In case you hadn’t noticed, there’s a new administration in Washington, D.C., and the Republican Party is now in firm control not only of the Oval Office but also of both branches of Congress. Because some of the policies now being advocated by the new political leadership – particularly concerning Medicaid – are of special interest to seniors, we want to share two articles that fill us with a sense of foreboding. Here at AgingOptions, we fear that proposed changes to Medicaid could pose a serious risk to vulnerable retirees, and we want you to be informed.
The first “red flag” that caught our attention appeared in this article that was recently published in Great Britain, in the Daily Mail. This article revealed the shocking news that vulnerable seniors in the United Kingdom, already deemed to be eligible for home care, were being forced to wait for up to one year before receiving the help they urgently needed. One survey cited in the Daily Mail article “revealed many vulnerable people routinely face delays of more than six months before they get the help they need with tasks such as washing, dressing, cleaning and cooking.” For some the wait stretched for twice that long.
Along with this disturbing delay in providing treatment, separate figures from Great Britain also revealed a parallel problem: an unconscionable delay in releasing patients from hospitals to nursing homes. “Almost three quarters of hospitals in England have had patients wait for more than 100 days to be discharged (to a nursing home), even though they are medically fit to leave,” the article reports.
The Daily Mail suggests that a big part of the crisis stems from government budget cuts. Social care spending in the UK has fallen 6 percent, having been cut by more than $20 billion (16.4 billion pounds) in the past year alone. These reductions have forced Britain’s National Health Service to make drastic service cuts including keeping patients hospitalized far longer than necessary to avoid the higher cost of government-subsidized nursing home care. In some cases there aren’t enough nursing home beds to meet the need, and not enough home health care workers for those awaiting care in their own homes. One expert quoted by the Daily Mail asserted that “Only genuinely new additional government funding will give any chance of protecting… our elderly and disabled (to) ensure they can enjoy dignified, healthy and independent lives.”
So what does this have to do with Medicaid and the policies of the new administration? For that answer we discovered this very timely and revealing article on the website of the authoritative Kaiser Health News. It’s called “Everything You Need to Know about Block Grants – the Heart of GOP’s Medicaid Plans.” According to this analysis, which first appeared in late January of this year, the administration of incoming President Donald Trump has expressed agreement with what Kaiser calls “an old GOP strategy for managing Medicaid: turning control of the program to states and capping what the federal government spends on it each year.” This strategy is called “block granting.”
Today, following a significant expansion in 2010, the Medicaid program covers almost 75 million adults and children. “Because it is an entitlement,” says Kaiser Health News, “everyone who qualifies is guaranteed coverage, and the states and the federal government combine funds to cover the costs.” (Kaiser explains that poorer states receive a larger federal subsidy while wealthier states receive proportionately less.) Under block grants, supported by most conservatives, states would receive a lump sum from the federal government and then manage the program as they saw fit. On the surface, that may sound good. However, advocates for Medicaid recipients warn of unintended consequences. Block grants, these advocates argue, “would mean less funding for the program —eventually translating into greater challenges in getting care for low-income people.” Under a scenario like that, the situation now being experienced in Great Britain could certainly happen here.
The stakes in this debate are extraordinarily high. In 2015 Medicaid expenditures, according to Kaiser Health News, accounted for 17 percent of the nation’s health care expenditures. The 75 million people covered under Medicaid make up nearly one-quarter of the U.S. population. By far the majority of Medicaid expenditures go to benefit lower income elderly and disabled Americans, which makes it hard to see how program cuts could avoid harming those most vulnerable.
Rajiv Nagaich of AgingOptions has this sobering assessment. “This story from England gives a glimpse of what could hit us if the Trump administration passes the block grant bill,” he says. Today the amount of federal subsidy, based on a match from each state, is essentially unlimited. “If the block grant model is adopted, there will be long waits for care,” Nagaich warns – “and without money, the wait could easily be one the client may not be able to outlive. It is even more important NOW for people to get this issue addressed and not rely on the government when instead they can do something about it themselves.”
This is clearly a critical issue, one most of our clients and radio listeners – essentially anyone with a combined estate worth $500,000 or less – will have to face. As an excellent next step, and to learn more about your options in retirement, we strongly suggest you attend one of our free LifePlanning Seminars, held in locations throughout the area. Here you’ll learn how every piece of the retirement puzzle – finances, medical care, housing, family communications and legal protection – fit together into a seamless LifePlan. You’ll also learn how to protect yourself and your assets, regardless of how the political winds may blow. For information and online registration, click on this link, or contact us during the week.
We urge you to become informed about some of these critical retirement-related issues facing us today. It has never been more important!