Why would House Republicans slash programs that make it possible for the frail elderly and adults with disabilities to live at home? Especially since the alternative would often be more costly nursing home care.

GOP lawmakers say they support Medicaid’s Home and Community Based programs that provide long-term services and supports in the community rather than in nursing homes. Many GOP governors are leading efforts to shift Medicaid spending to home care. Yet, the new House GOP budget would slash the very federal programs that provide the infrastructure this vulnerable poulation needs to stay at home.

The House would not directly cut Medicaid long-term care benefits themslves. But it would entirely eliminate funding for the Social Services Block Grant program, which helps fund Meals on Wheels, transportation, and other important assistance for people with chronic disease who live at home. It would also eliminate or cut other key programs for respite care, food stamps for low-income seniors, and other key services

Even with a well-functioning Medicaid home care program, it is not possible for the low-income frail elderly to live safely at home without these additional supports. Medicaid itself does not pay for these services but they are often not available without other federal support.

Without this assistance, many frail elderly will have no choice other than to move into a nursing facility–an inappropriate setting for many and a more costly option for Medicaid.

The block grant cuts are especially curious because House Republicans say they support the oncept, which provides states with far more flexibility than typical federal programs. Indeed, the House GOP likes the idea so much that it wants to turn Medicaid into a block grant.

The losers in these cuts would be the frail elderly, adults with disabilities, and their caregivers. But governors,including many Republicans, would also suffer because they’d end up footing the bill for that costly nursing home care.

This budget will never pass the Senate, at least not this year. But budgets send an important message about a political party’s priorities. And these seem pretty strange. 

I understand that House Republicans are anxious to find ways to stop scheduled cuts in defense spending that are due to take effect at the end of the year. But slashing home care services for vulnerable seniors is an especially bad way to do it.