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States, Feds in Clawing Match That May Cost Poorest
Seniors Dearly
 July
12, 2005 – Federal and state governments are in a “clawing match” and
the losers in the fight will most likely be some of the poorest senior
citizens in America. And, it is a loss that could be fatal, as their
Medicaid coverage is yanked by their state government that is trying to
keep from giving money back to the federal government. Estimates are
that in Florida, which has already begun the process, as many as 77,000
elderly and disabled will lose their Medicaid assistance.
The following is from ElderLawAnwers.com and at the
end of the story is a link to the full report by Families USA.
New Medicare Drug Law Puts Lowest-Income Elderly
at Risk
A little-noticed provision of the new Medicare drug
law will cause serious — and perhaps irreparable — harm to many of the
lowest-income elderly and people with disabilities, according to a
special report issued by the national consumer health organization
Families USA.
Those most at risk of losing essential health care
services are the 6.4 million low-income individuals who receive both
Medicare and Medicaid, also known as “dual eligibles.”
On January 1, 2006, when the new drug law takes
effect, dual eligibles will begin receiving drug coverage through the
Medicare drug benefit rather then through Medicaid. In order to help
finance the new drug benefit, states are required to pay the federal
government most of the savings that they would realize from no longer
having to provide drugs to dual eligibles under their Medicaid programs.
This provision is called the “clawback” payment because the federal
government is seen as “clawing back” the savings that would otherwise
have accrued to the states.
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The only way states can reduce their clawback
payments is by reducing the number of dual eligibles currently enrolled
in Medicaid.
“The clawback formula creates a perverse incentive
to cut the poorest of the poor off the Medicaid program because that is
the only way states can reduce their payments to the federal
government,” said Ron Pollack, Executive Director of Families USA.
“Unfortunately, this will threaten the health and well-being of the most
vulnerable elderly and people with disabilities.”
Three states—Florida, Mississippi, and
Missouri—have already announced plans to reduce or eliminate Medicaid
coverage for some or all elderly enrollees and people with disabilities.
It is estimated that 77,000 elderly or disabled beneficiaries will lose
Medicaid coverage in Florida alone.
Although there is no way to predict which states
will follow the lead of Florida, Mississippi, and Missouri in cutting
enrollees, it is highly likely that other states will at least consider
such cuts as they look for ways to reduce spending.
The people who will be hit hardest by the loss of
Medicaid coverage are those who currently live at home or with their
families, rather than those in long-term care facilities.
Click here for a copy of the report
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