Medicaid Plays an Essential Role in the Lives of Americans 65+

The Modern Medicaid Alliance is dedicating the next several weeks to publishing resources that highlight the role that Medicaid plays in providing Americans 65+ with access to high-quality, affordable health care. The Alliance will be collaborating with partners to publish new content and share insights from leading organizations about the critical safety net that Medicaid provides for millions of Americans 65+, especially as our nation works to overcome the COVID-19 crisis. 

Today, there are more than 54 million older adults living in the United States. Many of those individuals receive health care coverage through Medicare, which is a federal health insurance program for people who are 65 and older or who have a disability. Medicaid also plays an essential role in providing coverage for 7.2 million Americans 65+. Together Medicare and Medicaid provide health insurance coverage to more than 134 million people. 

Americans 65+ rely on Medicaid to cover nursing home care, long-term services and supports, and medical care. For example, Medicaid covers personal care services (PCS) such as bathing and light housework, enabling many Americans 65+ remain in their homes. Medicaid coverage helps millions of Americans 65+ access the care and services that keep them as healthy as possible.  

Nearly 1 in 5 Medicare enrollees are considered “dually eligible beneficiaries,” who qualify for benefits under both the Medicare program and their state Medicaid program. Medicare beneficiaries can qualify for Medicaid based on income, age, and/or disability. Medicaid coverage helps with their Medicare premiums, deductibles, and cost-sharing, and provides additional benefits such as nursing home care, personal care, and home-and community-based services.  

During the COVID-19 crisis, older adults have been at the greatest risk for hospitalizations and severe complications caused by the virus. The elevated risk is due to both increased age and a higher likelihood of having multiple chronic conditions. In fact, according to the Centers for Disease Control and Prevention (CDC), 8 out of 10 COVID-19 deaths in the U.S. have been in adults 65 and older.  

Fortunately, home and community based services (HCBS) programs have served as a lifeline for many Americans 65+ during the COVID-19 crisis. The Centers for Medicare & Medicaid Services (CMS) has made it easier for Americans 65+ and people with disabilities to receive HCBS during the pandemic. State Medicaid programs have also allowed for greater flexibility where enrollees can receive HCBS and allowing for expanded services beyond the typical limits. These changes are helping to prevent the spread of COVID-19 by allowing the most vulnerable populations to receive care from their homes rather than go to crowded doctor’s offices and hospitals.  

In addition to HCBS, Medicaid programs like the Program of All-Inclusive Care for the Elderly (PACE) also help Americans 65+ live in their homes and communities longer. PACE provides medical and social services to primarily dually eligible beneficiaries still living in their communities. Due to the COVID-19 crisis, PACE organizations have innovated to shift more of their services into the home. One program even turned buses that were typically used to transport PACE participants to care centers into mobile clinics to make house calls for patients.  

As our nation continues to work together to stop the spread of COVID-19, policymakers must prioritize the health and safety of Americans 65+. A strong, reliable Medicaid program is critical to overcoming the crisis and protecting our most vulnerable populations.