We have discussed this before, but it bears repeating now that there is a new push by the Trump administration to restrict funding necessary for Medicaid at the state level. These changes have the potential to affect Medicaid applications in Montgomery County and the rest of Pennsylvania, so read on to learn more about how this may affect you.
Medicaid is a joint state/federal program. As long as the states do not make Medicaid harder to get than the broad federal eligibility rules, the federal government will match the state outlays for Medicaid on a roughly 50/50 basis. So if a given state has a particularly bad year for costs (can you say Coronavirus?), then they share the hit with the federal government. Currently, there are proposals by the Trump Administration to erode that safety net for the most vulnerable population.
The White House introduced their “Healthy Adult Opportunity” plan a couple of months ago – just months after their similar Medicaid Fiscal Accountability Rule proposal was announced. The purpose of this plan is to turn Medicaid financing as a block grant plan, which would let the individual states put caps on ACA-based Medicaid funding, especially when it comes to drugs and primary benefits.
These plans are set to be official as soon as the end of this year, and it could deliver a blow to Medicaid funding at a rate that could go as high as $49 billion annually. While Pennsylvania Governor Tom Wolf has spoken out against these changes, states that are affected by it could be looking at as many as half of all disabled people living there being drastically impacted and losing the care they rely on.
The benefits of Medicaid are evident, especially within our home state of Pennsylvania. Those with access to Medicaid are more likely to have access to life-saving procedures than uninsured people are, and the passage of the ACA has reduced the number of uninsured in the state dramatically. Not only that, but students who are eligible for Medicaid are more likely to thrive throughout their educational careers. And, of course, having more insured people benefits the economy.
Perhaps the biggest beneficiaries of Medicaid are our hospitals. If these cuts end up being implemented, some of these hospitals could be looking at significant blows that could result in more preventable deaths on a statewide basis. According to the Pennsylvania Health Care Cost Containment Council (PHC4), 66 hospitals posted negative aggregate operating margins in 2018. This number represents 39% of the state’s hospitals, and the total amount is up from 30% two years prior.
Those of us who work with the senior and disabled population know that Medicaid reimbursements to nursing homes are at or lower than the actual cost to provide care. If not for the Medicare rehabilitation patients and the few being billed at much higher private pay rates, many nursing homes would go out of business. We have seen many hospitals in our area go under in the last 20 years.
Because of these reasons, Slutsky Elder Law is prepared to fight for your Medicaid rights harder than ever. For assistance with any legal disputes involving your Medicaid applications in the Chester County area, call (610) 940-0650 or contact us online to schedule your consultation.