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Justice in Aging’s Statement on CMS’s Guidance Regarding Work Requirements for Medicaid-Eligible Individuals

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(January 12, 2018) Yesterday, the Centers for Medicare & Medicaid (CMS) issued guidance to states that would allow them to condition Medicaid eligibility on fulfilling work and “community engagement” requirements. This represents an unprecedented change to Medicaid eligibility that threatens healthcare for millions of low-income persons, including older adults who are not yet eligible for Medicare, people with disabilities and chronic health conditions, and family caregivers.

Not only have punitive work requirements been proven ineffective at lifting people out of poverty or improving health outcomes, they are also extremely burdensome for beneficiaries to navigate and for states to administer. Requiring people to verify that they are either working or exempt from the requirement will inevitably lead to Medicaid-eligible people falling through the cracks simply because the process is too complicated, onerous or doesn’t work correctly.

CMS intends to allow states broad leeway in determining who would be subject to work requirements and what activities would satisfy those requirements.  For example, while CMS recognizes that Medicaid beneficiaries may be caregiving for elderly family members, there are no required protections for caregivers. As a result, depending on how the state defines “work,” family caregivers, who are more likely to be women, risk losing their health coverage. Similarly, many people with chronic health conditions and disabilities that limit their ability to work could be excluded from coverage or face onerous verification processes to be exempted from a work requirement.

We strongly oppose this change in longstanding policy as defying the objectives of the Medicaid program and endangering the lives and well-being of those who rely on it. We urge CMS to reconsider this policy and call on states to maintain the purpose of Medicaid, protect the health of their residents, and not impose work requirements.

Justice in Aging’s Statement on California’s Proposed Budget

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Governor Brown released his proposed budget for fiscal year 2018-2019 earlier this week. Despite the governor’s recognition of growing levels of poverty across California, his proposal prioritizes increasing California’s reserves without including any new investments or initiatives to increase the health care and economic security of older adults in California. With a Rainy Day Fund now totaling $13.5 billion, California is in a financial position to restore and strengthen programs that lift seniors and people with disabilities out of poverty while also maintaining sufficient reserves to protect against future federal threats and economic uncertainties. For low-income seniors aging into homelessness and struggling on fixed incomes, we can and must do more.

Most critically, the budget proposal does not restore benefits for elderly Californians and people with disabilities who rely on Supplemental Security Income (SSI) to meet basic needs. Specifically, the proposal fails to increase the State Supplementary Payment (SSP), which is the state-funded addition to the federal SSI benefit, or to provide a Cost-of-Living Adjustment (COLA) to the SSP. SSI/SSP helps ensure stability for seniors and people with disabilities at the very lowest income levels. However, as a result of recession-era cuts to the SSP, the benefit for an individual fell from 100.5% of the federal poverty level in 2009 to 90.5% of the federal poverty level in 2018, leaving individuals with a total SSI/SSP monthly individual benefit of just $910. As a part of the Californians for SSI coalition, Justice in Aging will continue pushing for full restoration of the SSP and annual COLA so that we can lift all seniors in California out of poverty.

Summary of Other Key Budget Proposals for Low-Income Older Adults:

Funding for Medi-Cal Dental Benefits and the State Oral Health Program

Last year, the Legislature and Governor implemented legislation to fully restore dental benefits to adult Medi-Cal recipients starting January 1, 2018, including root canals on the back teeth, gum treatment, and partial dentures. This year’s budget proposal includes $212.2 million to fund the restoration. This is a huge win for the overall health of older adults. For more information on the newly restored benefits, take a look at these Dental Factsheets we developed in collaboration with our partners at CPEHN and Asian Americans Advancing Justice.

This year’s budget proposal will also continue funding to California’s Oral Health Program within the Department of Public Health. This year the program will receive $30 million in funding to improve the oral health of all Californians at the local level through prevention, education, and community organizing.

Minimum Wage Increase and Provider Paid Sick Leave for IHSS Providers

This year’s budget proposal allocates $119.4 million to implement the state’s minimum wage increase for In-Home Supportive Services (IHSS) workers. The proposal also includes $29.9 million to fund the eight hours of paid sick leave IHSS workers are entitled to starting July 1, 2018.

Provider Rate Increases and Supplemental Payments

The budget proposal includes $649.9 million to fund provider rate increases and supplemental provider payments for both physician and dental services. The goal of these increases is to improve access to Medi-Cal services.

