There are many versions of the history of Mother’s Day and I found an excellent compilation at the National Women’s History Project. As we all know, Mother’s Day will be celebrated (in this country) this Sunday, May 14, 2017. There are many ways to honor our mothers – even if our mothers are no longer living. In this post I’m tying together two seemingly disparate threads: how to honor our elder mothers on Mother’s Day by considering the plight of a large number of impoverished elder mothers if the American Health Care Act becomes the law of the land.
Last week I posted about long term care insurance, why it is helpful and . . . how we shouldn’t be complacent about the availability of Medicaid services for poor and sick elders who lack the resources or savings to self-insure. Little did I know that just hours after that post, I would get news of the U.S. House approving a version of the American Health Care Act which would, if it becomes law, gut Medicaid for millions of people, including elders!
What’s at stake?
Medicaid expansion under the ACA will be rolled back under the AHCA. Here are some details about Medicaid expansion from a 3/26/17 Forbes article: From 2014 through 2016, the ACA’s Medicaid expansion population is funded 100% with federal dollars. Beginning this year, states gradually have to pick up some costs, but the federal government still picks up 90% or more of Medicaid expansion through 2020. It was a better deal than before the ACA, when Medicaid programs were funded via a much less generous split between state and federal tax dollars. That article points out that the Medicaid expansion has been a boon to health insurance company giants like Aetna, Anthem, Centene, Humana and UnitedHealth Group, who have enrolled millions of new members under the expansion.
As this article from the Kaiser Family Foundation illustrates, the hardest hit under the AHCA appear to be nonelderly disabled adults, folks with conditions or diseases like cerebral palsy, multiple sclerosis, developmental disabilities, people affected by brain injuries and so on. But the AHCA would adversely impact elders as well, by its move to a “block grant” to states (a fixed $$ amount for each beneficiary) as well as the elimination of the ACA’s protections for people with pre-existing conditions. Of note is the “no” vote of U.S. Rep. Mike Coffman (R – CO) on the grounds of the AHCA’s failure to protect the relatively small number of persons with preexisting conditions, who would be left without any coverage. You can read the AARP’s post about this here.
It is unlikely that elders on Medicaid will be heard from in large numbers about their loss of insurance coverage and benefits, but elders who will see their insurance premiums increase may be more vocal, and I think it’s a safe bet to count on the insurance companies (who benefitted from Medicaid expansion) to raise a hue and cry when the U.S. Senate examines the proposed legislation. A Forbes article from 5/7/17 notes that “Of the 75.2 million Americans covered by Medicaid, 54.7 million are enrolled in private plans, a report from consulting firm PwC indicates. Much of the recent growth has come from Medicaid expansion, benefitting not only insurance companies but hospitals, doctors and other medical care providers.”
Without Medicaid funding from the federal government, which was the impetus for Medicaid expansion under the ACA, states will be left on their own, with limited funds from federal “block grants” to cover a fraction of those persons who were enrolled and covered under Medicaid, or a fraction of those persons’ health care. The Congressional Budget Office published its analysis of the AHCA on 3/13/17 and the summary states that the CBO and the JCT (Joint Committee on Taxation) “estimate that enacting the American Health Care Act would reduce federal deficits by $337 billion over the coming decade and increase the number of people who are uninsured by 24 million in 2026 relative to current law.”
For more information about the AHCA’s impact in Colorado, you can read a Denver Post article here from several weeks back. The American Medical Association, which opposed the AHCA prior to its House approval, issued this statement on May 4, 2017, criticizing the bill for its results which would cause millions of Americans to lost access to quality, affordable healthcare and un-insuring those with pre-existing conditions. Many of those folks with pre-existing conditions are elders.
If you aren’t tired of seeing all these links and want to read more, here’s a link to a New York Times article about who would be the winners and the losers under the AHCA.
Please consider honoring mothers by educating yourself about the AHCA and sharing your thoughts and opinions with others, perhaps even your elected officials. It’s time to make the conversation about something other than money…
© Barbara E. Cashman 2017 www.DenverElderLaw.org