US Senate health bill would decimate long-term care coverage
long-term care coverage: When Americans think of retirement planning, long-term care (LTC) are generally a major stalemate. But we would do well to think now.
About half of Americans aged 65 will require a certain level of LTC during retirement. And when professional care is required, it is generally paid for Medicaid, which covers 62% of LTC in the US, according to the Kaiser Family Foundation (KFF). It may surprise people who think Medicaid is a safety net for the poor. In fact, the program is a critical line of life for 35 million children and 27 million adults in low-income households.
However, nursing is expensive and 62% of retiree households saved less than a year in annual income for retirement, according to the National Institute of Pension Security. When the economies run out, Medicaid is involved – nearly two-thirds of the spending in 2014 went to the elderly and disabled, according to the KFF.
“Medicaid is a critical safety net for 50 years for people who have exhausted their life savings,” said Jean Accius, vice president of the Public Policy Institute at AARP. “It is safe for your mother or father or perhaps for yourself, because prices can be so high.”
The Better Care Reconciliation Act (BCRA) proposes to reduce Medicaid’s planned spending of $ 772 billion over 10 years. This would destabilize not only access to home care, but in services for the home and community.
Medicaid is administered by the states, but funded with the federal government. The federal contribution is now open. Under BCRA, from 2020, states could opt for a federal tax subject to a ceiling or registration as a global grant. The contribution is based on the actual amount sent to a state and then adjusted annually for inflation.
Proponents of BCRA claim that this will not prevent states from adjusting for inflation will be linked to the federal measure of medical inflation (CPI-M). But as the population ages Medicaid in the 80s and 90s, the attention needs will intensify.
And after 2025, the measure of inflation would increase to a measure of more general inflation would increase much more slowly than the costs of health care. Finally, membership ceilings do not adjust to the new needs of major unforeseen expenses.
Slowly, since federal funding would fall behind, states would be stopped raising taxes to fill gaps, reduce budgets elsewhere, or provide Medicaid coverage. Cutbacks could be made in the context of home and community care, but nursing home coverage also suffers, said Jessica Schubel, Policy Analyst, Budget Center and Policy Priorities.
“United may be forced to reduce rates for suppliers – they are no longer very high,” he said. “Providers will then be forced to do more with less – they can reduce staff to fewer beds available to Medicaid patients or shut down altogether.”
Overall, Medicaid enrollment would fall to 15 million by 2026. In insurance exchanges, premiums for older people would rise to unaffordable levels, CBO said. For example, the net premium (after tax credits) for a 64 year old student with an income of $ 56,800 increased from $ 6,800 to $ 20,500.
At the same time, tax cuts at the BCRA reduce federal revenues by $ 700 billion, 45% of those earning $ 875,000 or more, according to the Tax Policy Center. The bill repeals the net income tax of the ACA of 3.8% on dividends, interest and capital gains and the payroll tax surcharge 0.9%.
The compromise in BCRA insurance for tax cuts for the rich, are a little less atrocious. Governor John Kasich, Ohio, has expressed his position against the BCRA this week: “Is this a good public policy? What are you doing?