Did you know there is a risk from the federal government that may impact services to persons with disabilities and their families?
President Donald Trump and some members of Congress want to change the way the Medicaid program is funded. They are calling for doing away with the current program (in which people are entitled to coverage and states are guaranteed federal matching dollars with no pre-set limits) and replacing it with either a block grant system or a per-capita system that would cap the amount of money available.
Under a block grant, states would receive a pre-set amount of funding for Medicaid. Typically, a base year of Medicaid spending would be established, and then the cap would increase by a specified amount each year (typically tied to inflation or inflation plus some percentage). To achieve financial savings, the total amount of federal spending would be less than what is expected under current law. (Under current law, federal Medicaid spending matches state spending for eligible beneficiaries and services, without a pre-set limit. If state spending increases due to increased enrollment or program costs, then federal spending increases as well.) Under a block grant, if program costs exceed the federal spending cap due to increased enrollment during a recession, or a rise in health costs, states would have to either increase state spending or reduce enrollment or services.
Under a per capita cap, federal funding per Medicaid enrollee would be capped. A base year of per-enrollee spending would be determined, and then that amount would increase over time by a pre-set amount. Per-capita cap systems generally do not include a mechanism to ensure that the capitated rate will keep up with increased costs, resulting in a deficit. While state could choose to absorb these deficits, in reality states instead would overcome such deficits by a) reducing the number of people enrolled in the Medicaid program; b) limiting the benefits and supports available to people receiving Medicaid; or c) slashing the rates paid to service providers like The Resource Center. These cuts would put a number of people and providers at risk, including poor children, people who are elderly, individuals with disabilities, nursing homes, community-based long-term care providers, and safety-net hospitals and clinics.
Those who are in favor of changing the way the Medicaid program is funded say that switching to a block grant or per capita system will give states more flexibility in how Medicaid dollars are allocated. But a recent study concluded that restructuring Medicaid from an open-ended entitlement program to one using block grants or per-capita caps would significantly reduce federal Medicaid spending. According to the analysis, block grants would receive $150 billion less in federal spending over five years, and per-capita caps would result in a $110 billion reduction over the same period.
Medicaid is the primary public source of funding for long-term services and supports to people with disabilities. Program cuts, along with block grant or per-capita cap proposals, would hurt people who have no alternative means of paying for essential services.
Congressman Tom Reed will be holding Town Hall meetings this Saturday, February 18. If you’re concerned about changes in the way Medicaid is funded, plan to attend one of the meetings and make your voice heard. Here are the meeting times and locations:
North Harmony Senior Citizens Center
9:15 to 10:15 a.m.
5377 Stow Ferry Road
Ashville, NY 14710
Pine Valley VFW Post #2522
11:30 a.m. to 12:30 p.m.
7117 Route 83
Cherry Creek, NY 14723