Keeping an Eye on Medicaid

Regulation | April 03, 2018 | by Aaron Tripp

One of LeadingAge’s policy priorities for 2018 is a robust safety net that ensures older adults will have the income, housing, health care and services, including long-term services and supports (LTSS), they need. This includes the Medicaid program, which is the largest single payer for LTSS in the country.

In 2017, LeadingAge successfully advocated for the preservation of the existing structure and financing of Medicaid, protecting it from reform proposals that would have slashed funding with serious negative consequences for members and the older adults that rely on them. While there has not been and we are not anticipating much Congressional activity around Medicaid reforms in this election year, the action has shifted to the states and the Centers for Medicare & Medicaid Services (CMS).

Recent stories have highlighted the fact that five states, Maine, Arizona, Utah, Wisconsin and Kansas, have submitted waivers to CMS that propose some version of time limits to Medicaid eligibility. To date, the administration has not issued decisions on those proposals, and Administrator Verma has indicated that requests for CMS approval must meet the objectives of the Medicaid program.

LeadingAge strongly believes in the role of Medicaid as a safety net for older adults and people with disabilities. The program is a lifeline for older adults, covering more than one in seven (6 million) older Americans in 2015. These are individuals who cannot afford insurance through the private market in any meaningful sense to match their needs. Medicaid coverage is particularly important for older adults and people with disabilities who need services not covered by Medicare, who cannot afford Medicare premiums and cost-sharing, who require mental health care or substance abuse treatment, and who live in rural communities. We oppose the concept of lifetime limits for Medicaid as they would cruelly force families alone to attempt to meet the needs of their loved ones requiring functional support. They could also be disastrous for providers serving this vulnerable population, threatening providers’ ability to continue serving both the Medicaid and private pay populations.

LeadingAge will continue to be the trusted voice for aging and fight to preserve this critical program for older adults. While we have not seen this style of proposal approved to date and it is likely that the specifics of these and future state time limit proposals will evolve, we will continue to engage at both the federal and state levels to protect attacks on the safety net for older adults.