Larry Letters

Larry Letter: Why the House Budget Proposal Should Anger You

by Published On: Apr 08, 2011Updated On: May 05, 2011

If you have never been incensed about public policy and its impact on our field, now is the time.

A budget proposal submitted this week for fiscal year 2012 calls for major cuts in Medicare, Medicaid, senior housing, and Older Americans Act programs.

This proposal will likely come to the floor of the U.S. House of Representatives for a vote the week of April 10, when many of you will be in Washington, DC, to visit your legislators during our Future of Aging Services Conference. We need to make all members of Congress aware of the harm this budget would do to the aging-services field and the people we serve.

Among the cuts called for in the budget resolution are the following:

  • Transforming Medicaid into a block grant program with a reduction in federal Medicaid funding of $750 billion over the next 10 years. That means states will get a set amount of money for Medicaid no matter if needs increase. Do we really want to ration care?
  • Converting Medicare into a voucher program for those now aged 55 and under, beginning in 2022. Also an increase in the Medicare eligibility age to 67. As a member of Congress said earlier this week at a press event, this is equivalent to turning Medicare into a discount card program. Do you want a health care system where some people get to go to Neiman Marcus but others can only go to the Dollar Store? Are these American values we’ve developed?
  • Repealing the Community Living Assistance Services and Supports (CLASS) plan for financing long-term services and supports. CLASS is a new program that will help people plan for and take responsibility for their long-term services and supports needs. It is voluntary, puts money in the hands of consumers and makes it easier for those who need services and supports to stay at home. Why would we scrap CLASS before it has a chance?
  • Making eligibility for rental assistance and supplemental nutrition assistance (food stamps) contingent on a work requirement. Believe it or not, the budget resolution does not exempt seniors or persons with disabilities. Can all of your residents and clients get a job and go to work? Should poor, frail seniors need to work to have basic food and shelter?
  • Decreasing spending on Section 202 and 811 housing, Section 8 rental assistance, senior nutrition, transportation and social services programs would be ratcheted down to 2008 levels and held there for the next 5 years. There are already long waiting lists for these services. Members have used these programs to help people for two generations and have repaid the loans. How can we scale them back when our country needs more?

These proposals are unethical based on the American character, and they reflect bad economics.

Seniors would lose coverage for essential long-term services and supports as well as access to affordable housing and rental assistance. Direct-care workers would suffer wage cuts and job losses. Family caregivers would lose the supportive services that enable many of them to remain employed while maintaining an elder at home.

As the Congressional Budget Office (CBO) said in a recent report, “Given that payment rates for providers under Medicaid are already generally lower than they are under Medicare and private insurance, if states lowered payment rates even further, providers might be less willing to treat Medicaid enrollees.” In Illinois, the Medicaid reimbursement rate is equivalent to about $5 per hour. That's less than what people pay for a babysitter or a dog walker.

CBO goes on to say that if enrollees are cut out of Medicaid, there is going to be more uncompensated care. This means more emergency room visits, longer hospital stays, fewer jobs, lower quality care, more lawsuits, more regulation, and higher insurance premiums. Is that good economics?

Every family is one health care event away from needing long-term services and supports. Under this budget proposal, families would have to pay more for less coverage and fewer services. It is unconscionable for these policy makers to think we should address the country’s financial woes on the backs of vulnerable people and those who care for them.

Please Contact Congress and urge your senators and representatives not to support this proposed attack on programs that are there when the phone rings in the middle of the night and Grandpa has a stroke or Mom has to choose between paying rent and buying groceries.

Tell them our country’s seniors need a safety net, not a black hole.

Helping people is the solution for a healthy and viable America, not the problem. Now is the time to be vocal about your anger.

Now is the time to act.


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