By now just about everyone has heard at least some of the details of the Senate’s version of the American Health Care Act – the law that Republicans have been crafting in order to fulfill an eight-year-old promise to their voters to repeal and replace the Affordable Care Act, better known as Obamacare. After the house passed their version of the AHCA in May, all eyes turned to the Senate to see what legislators would craft behind closed doors. The final proposed bill, released to the public on June 22nd, looks a lot like the House version, but with some proposed differences.
Now the debate will begin in earnest. But no matter what eventually happens to this legislation, the big news to us here at AgingOptions is the impact of the AHCA on Medicaid, the federal and state program which pays for all or part of the medical needs of more than 73 million Americans, most of them the low income elderly. This is a major story to watch, because for many of our clients, radio listeners and seminar guests, Medicaid will play a significant role in their eventual long-term care. If you have a small to medium sized estate, understanding the issues surrounding Medicaid has never been more urgent.
Since the Senate released its version of the bill, there has been a blizzard of news reports and analyses trying to make sense of its provisions and changes. This article just published on the website of The Atlantic does a good job of describing the proposed new health care law from a more liberal point of view, as indicated by its title: “The Senate Puts Medicaid on the Chopping Block.” The bottom line, says the article, is that the Senate’s version of the AHCA “restricts and slashes Medicaid funding deeply over the next decade” – and, we would add, well beyond that time if the law passes unchanged.
We should, of course, point out the obvious: we live in politically turbulent times. It’s entirely possible that the Democrats may return to power in the House in 2018 or the Senate (or even the White House) in 2020, and if they do they would likely attempt to roll back the GOP’s changes to Obamacare. But whether or not that happens, anyone regardless of political persuasion can see that we are entering a time of great instability and unpredictability in national health care policy, and if you (like millions of other retirees and those facing retirement) are counting on Medicaid to be there for you, you may need to think again. Don’t base your future security on a dangerous illusion!
There are far too many details in this proposed law for us to discuss here, but the changes to Medicaid rules in both the Senate bill and the House bill are what really caught our attention. Some of the particulars involve the GOP’s aim to roll back the expansion of Medicaid to many who formerly had been ineligible, a provision of Obamacare that a large number of Republicans have long disliked. Many of those now covered by Medicaid are part of the group often called “the working poor,” people who are employed but unable to afford health insurance in the marketplace. The Senate bill would phase out Medicaid expansion funds more slowly than the House version, which makes the Senate version sound less harsh. But the new law, if passed, would have immediate unintended consequences. “Seven states,” says The Atlantic, “have ‘trigger laws’ that would immediately void their Medicaid expansions with any change in federal support,” which could suddenly add millions to the ranks of the uninsured.
We are also especially concerned about the proposal in the new law that changes what is now open-ended Medicaid funding into a “block grant” to the states. This change, says The Atlantic analysis, turns Medicaid into “a per-capita cap scheme, where states receive a capped amount of funding each year per enrollee.” This shift, say analysts, “would underfund Medicaid over time, leading to a growing gap between the number of patients who would be eligible under current guidelines, and the funds available to pay for their care.” The eventual outcome would be “large-scale shortfalls in every state, which would need to be closed by reducing enrollment or benefits, and cutting capacity to respond to disasters and public-health crises.” The ones who would suffer the most would be children, seniors and the disabled.
Critics of the new proposed law call it “a massive constriction of the safety net. It will have a substantial impact on both wealth and health, shifting the benefits of public policy away from the poor and the sick, and toward the healthy and the affluent.” Whether or not you agree, as we said before, it has never been more urgent that you become well informed about the need to protect your assets and cover the costs of your future health care needs with a Safe Harbor Trust or other well-planned financial and legal tool.
The best way to begin getting the answers you need right now is to attend a free AgingOptions LifePlanning Seminar. We offer these at locations throughout the area, and because of the recent spate of headlines we expect our currently-scheduled seminars to fill up rapidly. Click here for details and online registration, or call us for assistance. Don’t let the changes in the health care law catch you off guard! We’ll see you soon at an AgingOptions LifePlanning Seminar in your area.
(originally reported at www.theatlantic.com)