Current proposals to repeal and replace the Affordable Care Act will cause great harm to seniors and poor families. The proposals also pit the welfare of seniors against the welfare of children and poor families. Here’s why:
- Nearly half of all Medicare members have incomes under $26,000 per year
- Voucher programs with flat fees could make health services out of reach financially if the voucher is tied to social security income which is lower for low income workers (AARP—Policy Institute)
- Many people 60 to 64 who buy individual health insurance policies have median incomes around $20,000 (AARP Policy Institute)
- Simply because of age, many 60 to 64 are more likely to have pre-existing health conditions (AARP Policy Institute)
- This group could face higher premiums if premiums are based on pre-existing conditions
- People eligible for both Medicare and Medicaid will be hit hard with proposed Medicaid cuts
- Flat fees to the states for Medicaid mean states will be faced with balancing the needs of the disabled, low-income and disabled seniors with the needs of low income women, children and families
- In 2003 one state proposed balancing its budget by cutting 13,000 Medicaid nursing home beds. After several fights between the governor and the legislature, these cuts never happened. That this was even considered is chilling
- Medicaid eligibility is based on complex state and federal formulas to determine how poor someone is. Poverty is defined as $12,060 per year for individuals and $24, 060 for a family of four. These strict formulas dictate the “percent” of poverty which in turn dictates financial eligibility. For information on these complex formulas see: https://aspe.hhs.gov/poverty-guidelines ($12,060 and $24,060 are considered/labeled “100% of poverty”)
- Nearly two thirds of the money spent on Medicaid is for older, sicker and disabled adults rather than children and families
- As the nation ages, more funds will be needed for low income seniors in long-term care facilities squeezing out funds for low-income children, women and families
- Medicare does not cover long-term care, such as nursing home care. Long-term care is covered either by Medicaid or private long-term care insurance or family funds.
- Meals on Wheels, a nutrition program that delivers meals to low income and disabled adults is also at risk.
- The program is funded by Community Block Grants to the states through US Housing and Urban Development HUD program. Nearly 15% of block grant funds are dedicated for nutrition programs. As community block grant funds are reduced, funding for these programs erodes. The American’s with Disabilities Act is also at risk.
Any consideration of cutting these programs should be a national shame. Somewhere along the way we have lost who we are as a nation–our sense of community and our conscience. Instead we now debate if someone is really disabled or really poor and hire gatekeepers to control access and cut vital programs. If we focused on what would nurture rather than restrict, we could solve many problems. And, we could restore our soul and the heart of our country.
Our Constitution’s preamble specifies what we must have to form a more perfect Union: “…establish Justice, insure domestic Tranquility and ….promote the general Welfare..” With the integrity and heart of this vision in mind we must choose these priorities. We have more than enough money to care for our children, seniors, the poor, disabled and the most vulnerable. Instead we punish them for being so.
We should be ashamed.
© Kathleen O’Connor, May 31, 2017