Caps Would Pinch Medicaid For Decades To Come
Cuts to Medicaid — the primary source of supports for millions with disabilities — would continue for decades under a U.S. Senate proposal to cap the program, a nonpartisan analysis finds.
Spending on Medicaid is projected to be 35 percent lower than under current policy by 2036. That’s according to a new report from the Congressional Budget Office.
The latest report, requested by Senate Democrats, looks specifically at the long-term fallout for Medicaid if a Republican bill to repeal and replace the Affordable Care Act is adopted.
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“Over the next decade, CBO projects, a large gap would grow between Medicaid spending under current law and under this bill. In later years, that gap would continue to widen because of the compounding effect of the differences in spending growth rates,” the budget office said.
Currently, Medicaid operates as an entitlement program meaning that services are provided to anyone who meets eligibility requirements. The federal government provides matching grants to states to help cover the cost.
Under a per-capita cap system, however, the federal government would chip in a fixed amount for each beneficiary regardless of the true cost of their care and leave states to make up any difference.
The budget office previously projected that the Senate plan would mean $772 billion less in federal Medicaid spending over the next decade, a drop of 26 percent. The new report qualifies how these changes would be exacerbated over time.
“Under this legislation, after the next decade, states would continue to need to arrive at more efficient methods for delivering services (to the extent feasible) and to decide whether to commit more of their own resources, cut payments to health care providers and health plans, eliminate optional services, restrict eligibility for enrollment or adopt some combination of those approaches,” the Congressional Budget Office concluded. “Over the long term, there would be increasing pressure on more states to use all of those tools to a greater extent.”
The report is adding to anxiety for disability advocates who say that lives are on the line.
People with disabilities are especially reliant on Medicaid, which provides doctor and hospital services as well as behavioral health supports and assistance for people to live and work in the community.
Individuals with disabilities represent just 15 percent of Medicaid beneficiaries, but account for 42 percent of the program’s costs, according to the Kaiser Family Foundation.
“CBO’s latest report confirms that the Medicaid caps proposed by the Senate would absolutely decimate the Medicaid services on which people with disabilities rely for critical services and supports,” said Alison Barkoff, director of advocacy at the Center for Public Representation. “Cutting 35 percent from states’ Medicaid systems would absolutely mean cuts in critical services, longer wait lists and even elimination of optional services like home and community-based waivers.”
With senators delaying any vote on health care until after the July 4 holiday, advocacy groups are urging their members across the nation to reach out to their elected officials.
Already, protests organized by the disability rights group ADAPT from New York to Colorado have ended with arrests. Additional actions are expected while lawmakers are home during the holiday break and again when they return to Washington.
“(We’re) strongly urging our grass roots to meet with members of Congress over the recess wherever they can find them — at parades, rallies, in their home offices, at church, etc., and make sure they understand how devastating these policies will be for all Americans, but especially people with disabilities and those who are aging,” said Kim Musheno, chair of the Consortium for Citizens with Disabilities, a coalition of disability advocacy groups. “We are further urging Congress to work in a bipartisan fashion to make real reforms that will actually fix what is broken.”