The Shortsightedness of Capped Funding for Elders and People with Disabilities
By Nancy Muller, PhD
In May, The Henry J. Kaiser Family Foundation reported from results of its latest public opinion poll designed by its research team that most Americans oppose the idea of converting Medicaid to block grant financing to reduce the federal deficit. More than half want to see no reductions at all in Medicaid spending. One in five adults has received Medicaid benefits over an extended time, and for most, experiences were positive. However, one-third of them report having had problems finding a doctor, signaling issues with the practical access to care even when coverage is available, at least in theory1. Kaiser analysts believe that support for maintaining the current program may be due at least in part to the public's personal connections to Medicaid and a strong sense of the program's importance. About half (51%) of the 1,203 American adults surveyed say they or a friend or family member has received Medicaid assistance at some point, and a similar share say the program is important to their family.
Digging by a Wall Street Journal blogger into who actually receives Medicaid explains how so many Americans have had a brush with the program. According to previous Kaiser research, 70% of nursing-home residents have Medicaid coverage because even seniors who start out with savings often spend all their money on long-term care. According to the Kaiser data, 60% of low-income kids, 44% of HIV/AIDS patients, 41% of pregnant women, 20% of people with severe disabilities and 21% of Medicare beneficiaries receive Medicaid coverage.2
The findings come at a time of intense public debate in Washington about the future of entitlement programs such as Medicare and Medicaid as policymakers attempt to address rising public concerns about the federal deficit. While recent public opinion polling has suggested that dramatic changes in Medicare would be politically unpopular, the poll findings illustrate that major alterations to Medicaid also could be met with resistance by many Americans. Still, the problem of raging state deficits with a record-shattering national debt in the backdrop, goes unresolved. And the deep economic recession continues to hang over us as the country very slowly recovers and tax revenues remain depressed for an extended period.
Will those most affected by the proposal have the same voice and clout as those proposing such a solution?
The Kaiser Family Foundation was not the only national organization releasing analyses on the consequences of converting the Medicaid program into block grants to states. The National Senior Citizens Law Center (NSCLC) released a report in April that provided examples of eight lawsuits that the NSCLC had already waged against states that curtailed or refused to provide Medicaid coverage to older adults needing nursing home care and community based services and long-term care support. The report warned that if Medicaid were turned into a block grant, or capped, arrangement, such a change could make it harder for individuals to qualify for benefits, threaten coverage for services, result in loss of access to nursing home care, and eliminate essential community services. The AARP echoed similar fears in a report also issued in April, criticizing the use of capped funding arrangements to help balance the federal budget.
What policymakers and politicians should instead be concerned with is how to provide higher value and higher quality care for the dollars we are spending. With thousands of baby boomers turning 65 by the day and the elderly growing older with multiple co-morbidities, it is the skin - the body's largest organ - that is most threatened when continence care is neglected or shortchanged by reduced services, inferior products, untrained workers, and gaps in access to providers to guide management and intervention.
1 http://www.kff.org/kaiserpolls/posr052511nr.cfm, accessed May 25, 2011.
2Hobson K, Kaiser Poll: Half of Americans Report Personal Tie to Medicaid, Health Blog, Wall Street Journal, May 25, 2011.
Published On: June 03, 2011