Medicaid is an essential safety net, providing health care coverage for millions of Americans – including 1 in 4 enrollees who are eligible for the program because they are ages 65 and older or they have a disability.
Recent federal budget proposals include substantial cuts to the Medicaid program. These changes would strip needed care from seniors and people with disabilities, as well as the caregivers and families that help them remain healthy and live comfortably in their homes and communities.
The Facts: Medicaid Supports Americans with Complex Medical Conditions Who Are Dually Enrolled in Medicare
- Over 12 million adults, or nearly 20% of all Medicare enrollees, are “dually eligible” for both Medicaid and Medicare.
- This includes over seven million Americans aged 65 and older who are enrolled in both Medicaid and Medicare.
- Medicaid also provides coverage to nearly six million adults with disabilities, including 4.8 million who are also enrolled in Medicare.
Medicaid Provides Essential Long-Term Care for Seniors and People with Disabilities
- Over half of all Medicaid spending goes towards care for seniors and people with disabilities, ensuring that they have access to services that are not typically covered by Medicare, including long-term assistance and nursing home support.
- Medicaid is the primary source of coverage for long-term services and supports (LTSS), providing over half of all national spending on these vital services.
- LTSS includes nursing facility care, adult day services, home health aide services and family caregiving.
- Nearly two-thirds of all Medicaid spending for LTSS is now for services provided in the home or community (known as “home and community-based services” or “HCBS”) that enable older adults and people with disabilities to live independently rather than in facilities.
- Medicaid covers almost half of all children with disabilities, who also rely on LTSS and HCBS for essential services and supports to grow up healthy.
- Medicaid helps finance Program of All-Inclusive Care for the Elderly (PACE), a form of community-based, integrated care from an interdisciplinary team of health professionals that enables medically complex seniors to live at home. PACE has shown to reduce hospitalizations by 60% and mental health challenges by 80%.
Cuts to Medicaid Threaten the Health and Financial Stability of Seniors and People with Disabilities
- Medicaid helps both seniors and people with disabilities cover out-of-pocket costs and other health expenses. If Medicaid funding is cut, older adults and people with disabilities will face increased financial strain, leading to a higher risk of these individuals delaying or forgoing needed care.
Medicaid is a lifeline for millions of older adults, people with disabilities and others with medically complex needs. Any funding cuts to Medicaid will strip away critical supports and services these populations need to live and thrive in their communities.
For more information on Medicaid’s vital role, visit https://modernmedicaid.org.