It’s no secret that the number of older Americans is growing at a rapid pace. Even though we’re all living longer, we inevitably encounter health challenges as we age. The bottom line is that our reliance on the health care system increases with age. For many of us, that also means relying on Medicaid, also known as MaineCare in Maine.
Medicaid is government-sponsored health care coverage for low-income adults and children, persons with disabilities and older adults who can’t afford to pay for long-term services and supports. Medicaid covers nearly 63,000 older adults in Maine, ensuring they can access the care they need, including assistance with routine activities such as bathing, dressing and eating. More than half of all adults turning 65 this year will eventually need this level of help. This need cuts across all demographics, political parties and corners of the country.
Yet, opinions are sharply divided on how to pay for such essential services. Medicaid funding is at risk under the Senate’s Better Care Reconciliation Act, which could be voted on as early as next week. The result could be devastating for Maine’s older adult population.
Right now, Medicaid operates as a federal-state partnership where each pays a percentage of costs, and federal support increases as a state’s need increases. This flexibility is how Medicaid is able to deal with emerging health and service needs of enrollees — particularly new waves of older adults who qualify for the program. The Senate bill proposes to set a cap on the federal government’s contribution and then index it to inflation going forward. This would essentially mean a flat payment to states, rather than funding based on the actual cost of care.
Capped funding poses a serious threat to the health and well-being of Maine’s aging population. An inflexible cap on federal funding for MaineCare would give our state government less flexibility over how to respond to the changing health care needs of our residents. States would be responsible for filling the gap between the cap and growing costs, a burden our state might not be able to bear.
Maine would likely be forced to limit access to care by changing eligibility criteria or cutting benefits to many of our oldest, poorest neighbors. Providers of long-term services and supports would likely see their payments cut, and some might be forced to close their doors. Those most vulnerable — the elderly who paid into the system and now need care — would be added to a waiting list and left to hope for the best.
A society is judged by how it treats its oldest members. We can do better. U.S. Sens. Susan Collins and Angus King are standing with Mainers and rejecting these proposed changes to Medicaid. Let’s hope they stay the course and protect our seniors.
Lisa Henderson is executive director of LeadingAge Maine & New Hampshire, an association of not-for-profit senior living communities and care providers. The Maine membership includes 33 nursing homes, assisted living communities, adult day care providers, independent living communities, and Life Plan Communities. The association advocates on a wide range of issues, believing quality, affordable long-term services and supports should be readily available to older adults.