Many older adults who rely on Medicaid for their long-term services and supports also need transportation to medical services. Federal regulations require states to ensure eligible, qualified Medicaid beneficiaries have access to services to take them to and from providers. However, each state’s Medicaid and managed care programs may implement the regulations differently, making it difficult for older adults to get the transportation they need.
Dual eligible individuals, those with both Medicare and Medicaid coverage, represent the most medically needy and costly population for both Medicare and Medicaid. In an effort improve health outcomes and reduce healthcare spending, the Centers for Medicare and Medicaid Services (CMS) has been testing financial alignment demonstrations in thirteen states to better coordinate and integrate care for dual eligibles. Read More
Understanding Medicaid is a key to understanding the health and long-term care delivery system for older adults. Every year, over 6 million older Americans rely on Medicaid every year to pay for necessary health services. Over two-thirds of all older adults who receive long-term care at home or in a nursing facility, participate in the Medicaid program. Read More
Below is a statement by Executive Director Kevin Prindiville of Justice in Aging
Today, the Senate took a reckless and irresponsible step towards gutting healthcare for older adults and others, and removing critical consumer protections that save lives. With Vice President Pence casting the tie-breaking vote, the Senate voted to begin a curtailed 20-hour debate on several bills that would drastically change our health care system, stripping coverage from millions of Americans and cutting over $750 billion from Medicaid. Any bill that emerges from such a chaotic process would have devastating effects on older Americans and their families.
Below is a statement by Executive Director Kevin Prindiville on the Obamacare Repeal Reconciliation Act of 2017 (ORRA)
Today the non-partisan Congressional Budget Office (CBO) confirmed what we already knew: repealing the Affordable Care Act and delaying replacement will wreak havoc on our health care system. According to the CBO’s report, the Senate’s latest bill would strip coverage from 32 million Americans and cause health insurance premiums to nearly double in the next decade.
Senate leadership has announced that they will no longer move forward with the Better Care Reconciliation Act (BCRA) of 2017. Instead, they seek to proceed to a vote to immediately repeal the Affordable Care Act, and delay replacement to a later date.
While we are relieved that the BCRA, and its unprecedented cuts to Medicaid, is off the table, repealing the ACA remains a terrible idea that would harm older adults—especially in the absence of a meaningful replacement bill.
Modern Healthcare: Patient advocates say Medicaid per capita caps would demolish long-term care for elderly (7/11/2017) Justice in Aging’s Jennifer Goldberg discusses the harmful consequences of the recent Senate bill aimed to repeal and replace the Affordable Care Act. “Over two-thirds of Medicaid spending is considered optional under federal law. If the federal government starves Medicaid through per capita caps, optional services will be the first to be cut.” Optional services include home-based care and adult day care.
California Healthline: California Lawsuit Aims To Protect Spouses Of Disabled From Financial Ruin (7/10/2017) Justice in Aging, along with partner advocacy groups, filed a lawsuit against the State of California for failing to implement a Medicaid federal spousal impoverishment law meant to protect patients and their partners from becoming impoverished while paying for in-home care. Plaintiffs seek to compel the State of California to implement the law back to January 1, 2014, to notify individuals who potentially were eligible for the protections of their rights, and to reimburse them for any out-of-pocket expenses they paid that should have been free.
July 6, 2017 – The State of California has failed to implement a federal law that requires Medi-Cal to implement eligibility rules intended to prevent one spouse from going broke while paying for at-home care for a spouse with a disability, according to a class action lawsuit filed today, Kelley v. Kent (LA. Super. Ct.).
When one spouse has chronic conditions requiring home-based care, the other spouse must balance the cost of that care against the couple’s basic needs. The federal law allows a person to get needed home-based services in certain instances in which a couple has income or resources higher than the typical maximum limit to qualify for Medicaid. Though the federal rule has been in effect for three and a half years, California has failed to implement it, forcing many families to teeter on the brink of financial ruin in an effort to care for their loved ones at home. The case was filed in Los Angeles Superior Court today by Bet Tzedek, Justice in Aging, Disability Rights California, and Western Center on Law and Poverty with pro-bono partner McDermott Will & Emery.