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Elder Law Blog

Tuesday, November 15, 2016

Will Trump Dump Medicaid on the States?

How will elder care be affected when Donald Trump becomes president and a Republican-controlled Congress convenes in January?  We should prepare for potentially severe budget cuts in Medicaid and other programs affecting seniors and people with disabilities, according to news sources, experts, and advocates.

On his website, the president-elect supports turning Medicaid into a block grant, which could adversely affect elderly and disabled individuals and their families, as well as Medicare and Medicaid beneficiaries.  The idea of transforming Medicaid into a block grant was first introduced in the 1980s by President Reagan.  Medicaid is an entitlement program in which everyone who is qualified receives benefits funded by state government and matching federal dollars, and has been since the program was enacted in the 1960s.  If Medicaid is converted to a block grant, the federal government will simply issue grants, or fixed amounts of money, to the states.  The states will be responsible for the balance of funding and have more flexibility in administering the program.  This means that Medicaid spending will be capped and there will be no guarantee that all eligible individuals will receive benefits.  In addition, states may have the flexibility to narrow eligibility criteria and cut benefits in response to budget pressures.  Tens of millions of people could lose coverage now and in the future if the open-ended Medicaid entitlement is replaced by a limited block grant.

Medicaid is the largest pay source for long-term care, as well as a safety-net health insurance program for the poor and unemployed.  Turning Medicaid into a block grant is a strategy for saving money on the backs of the poor, New York University professor Richard Nathan told CBS News "Many of the people who will get hurt are children and people in nursing homes," he further stated.  Medicaid long-term care beneficiaries are often on Medicare as well, however Medicare does not cover long-term care and shifts those care costs to Medicaid.

Congress enacted legislation earlier this year to repeal key parts of the Affordable Care Act ("Obamacare") and partially convert Medicaid to a block grant, however the president vetoed it.  With Donald Trump as president, "older adults and people with disabilities should prepare themselves for a very different world," a Forbes opinion piece concluded.  

The media spotlight is focused on Donald Trump's controversial promise to repeal "Obamacare" which could result in about 20 million people losing their health insurance coverage.  It is vital, however, to raise public awareness and to communicate with elected representatives about the looming threat to Medicaid, a long-standing entitlement and safety-net program that especially benefits the elderly and disabled.




Attorney Nancy Stone assists clients with Elder Law, Medicaid Planning, and Estate Planning throughout Harris County, TX. I am now based in Sugar Land and serve all of Houston, Harris County, Bellaire, Jersey Village, Cypress, West University, The Heights, Pearland, Alvin, Sugar Land, Missouri City, Kingwood, Humble, The Woodlands, Spring, Tomball, Richmond, Rosenberg Pasadena, Baytown, La Porte, Clear Lake, Texas City, Katy, Friendswood, Stafford, as well as Fort Bend County, Brazoria County, Montgomery County, Galveston County, Liberty County, Chambers County, Waller County and throughout Southeast TX.



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