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‘Obscene Cuts’ to Medicaid Would Impact LTC: Sen. Casey

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As lawmakers wrestle with passing a spending bill to fund the government until Dec. 9, Sen. Bob Casey, D-Pa., said Thursday the lack of consensus on operating the federal government “is emblematic of some of the dysfunction here.”

Speaking at a long-term care symposium on Capitol Hill, sponsored by Genworth Financial, Casey said, “We thought we might have a decision today” on the spending bill, and he added, “We’re trying to get from here to Dec. 9,” on legislation to fund the federal government, “and we still haven’t gotten a decision about that.”

Casey also said a “big debate” going forward for lawmakers will be how to “make the math work” so that “the best possible strategies” can be developed to protect older folks, “whether it’s in Social Security obligation and promise—or Medicare or Medicaid.”

But he said lawmakers and policymakers in Washington “are talking about making obscene cuts to Medicaid,”—the program that, “by one estimate, accounts for all nursing home placements.”

Casey, a member of the Senate Special Committee on Aging, said, “We should be honest about the value of these programs, honest about assessing and preserving them, and honest about improving them while meeting that obligation to older citizens.”

Citing National Academy of Sciences data from 2011, Casey said that nearly 18 million family care givers were providing $234 billion in dollars in uncompensated care.  

(Related: 5 Shocking Facts About Retirement Health Care Costs)

Howard Gleckman, a senior fellow at the Urban Institute, noted during a panel discussion at the event that Medicaid spends in excess of $100 billion each year on long-term care for the elderly and younger people with disabilities. The estimates range from about $100 billion to about $120 billion, he said, with that money being paid directly by Medicaid to providers such as nursing homes or home health agencies.

Gleckman added that both the new Congress and new administration will focus a lot of their attention on entitlement reform.  

Indeed, Sen. Thom Tillis, R-N.C., another Aging Committee member, said at the Genworth event lawmakers’ goal should be to ensure that the federal government is “not getting in the way” of private sector LTC solutions.

Senate Finance Committee Ranking Member Ron Wyden, D-Ore., introduced a bill Wednesday that would improve Medicare coverage for seniors and individuals with disabilities.

The “Medicare Affordability and Enrollment Act” would establish an out-of-pocket spending cap, streamline the Medicare enrollment process by reducing penalties and roadblocks for those seeking coverage, and make the program more equitable for lower-income seniors and individuals with disabilities.

Tom McInerney, Genworth’s president and CEO, noted at the event 10,000 people in the U.S. are turning 65 daily, adding that while the private LTC market is helping them pick up some cost it’s only at about 8%. “We should focus on increasing that to 20% to 30%,” he said.

He also noted that 70% of care is given in the home today, a “trend that will continue.”

In 10 years, the baby boomers will be turning 85, he continued. “We don’t have a lot of time to get going in creating the [LTC] solutions.”

Katherine Hayes, director of health policy at the Bipartisan Policy Center, noted that while there’s “no one product” to address boomers’ LTC needs, she sees “shorter-term policy solutions” being developed, adding that there needs to be both private and public sector options.

Gleckman added that while “it is very late for the boomers, there are still ways for people to use savings, short-term insurance and home equity” to pay for a couple years of care, and then catastrophic insurance to pay for the rest. 

He noted that catostrophic insurance would be available in a “reformed” LTC system, as it’s not available in the current system.

Gordon Saunders, Genworth’s senior brand marketing manager, noted the statistic that 34.2 million U.S. adults are a voluntary unpaid caregiver to someone over the age of 50, and that the cost of care continues to rise.

In 2016, the cost of a private nursing home room came in at $92,378, while the median income was at $54,000. 

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