Sec. 71111
- Understaffing harms residents and employees, leading to accidents, diseases and even deaths
- Repealing the rule will result in an estimated 13,000 lives misplaced yearly as a result of understaffing
Secs.
71115 & 71116
- Prohibits all states from establishing any new supplier taxes or rising present taxes that they use to fund their share of Medicaid prices
- Reduces cap on supplier taxes and native authorities taxes in enlargement states by .5% per yr starting in 2027 to three.5% in 2031.
- Applies to all supplier taxes besides nursing amenities and intermediate care amenities.
- Restricts state-directed funds (SDPs) in managed care and discourage non-expansion states from increasing Medicaid
- Reduces grandfathered SDPs by 10% per yr till they attain the allowable Medicare-related cap.
- One or each insurance policies immediately affect each state however Alaska
- Shifts prices to states forcing them to chop Medicaid spending
- Limits states’ means to bolster Medicaid to answer emergencies and financial downturns
- States will likely be compelled to chop elective advantages or eligibility classes, enrollment, or supplier charges
- Dwelling-and Group-Based mostly Companies (HCBS) account for almost all of elective spending and are more likely to be lower first, resulting in longer ready lists and extra institutionalization
- States are additionally more likely to lower elective companies like grownup dental, imaginative and prescient, and listening to that Medicare doesn’t cowl
Get Streamlining Eligibility & Enrollment Rule Moratorium
Secs. 71101 & 71102
- Prohibits implementing, administering, or imposing sure provisions of the Medicaid Streamlining Eligibility & Enrollment Rules finalized in 2024 that modernize guidelines and processes for folks eligible for Medicaid based mostly on incapacity or being age 65+
- Provisions of the rule already in impact will proceed.
- Makes it tougher for older adults to get and keep Medicaid protection by permitting states to proceed bureaucratic boundaries reminiscent of complicated revenue verification, paperwork, and frequent renewals that presently trigger wrongful protection losses
- See Medicare part for impacts on Medicare Financial savings Program enrollment
Sec. 71108
- Reduces and freezes the utmost allowable dwelling fairness restrict at $1 million, which is decrease than the 2025 most restrict, with no changes for inflation
- Permits exemption for agricultural land
- Limits who can qualify for Medicaid for long-term care, reducing again eligibility on January 1, 2028, in states that use the utmost restrict
- Makes it tougher for folks needing long-term care to maintain their dwelling, which may result in pointless institutionalization
- Disproportionately impacts low-income older adults whose solely asset is a house they’ve lived in for many years that has elevated in worth
- Prevents households—particularly in communities of color–from escaping poverty by rising intergenerational wealth
Sec. 71112
- Limits retroactive protection to:
- 1 month earlier than utility for enlargement enrollees
- 2 months earlier than utility for all different eligibility teams
- Makes it tougher to entry long-term care and will increase threat of medical debt
- Many older adults won’t have monetary safety when confronted with surprising medical emergencies or want long-term care. Medicaid purposes are complicated, sluggish to course of, and sometimes require weeks or months for approval.
- Unfairly penalizes those that qualify for Medicaid, however face medical or administrative obstacles, rising their threat of medical debt and protection gaps.
Sec. 71121
- Authorizes restricted state demonstrations to supply HCBS by 1915(c) waivers to individuals who don’t meet institutional stage of care
- Requires states to indicate that the brand new waiver won’t enhance the typical period of time that individuals who want an institutional stage of care will watch for companies.
- Bars states utilizing these waivers from deducting commonplace employment advantages reminiscent of well being care and union dues from non-agency based mostly HCBS employee funds
- Unlikely states would have the ability to implement the demonstration as they are going to be dealing with large Medicaid funding cuts
- States have already got authority to supply protection to folks not assembly the institutional stage of care beneath the 1915(i) state plan possibility
- Prohibiting deductions of employment advantages would weaken entry to HCBS by harming the workforce
