Medicaid has grown into one of the largest and most critical payers of healthcare services in the country. It covers more than 70 million Americans annually and accounts for roughly one-sixth of all U.S. healthcare expenditures. It provides millions of children and pregnant women, aged, blind, and disabled individuals, and other low-income and vulnerable populations with the ability to receive crucial healthcare services. One group which benefits the most from Medicaid is the elderly. Medicaid pays for services such as care in skilled nursing facilities, home- and community-based services, and other services on which many elderly Americans rely. Medicaid is the largest payer of long-term services and supports in the country; it pays for nearly half of all nursing home costs and represents a disproportionate share of all Medicaid spending. As the population ages and more Baby Boomers reach retirement age and beyond, the demand for these long-term services and supports will continue to increase. Older Americans with fixed incomes will require more assistance paying medical bills even as their age makes it more likely that they will face complex medical issues such as heart disease, dementia, Alzheimer’s, and diabetes.
Instead of investing in this critical population for the future, the Republican-controlled Congress’s and the Trump administration’s actions demonstrate that they do not place a priority on the healthcare and well-being of older Americans. The Senate’s Better Care Reconciliation Act of 2017 (BCRA) would phase out Medicaid expansion over three years and would allow states to cap Medicaid spending through either a per capita cap mechanism or through a block grant (read ANA’s policy primer on Medicaid block grants here). According to the non-partisan Congressional Budget Office, the Senate bill would result in a 26 percent reduction in Medicaid spending by 2026 (a total reduction in spending of roughly $800 billion over the same time period) and a 35% reduction in Medicaid spending by 2036. The Trump administration’s budget proposal would also cut over $600 billion in Medicaid funding, not including changes made through the effort to repeal and replace the Affordable Care Act. Such cuts would squeeze state Medicaid budgets, forcing them to make tough decisions about the provision of care and likely resulting in restricted access and lower quality of care for the nation’s seniors.
It is clear that the Senate’s BCRA is more intent on saving money and providing tax cuts to the wealthy than they are with ensuring that Americans’ parents and grandparents receive the critical care that they need just as they confront complex medical needs and limited incomes. It is critical that nurses make their voices heard through ANA’s call campaign. Let your senator know that this bill is unacceptable and will negatively impact the lives and healthcare of millions of older Americans!