As costs continue to rise for housing, food, medical care, and other essentials, older adults and people with disabilities will struggle to live independently in the community without robust investment in and improvements to existing programs. In the coming months, as the budget process moves forward in the state legislature, we will continue to fight for increased economic security and access to affordable health care for seniors and to keep you informed about any changes to the programs that impact older Californians living in or near poverty.

Justice in Aging’s Statement on Passage of the Tax Bill

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December 20, 2017-Today, the House and Senate passed their destructive tax bill on a purely partisan basis. The tax bill provides an enormous tax break to wealthy individuals and big corporations at the expense of the well-being of millions of others, including older adults. The Joint Committee on Taxation estimates that the bill’s tax breaks for the wealthy will slash federal revenue by over $1 trillion, directly undermining critical programs that older adults rely on, such as Medicare, Medicaid, Supplemental Security Income, and Supplemental Nutrition Assistance Program (SNAP).

This bill threatens the health and economic security of older adults and their families in other ways as well. By repealing the Affordable Care Act’s individual mandate, the tax bill will leave 13 million Americans without health care, including older adults, people with disabilities and 5 million Medicaid-eligible individuals. The tax cuts will not provide financial relief to most older adults. The Institute on Taxation and Economic Policy finds that by 2027 the bottom three-fifths of Americans will see their tax bills rise, as temporary tax cuts for individuals expire and corporate tax cuts remain permanent. Further, under sequestration, the bill also triggers automatic cuts to certain federal programs, including $25 billion from Medicare in 2018 alone.

The fight is not over. Now that Congress has passed the tax bill, we must hold them accountable, and let them know that they can’t pay for tax cuts for the wealthy by slashing Medicare, Medicaid, Supplemental Security Income, SNAP, and many other programs that older adults depend on.

We will be here in the New Year ready to fight back and provide you with the information you need to do your jobs. Thank you for everything you do. Together we will protect older adults, people with disabilities, and their families from harm, and work to strengthen the programs they rely on.

Justice in Aging’s Statement on Senate Tax Bill

By | Economic Security, Health Care, NEWS, Statements | No Comments

Last night the Senate passed a tax bill that will take health care away from 13 million Americans including older adults and people with disabilities. Further, it will severely impact the economic security of millions of older Americans and people with preexisting conditions—all for the benefit of the wealthiest 1% of Americans and large corporations.

This tax bill, if passed as is by the House, will explode the deficit by at least a trillion dollars, leading these same Republicans to carry out their calls for massive cuts in Medicaid, Medicare, Social Security, and other critical programs that older adults and their families need, while offering little to no tax relief for struggling low and middle income families.

The Joint Committee on Taxation estimates that even considering economic growth, this bill will cut revenue by $1 trillion. This will force immediate cuts to Medicare and other programs under sequestration. The CBO projects cuts of $25 billion to Medicare in 2018 alone.

The repeal of the individual mandate will cause premiums to spike for those with preexisting conditions, especially impacting older adults age 55-64 who are enrolled in health insurance through the Affordable Care Act. Many will not be able to afford health care. An estimated 13 million Americans will lose their health care, including 5 million people who would not get Medicaid even though they qualify.

This full-fledged attack on people who are already struggling is unconscionable and will cause lasting harm not only to today’s seniors, but to tomorrows’ seniors as well. This includes our grandparents, our parents, ourselves, and our own children.

We call on the House to halt this rushed process, and urge Congress to start over to ensure that any changes to the tax code will not drive up deficits or reduce access to health care for older adults, people with disabilities, and their families.

Justice in Aging’s Statement on the House Passage of the Tax Bill

By | Affordable Care Act, Health Care, Health Care Defense, Medicaid, Medicare, Social Security, Statements, Supplemental Security Income | No Comments

Today, the House of Representatives passed a tax bill that is a full-fledged attack on the health and well-being of older Americans and their families.

As we’ve discussed, this is all part of the House Republican leadership’s two-step process. Step one is to cut taxes for the wealthy and drive up the deficit by $1.5 trillion. Step two is to use the higher deficit to justify additional future cuts to programs we all depend on, such as Medicare and Medicaid, Social Security and Supplemental Security Income (SSI), Older American Act programs, and many others.

The inevitable program cuts that Republican leadership will push for, after they balloon the deficit, will cause lasting harm to seniors today and in the future. Further, the House bill passed today eliminates the medical expense tax deduction that provides tax relief to millions of older adults with high out-of-pocket and long-term care costs and modest incomes.

This bill overwhelmingly benefits the wealthiest Americans and big corporations at the expense of everyone else. We urge the Senate to stop this reckless process and reject any bill that drives up the deficit and takes away health care from older Americans and their families.