Recent months have seen increased discussion of proposals to cap federal Medicaid spending. Under these proposals, the federal government would provide limited funding through either block grants or per capita payments to states, and states would have broad discretion to set their own Medicaid standards.
A new issue brief from Justice in Aging explains how these proposals would harm older Americans. The caps would result in a dramatic reduction in federal funding for Medicaid, and these crippling cuts would be exacerbated by the loss of longstanding federal protections. Potential consequences include loss of services, cutbacks in eligibility, unaffordable health care costs, and diminished quality of care.
The issue brief provides careful analysis of both the “cap” proposals and the protections of existing Medicaid law. Many of the proposals tout the “flexibility” of giving almost complete discretion to states. As the issue brief highlights, however, consumer protections in current Medicaid law are vital to older Americans’ health and financial security.
So many health care protections are at risk in the months ahead, including Section 1557, the provision in the Affordable Care Act (ACA) that specifically applies civil rights protections to health care settings.
This ACA provision has already been targeted, as a nationwide preliminary injunction issued on December 31 by a Federal District Court in Texas prohibits the Department of Health and Human Services (HHS) from enforcing the provisions in the implementing regulations that pertain to transgender discrimination and discrimination based on termination of pregnancy. The temporary order leaves the rest of Section 1557 intact, although some in the new administration and the new Congress would like to go further, seeking to repeal Section 1557 as part of a broader ACA repeal effort.
Justice in Aging has prepared a brief summary of the extent to which the injunction is likely to impact programs that affect older adults.
Justice in Aging also created an issue brief that discusses how Section 1557 and the HHS implementing regulations affect programs that serve older adults. The brief looks at discrimination protections around language access for beneficiaries with limited English proficiency, sex and gender discrimination, disability discrimination and discrimination based on age and race, with examples of how those provisions could play out for older adults using the Medicare or Medicaid benefit.
As the number of people age 65 and over living in America continues to rise, new leadership in Washington, DC is promising to dramatically reform and reduce the safety net upon which older adults rely. These changes – should they occur – will negatively impact all older adults, but they will cause particular harm to the millions of older adults already living in or near poverty. Read More
Diana is one of 7.1 million Americans who rely on Medicaid’s non-emergency transportation benefit (NEMT) to help her get to her medical appointments. NEMT is an important Medicaid benefit for the people who rely on transportation services to help them visit their doctors, receive treatment for chronic conditions, and travel to settings such as adult day health care. Yet, every year, an estimated 3.6 million Americans miss or delay health care because of difficulty accessing these critical services. When transportation services work, they help people get to their doctors and other needed health services so they can continue to live at home and in the community. When they do not work, Medicaid beneficiaries like Diana are left stranded, frustrated, and without access to needed medical care and services. Read More