by Julie Ladimer
Medicaid is a federal and state funded program which helps cover the cost of in-home and skilled nursing care for the elderly and the disabled. However, in today’s economy, the cost of in-home care and skilled nursing care are increasing dramatically, and the number of people who need these services are increasing exponentially. Therefore, the debate on whether to cut federal funding to the Medicaid program or to increase revenue to continue funding the program has become a hot topic.
According to the American Health Care Association, 63% of all Massachusetts nursing home residents are covered by Medicaid. The United States Census Bureau states that the number of people turning 65 will increase by 36% by the year 2020. These numbers reflect that there will be an increase in need for skilled nursing care and therefore a need for more workers in the industry. The skilled nursing care fields is not known for its high pay, nor does it provide above average benefits as an incentive. The purse strings at skilled nursing facilities are stretched tight.
However, since Medicaid is a federally funded and state funded program, discussion of cutting funding is tricky. If the federal government cuts spending on Medicaid, the states would have to make up the loss through one of two ways. The states could either raise taxes, or they could cut benefits. If Massachusetts raises taxes to pay for the medicaid program (MassHealth here in Massachusetts), then the tax payers will be picking up the loss as a result of the budget cuts. If Massachusetts cuts the benefits for MassHealth, or tightens up the eligibility criteria for benefits, it will become harder for nursing home applicants to pay for nursing home care. The applicants or their children will pay out of pocket.
These scenarios lead to many unanswered questions. What happens if an applicant spends all of their money on nursing home care, and become eligible for MassHealth, but there are no funds available in the MassHealth program, who bares this burden. Does the nursing home cover the cost? Does the elder become homeless? Does the government go into a deeper deficit to cover the costs? Will the children be forced into financial struggles to cover the costs of their parents’ care?
These questions make it clear that the debate on how to fund Medicaid and MassHealth effects everyone, whether you are a tax payer, a caretaker child, an elder who needs care. It future of Medicaid and MassHealth also effect the economy on a greater scale because of the funds affect the in-home services and the skilled facilities. If there are means to pay for employees, who will be taking care of the elderly? In addition, if caretaker children are either leaving their jobs or taking time off to care for their aging parent, the caretaker child’s employer will suffer a loss from their absence, either by paying someone else to cover for the job, or by not having the expected work accomplished. In conclusion, it seems there is a cyclical effect as a result of the increase in cost of long-term care for the elderly and disabled.
