📋 How Medicaid Changes Could Hurt Older Americans (AARP Article/Advocacy)

I really do wish that the various programs of Medicaid had some different names in order to identify them properly and understand who gets the services, what and how.  Sure would make it easier for people to understand all the different ones and how this may affect each of them, IF IT AFFECTS THEM AT ALL.

In my state, we pay family caregivers to take care of their MEDICAID eligible disabled loved ones.  There’s the work requirement that could be applied for the EXPANDED Medicaid recipient right there which the BBB would require - the son gets paid by his Mom’s LTC Medicaid coverage to keep her out of a nursing home by providing the everyday care that she needs - and he gets compliance for the work requirement.  Seems like a Win/WIn in this (story) situation.

Louisiana has a similar program except it is done a different way but possibly could still work.   The mom could still hire the son as her caregiver and satisfy the work requirement that he would need to stay on his ACA EXPANDED Medicaid.  Again Win/Win - where is the problem?  Plus it appears the state would monitor the caregiving to make sure that she is doing well with the caregiving he is giving to her.

Louisiana Office of Aging and Adult Services - Home and Community Based Services 

 from the link ~

Community Choices Waiver:

The Community Choices Waiver (CCW) is a home and community-based service that serves older adults and persons with adult onset disabilities as an alternative to nursing facility care. Based on a standardized assessment, each recipient is provided a budget based on acuity to create an individual service package. CCW contains a wide array of services, including support coordination, nursing and skilled therapy assessments and services, in-home monitoring systems, home modifications and assistive technologies, personal care, home-delivered meals, monitored in-home caregiving, and caregiver respite.

[ME] OR perhaps this other program could also work 

Long Term-Personal Care Services: 

The Long Term-Personal Care Services (LT-PCS) program provides help with activities of daily living for people who qualify for assistance under the program guidelines.  In addition to assistance with activities of daily living, this program also provides assistance with instrumental activities of daily living such as preparing meals, light housekeeping and medication reminders.  The LT-PCS program does not provide any type of medical or skilled care nor does it provide assistance 24 hours a day.  

Of course, every situation is different but when a state has certain options the writers of such human interest articles such as this, need to put in the time to figure out if there is already a better way for consideration.  

As to the 2nd story of the lady with stage 4 cancer and has been denied SSDI 3X - that makes no sense whatsoever - I do not know if she had a lawyer to file her 2nd claim for SSDI (BTW, the lawyer is paid after the fact by the SSA and is only paid once the claim is approved - the amount is a set amount.)

Again, we gave very difficult to understand programs and sometimes people do not know what to do in filing for benefits - it is a bureaucratic laden system that is not for the faint of heart to try to work through without help.

This woman needs to be on SSDI given her current health - and this can be done I am sure with perhaps some legal help.  

Also as it is now designed, it is easier to get EXPANDED MEDICAID without going thru the process of getting SSDI or SSI - this should not be how it works - this woman is definitely NOT an ABLED BODIED PERSON who the EXPANDED Medicaid program was designed to cover - she needs to be on Disability.  Not only for the disability Medicaid coverage but for the income also.  This is a situation where the benefit just does not fit the need and every situation is different. But people need to be on the best program for their needs -  

I think we all need a course in all the different Medicaid programs - and after this article evidently sanctioned by the AARP, they too need to be schooled on the right Medicaid benefit for a person’s need.

As simple as I can make it - Medicaid started out as a health program for the LOW INCOME

• elderly(65 +),
• blind,
• disabled -
• then we added children,
• then we added pregnant women + their newborns.  

The common thread for these programs is low income which also has an asset limit.  They are needy, the neediest.  Within these program there are sub-programs for some different needs but they are all under the original concept.  These programs remain the same - there is NO WORK REQUIREMENT in the Bill for those who get their Medicaid benefits under these categories - the low income elderly (65+), the blind, the disabled, the children, the pregnant women t + their newborns.

The ACA added a totally new classification of Medicaid - the ABLED BODIED ADULTS with low income - thing is, there is no asset test for these type individuals.  So you get a gamut of different types of people who may only be low income on paper.  There are students, people who have retired early, those who just don’t want to work or have some problem holding onto a job, those who may work “under the table”, etc.   Their common thread is that their income is low (not counting any assets they may have).  - too low for the ACA to subsidize (sometimes paying all ) their health care premiums for a regular ACA designed policy.  These are the ones that will have the work requirement of 80 hours a month or an approved substitute like volunteering or going to school - I don’t know what the end bill will look like specifically.

In addition to this coverage, the Federal government pays the state a higher rate than for those who are the neediest (mentioned above) - 

For the neediest categories, the government pays states a certain % of their care - for all states this comes in at between 50%-70%.

For the Abled Bodies Medicaid beneficiaries, the Feds pays the state 90% - this, in and of itself, bothers me.  IMO, it is actually a bribe for the state to add these individuals to their Medicaid rolls because these are the people that would most likely go without any coverage and end up in the ER for their care - I understand this but resent the fact that we are paying the state a higher rate for these individuals.  Seems to me that if taxpayers in the state where these individuals were needing care, that the Fed payment should be the same or less - maybe then the citizens in the state would pay  closer attention to who is within this Medicaid category.  

I have a hard time understanding why there is such resistance to some work requirement for these people but as I have said before each situation is different but people need to be on the MEDICAID program that best suits their needs. 

You do not go on the EXPANDED Medicaid program just because it is easier than filing for disability and having to wait for approval.  You file for the benefit that best suits the need and if a person cannot work in this low income ABLED BODIED category- then they are in the wrong Medicaid program.

📎  [Saturday 6/21/25] Dr. Oz applauds blue states rolling back migrant health coverage [THE HILL]

➡️[*** MY 1/2 CENT.

Finally, and now to hope my State of Virginia gets on this list. Over lack of medical staff & resources due to the illegals in my area. Legal Americans 1st. Then OTHERS if we have anything leftover. Geez!!! My area in Virginia is overloaded with them on Medicaid. Over it!

LINK TO ARTICLE.

https://thehill.com/policy/healthcare/5361875-dr-oz-medicaid-medicare-migrant-health-coverage/