal (Medicaid in California). The state receives $112 billion in federal funding to manage this system. With out Medi-Cal, most older adults who need assistance with day by day actions wouldn’t be capable to afford home-based or nursing facility care. Medi-Cal additionally helps older adults pay their Medicare cost-sharing and covers important advantages that Medicare doesn’t, similar to dental, imaginative and prescient, listening to, and non-emergency medical transportation.

Medicaid “reform” proposals that goal to take federal funding away from states or limit eligibility would all result in the identical consequence: reducing well being and long-term look after California’s seniors.

Right here’s what’s in danger for older adults if policymakers implement these proposals.

Cap or Minimize Federal Medicaid Funding to California

Medicaid is a state-federal partnership that ensures federal monetary assist to California to offer important well being and long-term care to older adults and different folks with restricted revenue and financial savings. Because the variety of older adults who want long-term care grows and Medi-Cal prices improve, the federal authorities helps meet these rising prices by matching a proportion of every greenback the state spends. Listed here are 3 ways proposed “reforms” would reduce Medi-Cal funding and damage older adults:

1. Underneath block grants or per capita caps, California would obtain a hard and fast quantity of federal Medicaid funding, no matter precise prices. This implies federal funding would now not sustain with elevated prices, shifting these prices to the state. Medi-Cal would shrink over time for all populations, together with older adults, and wouldn’t be capable to adequately reply throughout emergencies similar to pandemics or pure disasters when Medi-Cal has traditionally been a key useful resource.
2. Lowering the federal match (Federal Medical Help Proportion or FMAP), together with eradicating the minimal 50% FMAP, would shift prices to California, which might drive cuts to general Medi-Cal spending. Ending the improved 90% FMAP for Medicaid Growth, which covers older adults below age 65 in addition to paid and unpaid caregivers, would drive California to reduce Medi-Cal and the companies older adults depend on.
3. Proscribing allowable supplier and insurer taxes, which California makes use of to assist fund all the Medi-Cal program, would scale back the state finances and drive Medi-Cal cuts.

All of those proposals would starve Medi-Cal, forcing California to cut back spending by reducing applications and companies that federal legislation doesn’t require to be coated. The first goal would be the dwelling and community-based companies (HCBS), together with In-Dwelling Supportive Companies, grownup day companies via the Neighborhood-Primarily based Grownup Companies program, and HCBS waiver applications, as a result of these applications account for a big share of Medi-Cal spending. Different advantages like dental, imaginative and prescient, and listening to, would even be on the chopping block. California might additionally reduce eligibility expansions together with the rise to 138% of the federal poverty restrict for the aged and disabled program and growth of protection to older immigrants no matter standing.

With a lowered Medi-Cal finances, California would additionally doubtless reduce supplier fee charges, lowering supplier entry and worsening direct care workforce shortages. Consequently, older adults would have a more durable time discovering HCBS suppliers and folks residing in nursing services could be at elevated threat of poor care.

Chopping Medicaid additionally quantities to reducing Medicare. Over 1.75 million folks with Medicare in California depend upon Medi-Cal to afford and entry well being and long-term care. In some counties, over 30% of residents are dually eligible for Medicare and Medi-Cal, together with 44% in Tulare County and 30% in Los Angeles County.

Restrict the Variety of Eligible People Who Enroll in Medi-Cal

As a result of Medi-Cal eligibility and enrollment is difficult, many older adults who’re already eligible for HCBS, Medicare Financial savings Applications, and different advantages will not be enrolled. Some proposed federal Medicaid “reforms” goal to capitalize on this complexity to stop enrollment and take away protection from eligible folks. Listed here are two methods imposing extra purple tape would reduce Medi-Cal:

1. Repealing the not too long ago finalized Streamlining Medicaid Eligibility and Enrollment guidelines and different laws would threaten federal actions at present underway to assist eligible people entry and keep Medi-Cal.
2. Including purple tape similar to work necessities would make it more durable for older adults and their caregivers to maintain Medi-Cal. Expertise reveals work necessities will take away protection from older adults and folks with disabilities who’re already working, are retired or have problem discovering work, and household caregivers.

The first goal of those repeals and purple tape could be to remove Medi-Cal to chop spending, regardless of rising prices to manage needlessly advanced eligibility and renewal processes.

Any Measurement Medicaid Minimize Will Take Care Away from Older Adults

No matter what form or dimension these “reforms” take, they’re all cuts with the identical specific objective: to cut back Medicaid spending to pay for different priorities similar to tax cuts for the rich and firms. The results of each reduce can be the identical: taking away well being care and HCBS from older adults, folks with disabilities, and their caregivers.

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