This morning, the Centers for Medicare & Medicaid Services (CMS) issued new guidance encouraging states to fundamentally and radically change their Medicaid programs by accepting a cap on federal funding. Justice in Aging strongly opposes CMS’s attempt to bypass Congress’s rejection of this policy and urges states to reject the invitation. Implementing block grants of any size or shape in any state would greatly harm older adults, people with disabilities, and millions of families who depend on Medicaid, most especially people of color. 

Medicaid is uniquely designed with an open-ended funding partnership between states and the federal government to ensure it can serve all who are entitled to coverage. Medicaid is essential to filling in coverage gaps and making Medicare affordable for 1 in 5 Medicare beneficiaries. Medicaid is the only coverage option for the majority of people who need long-term services and supports. It covers 60% of nursing home stays and pays for the services and supports that enable older adults to age at home and in their communities. 

Capping Medicaid funding in any form would not only directly harm the low-income older adults and others who can no longer get the health care services they need, but it would also harm their entire families and households. There are no limits to or carve outs from the consequences of undermining the fundamental structure of the program as an entitlement. The harms will ripple deeply through every community in every state that chooses to adopt this policy, but will fall hardest on communities of color who are most excluded from other sources of health coverage and economic opportunities.

Rather than capping and cutting Medicaid, states should turn to the solution proven to strengthen health care coverage and outcomes: expanding Medicaid under the Affordable Care Act. The 37 states that have expanded Medicaid demonstrate that making Medicaid available to every low-income adult under age 65 who cannot afford commercial insurance works. It saves lives, improves economic security, and benefits states. 

Justice in Aging is here to defend the Medicaid program to make sure it continues to work for older adults, people on Medicare, and all low-income families. 

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