In the current budget battle in Congress there is an outright attack on the safety net for low- and middleincome older adults. Serious efforts to block grant Medicaid, transform Medicare into a "premium support" program, repeal the Affordable Care Act (ACA) and make significant changes to how people can access food or affordable housing support programs would effectively remove the safety net for millions.
Proposals to "reform" Medicaid by using block grants to give states a fixed amount of money to do with presumably as they choose, and without the same rules governing eligibility or benefits, should set off alarm bells for low- and middle-income older adults, their families and their advocates. Such proposals would drastically change Medicaid, which is currently a shared federal-state program in which the federal government sets the rules and shares the cost with states.
Medicaid Is for Most Everyone
Medicaid is not only a program for those with limited income and resources. The nearly 9 million people ages 65 and older (and countless families) it helps range from those living at or close to the federal poverty level to those in the middle class who have had to impoverish themselves in order to qualify for long-term-care benefits. Medicaid provides financing for long-term care in nursing homes for some 1.3 million people ages 65 and older, and long-term services and supports for 4.8 million in the community. Medicaid also covers 8 million people with disabilities younger than age 65. Close to half of all Medicaid beneficiaries are members of ethnic or racial minorities.
Because states are under enormous pressure to balance their budgets in a tight economy, many states are cutting Medicaid services at a rate not seen in 25 years. Over time, because of the growth of the program and its high costs, states have often sought to make it harder for their citizens to access Medicaid, or tried to change benefits or rules set out in federal law. …