The Ever-Changing Role of Family Caregivers and Modern Medicaid

The Ever-Changing Role of Family Caregivers and Modern Medicaid

Q & A with John Schall, Chief Executive Officer, Caregiver Action Network

It’s National Family Caregivers Month – the perfect time to discuss the important role caregivers play in ensuring and coordinating care for their loved ones covered by traditional Medicaid or a managed Medicaid plan.

We had the pleasure of sitting down with John Schall, the Chief Executive Officer of Caregiver Action Network (CAN) – a Modern Medicaid Alliance partner and leading national family caregiver organization – to talk about this role and how Medicaid’s innovations are making a difference for them.

Modern Medicaid Alliance (MMA): Medicaid covers a broad range of populations – from newborns and their families to low-income adults to seniors in nursing homes. How does caregiving affect these different populations of beneficiaries?

John Schall: The Medicaid population and the family caregiver population are almost the only ones I can think of in the U.S. that really cover the entire spectrum of care and lifespan. That’s why a family caregiver experience with Medicaid is so rich and far reaching. Caregiving impacts you as a Medicaid beneficiary, whether you’re a low-income family and you have a new baby, or if you’re in adulthood and caring for a family member with Down’s syndrome, or you’re older and you’re the caregiver for your elderly parents who are living in a nursing home. All those family caregivers, across that whole lifespan, are interacting and touching the Medicaid program.

MMA: During your career in health care, how have you seen Medicaid change?

JS: I’ve been in the healthcare sector now for more than 30 years, and it’s been interesting to see very big changes in Medicaid. There’s no question that the expansion of Medicaid coverage in the last five years has made a dramatic difference. Not only has it covered care for a lot more people, but there’s also something about that expansion that’s tremendously reduced the stigma that used to be associated with Medicaid. People now realize that with the expanded coverage that there are a lot of Americans in everyday life who now can benefit from Medicaid program. Medicaid expansion has helped reduce some of that stigma and led to tremendously better outcomes for these individuals. I do think the huge change of the expansion of the coverage in the last five years has really made a tremendous difference in Medicaid.

MMA: How would you describe the value of the Medicaid program for those you serve at CAN?

JS: In some cases, it’s vital. I think of a 55-year old woman out in Virginia who, after her parents died, became the sole caregiver for her 42-year old brother with Down’s syndrome. Without his coverage under Medicaid, it simply would be impossible from a caregiver’s standpoint. On the nursing home side, nobody wants to get to that stage, but sometimes that happens. Caregivers at home sometimes can’t continue to properly care for their elderly loved ones. Really, no other coverage in this country really gets to the nursing home part of caregiving.

MMA: What are some of the specific successes you’ve seen in the Medicaid program that have helped caregivers navigate the health care system?

JS: If there are a lot of different care settings – which is typically the case – it can be easier and more beneficial for caregivers of Medicaid beneficiaries because it’s all in one system. With Medicaid, there is an attempt to bring information into one place, which is not always the case for regular people who have to deal with multiple care settings. It also helps tremendously on the financial end. Caregiving is expensive. There are any number of expenses that come with caregiving that aren’t typically covered by insurance and they just generally come out of pocket, like incontinence products, diabetes monitors, blood pressure cuffs, and transportation back and forth to doctors. Think of low-income Medicaid beneficiaries. That’s a large portion of median income in America, so there’s no question that being able to rely on Medicaid can be all the difference between being able to care for your loved one or just really not being able to do it at all.


John Schall

Caregiver Action Network