Medicaid coverage can’t be compromised

One of the most devastating effects of the latest Republican effort to repeal the Affordable Care Act (Obamacare) is the effect it will have on long-term care for the elderly and disabled in nursing homes.

Among the biggest losers will be Pennsylvanians who rely on Medicaid for long-term care.

Currently, Medicaid funding guarantees coverage for low income elderly and disabled persons who need nursing home care. The Republican bill converts that funding to block grants and caps the total amount spent based on a per capita formula.

The primary sponsors, Sen. Lindsey Graham (R-S.C.) and Sen. Bill Cassidy (R-La.), claim this will give states more flexibility in designing health care in their states.

In fact, the bill penalizes states that expanded Medicaid coverage under Obamacare by taking money currently going to those states, dividing it among all 50 states, and capping it based on a per capita formula.

Doing this shifts Medicaid costs to Pennsylvania.

The Kaiser Family Foundation, a respected, non-partisan organization that examines health care issues, estimates that changing the funding formula will cost Pennsylvania over $11 billion in federal funds for the years 2020-26.

If Congress does not renew the block grants in 2027, Pennsyl­vania will lose an additional $10 billion.

Sixty-three percent of Pennsylvanians in nursing homes (over 50,000 seniors) rely on Medicaid to pay for nursing home care. Medicare does not pay for these services.

According to the Pennsylvania Health Care Association, the average cost of nursing homes in Pa. is $108,000/year. Many more elderly rely on Medicaid for services that make it possible for them to stay in their home.

If you have a loved one in a nursing home, start making plans to care for them yourself. If you think you will need nursing home care, start buying long-term care insurance, now.

Helen M. Sheehy