Here’s another straw in the wind suggesting that the times are becoming unfriendly to seniors.
House Republicans have unveiled preliminary outlines of their health care reform agenda, with the intention of moving forward with major changes in coming weeks. Changes to Medicaid are a high priority, and Republicans are considering either (1) giving states a fixed amount for each person enrolled in Medicaid or (2) giving states block grants to carry out the Medicaid program as each state sees fit.
Either choice could be a serious problem for the 4.6 million seniors with limited incomes who have dual eligibility for both Medicare and Medicaid. Medicare pays for their hospitalizations and physician services, but Medicaid is vital to these seniors for coverage of nursing facility care, prescription drugs, eyeglasses, and hearing aids.
The cost of skilled care in a nursing home or assisted living facility is a great worry for seniors and their families. Many simply do not have the resources to pay for either. Others have some resources, but not enough to pay for long term care. Typically, a senior in this situation who falls ill may be sent to a rehab facility after a hospital stay for the 100 days that Medicare allows, and then have to stay on or move to another facility at their own expense. With the average cost of a nursing home at $6,235 per month, and assisted living at $3,500, it doesn’t take long for even middle class seniors to deplete whatever savings they may have.
But the saving grace today is that once their resources are depleted, seniors can enroll in Medicaid. They are allowed to keep their house, if they have one, and they don’t have to bankrupt their children to pay for their care. Medicaid will take care of them.
If Congress limits the Medicaid amount available per person, or limits the states to block grants, Medicaid may no longer be able to meet its promise to care for seniors. According to the New York Times, “About 60 percent of the costs of traditional Medicaid come from providing nursing home care and other types of care for the elderly and those with disabilities.” With the percentage that high, seniors are almost certain to be hit by any reduction in Medicaid resources.
Seniors are worried about what the Republican Congress might eventually do to Medicare, and rightly so. But for the moment, Congress and the President don’t seem ready to take on that popular program. They may never be ready. Nonetheless, seniors should be alert to the dangers the Medicaid program faces. They could be hurt by these changes, and their children could be hurt as well.