My son has multiple disabilities and depends on a Medicaid waiver to live at home, get the health care he needs, and the ability to participate in school and community. This waiver also gets him nursing services that allow us, his parents, to work. I ask that Sen. Donnelly works to advocate for Medicaid not being limited by a block grant or capped spending. I have some thoughts to share on why this is not only the right thing to do, but the fiscally responsible thing to do as well.The parents and children in the Medicaid expansion represent a small amount of cost and a small percentage of the population. Cutting there will not save much. People with disabilities who depend on Medicaid waivers may seem to take a lot of money to maintain, but this is a small percentage of what it would cost if they lost waiver services and Medicaid coverage and were then institutionalized, as many would need to be. Nursing homes are much more expensive than home and community based waivers. In addition, there are opportunities for cost containment with the sick and disabled (like my son, by the way) through case management and care coordination, that helps individuals and families find ways to communicate their plans of care, medications and services from all of their medical and community providers to all their other medical and community providers. This improves life for the individuals and families, especially when the care coordination is family-centered, and reduces unnecessary and duplicative spending that can be a common problem with individuals involved in multiple systems of care.
In addition, I found these excellent questions that anyone, including legislators, should ponder when trying to decide what to do with Medicaid.
Medicaid is the nation’s largest health insurer for children. Thirty-three million children rely on Medicaid/CHIP for health care coverage. How many of them will lose their guarantee of coverage under the proposal to cap federal Medicaid funding to states?
Medicaid is the nation’s largest health insurer for kids with disabilities or other special health care needs, covering 43% of them. How will capping federal Medicaid payments to states affect their guarantee of coverage? How would the loss of coverage affect their health and their families’ economic security? I've already told you how devastating it would be to our family.
Medicaid is the nation’s largest insurer for births, covering about 48% of newborns to ensure a healthy delivery and strong start during their critical first year of life. If federal Medicaid payments to states are capped, will pregnant women and new mothers and their babies still have a guarantee of coverage? If not, how will this affect infant mortality?
Medicaid offers a child-centered benefit package (EPSDT) that covers all of the screenings and treatments recommended by pediatricians. If federal Medicaid payments to the states are capped, what will happen to these benefits and the children whom rely on them for their healthy development?
If the federal government caps Medicaid payments to states, will children covered by Medicaid be able to keep their doctors and continue to be cared for by their local hospitals?
Medicaid provides the lion’s share of federal funding flowing into state treasuries. How much will capping federal payments to states cut from my state’s federal revenues? How much will those cuts limit my state’s ability to keep children and families covered?
How will a federal Medicaid funding cap impact centers of excellence such as children’s hospitals, teaching hospitals, or specialty providers like the Cleveland Clinic or Mayo Clinic? Or Riley Hospital for Children in Indiana? Will they be able to continue serving as community resources to children and families?
Thanks for your work on behalf of Hoosiers. Please keep in mind my son in family, and the many families like ours, when you think about who you represent.
Beth DeHoff
Plainfield, IN
