The House GOP’s Medicaid Plan Will Mean More Flexibility, Less Money For States, Worse Care

House Republicans are right that Medicaid needs to be more flexible. But more flexibility with far fewer dollars won’t improve care for seniors, younger people with disabilities, or other beneficiaries of the program. It is possible to cut red tape without slashing spending. Congress should give it a try.

Medicaid is a critical safety net for people who need personal assistance and other supports because they are frail or disabled. Besides families themselves, the program is the biggest payer of long-term supports and services, spending about $140 billion annually on this care for frail elders and younger people with disabilities. And it helps the most vulnerable seniors. While the rules vary by state, in general people are only eligible if they make less than about $735-a-month, have less than $2,000 in financial assets, and have a high level of functional or cognitive impairment.

Trump’s Budget Framework Points To Big Cuts In Programs For Seniors

President Trump’s initial budget framework would slash programs for seniors and younger people with disabilities, especially those aiming to remain at home rather than move to a nursing home or other residential care. Combined with the House GOP’s proposed health plan, it may severely limit access to federally-funded medical care, personal assistance, and other supports and services.

A Closer Look At The House GOP Health Bill And Seniors: It Isn’t Getting Better

From the perspective of older adults, there is little good to say about the House Republican health care bill. The American Health Care Act (AHCA) would significantly raise insurance costs for people in their 50s and 60s, reduce important Medicaid benefits for the frail elderly, and put more financial pressure on Medicare.

Last week, I took a first look at what the plan would mean, but we have more information about the effects of the AHCA, so let’s take a closer look:

The House GOP Health Plan Would Be The Biggest Change For Seniors In A  Half-Century

House Republicans have proposed a major rewrite of the Affordable Care Act that would increase the cost of health insurance for older workers and profoundly change the Medicaid support system for the most vulnerable. It would be the biggest change in government assistance for long-term care since the creation of Medicaid a half century ago.

The proposal would retain the basic structure of the law but redesign individual insurance subsidies and sharply reduce the federal payments to the Medicaid program. The likely bottom line for seniors: Higher premiums and out-of-pocket costs for those aged 60 and older who are not yet enrolled in Medicare, and reduced benefits for low-income seniors who are receiving long-term services and supports from Medicaid.

Congress Should Not Kill End-Of-Life Talks Just As Physicians And Patients Are Having Them

We may be about to have a new debate over “death panels.” If we do, it would be a tragedy for tens of millions of Americans and their families.

You may remember this small piece of the Affordable Care Act that garnered outsized attention back in 2010. It allowed Medicare to pay physicians for having end-of-life conversations with their patients. The program, which the Obama Administration delayed for years in the face of conservative political pressure, finally came on line last year. And Kaiser Health News reports that it is catching on more quickly than expected.

Medicare’s Cruel Paradox: It Is A Costly Subsidy For Seniors, But They Can’t Live Without It

Which statement is true? 1) Medicare will impose huge burdens on future taxpayers by providing trillions of dollars in government-funded health care to older adults. 2) Many seniors face massive, unaffordable out-of-pocket health costs in old age, even with that government assistance.

The answer is: Both.  And that’s the challenge policymakers must confront as they debate what to do about the Medicare program as 77 million Boomers move inexorably into old age.

Stop Talking About Obamacare. It is Bad For Our Health

As the debate over remaking the US health system heats up, I’d like to make a modest request: Let’s stop talking about Obamacare.  Drop the partisan, misleading, counterproductive, and increasingly irrelevant hot button label. Instead let’s talk about the pros and cons of what are likely to be some complex and far-reaching changes to the way Americans get their medical care. No more toxic labels.

The very word Obamacare drives policymakers into a frenzy.  Yet, it mischaracterizes the current state of the individual health insurance market: Day-by-day, the law enacted in 2010 is already being changed, so whatever it is, it is no longer Obamacare. And the very word forces lawmakers into their partisan corners and makes it impossible for them to design a sustainable, well-functioning system.

Should Congress Cut ACA Insurance Premiums for Young People By Raising Them For Those 50+?

A proposal by congressional Republicans aimed at reducing health insurance costs for young people would substantially boost premiums for those over age 50, according to a new analysis by the actuarial firm Milliman Inc. The proposal could result in up to 18,000 older adults losing health coverage and increase the cost of federal insurance subsidies by $6.7 billion, if the government continues to offer Affordable Care Act-type subsidies.

The GOP plan would change a provision of the ACA intended to cap insurance costs for older adults who are not yet 65, when they become eligible for Medicare. The law bars insurance companies from charging them more than three times what young people pay for the same coverage. The proposal would allow insurers to charge them up to five times as much.

Could Congress Boost Medicaid Long-Term Care Benefits For Some By Curbing Spousal Annuities?

Is Medicaid’s long-term care benefit a zero-sum game where limited resources are shifted from one beneficiary to another? For instance, could the government significantly increase long-term care benefits for some by barring people from using spousal annuities to qualify for Medicaid?

Or should resources be expanded to provide all eligible seniors and younger people with disabilities the care they need?

What Medicaid Block Grants Would Mean For Seniors

The Trump Administration and congressional Republicans seem to be moving full speed towards capping federal payments for Medicaid–a design sometime called block grants. But they may be missing a key piece of the story: Two-thirds of the program’s dollars go to the frail elderly and younger people with disabilities.

The stereotype of a Medicaid beneficiary is a poor mom and her kids. And, in fact, three quarters of the program’s recipients are children and non-disabled working-age adults. But that isn’t where most of the money goes.