Greetings – Here are some Medicaid updates from the Evelyn Frank Legal Resources Program, with links for where to find more information.
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URGENT:  Let Congress Know You Oppose Cuts in Medicaid and Health Insurance!

The House of Representatives is getting ready right now to vote on a bill that will take away health insurance for 24 million Americans, cut Medicaid funding by 25%, and put the health of older adults in peril.

Representatives are under pressure to vote yes and need to hear from constituents TODAY.   Call your Representative today at 1-866-426-2631 and tell them to vote NO on the AHCA that Republican leaders are rushing through Congress. The bill is bad and getting worse.  In particular, these New York Congresspeople need to hear from you:

NY-11 – Staten Island Dan Donovan @RepDanDonovan
NY-24 – Syracuse/Auburn/Oswego John Katko @RepJohnKatko
NY-02 – Long Island Peter King @SI_PeterKing
NY-01 – Long Island Lee Zeldin @RepLeeZeldin

CALL CONGRESS NOW at 1-866-426-2631 and tell them to protect healthcare for seniors. Ask your Representative to publicly oppose the bill.

The American Health Care Act would leave many older New Yorkers without health care, or  harder for them to afford the health care they need.  About 11.4% of New York’s Medicaid beneficiaries are older adults; approximately 712,000 people ages 50-64 and 687,000 seniors in New York benefit from Medicaid.

Under the AHCA:
  • Older New Yorkers may lose access to nursing home care, home health care, and other services that help them maintain their independence.
  • Proposed cuts to Medicaid would slash federal funding by $880 billion, forcing states to cut important services for older adults, such as long term services and supports.
  • Approximately 423,387 New Yorkers received long-term services and supports through Medicaid.   Medicaid is the primary payer for 67% of nursing facilities in New York.
The proposed Medicaid cuts will grow over time, making it hard for New York to meet the needs of its growing aging population. By 2025, the number of New Yorkers over age 65 is expected to grow by 22.5%. The number of New Yorkers over 85, a population that relies on long term services and supports, is expected to grow by 12.4%.

Older adults may not be able to afford to pay their health insurance premiums. As of 2016, 126,000 New Yorkers age 50-64 received tax credits to purchase coverage through the Marketplace.  Nationwide, one in four people (26%) enrolled in Marketplace plans are ages 55-64.   For a 60-year-old living in Ithaca, New York with an income of $30,000/year, tax credits for paying insurance premiums could drop by 18% in 2020. The ACA tax credit would be $4,850, but the AHCA tax credit would only be  $4,000.
  • By changing the 3:1 limit on age rating to 5:1 (or higher if state law permits), premiums for older adults would  increase relative to younger adults. This “age tax” by itself would raise premiums in New York by $2,661 annually  for a 60-year-old.
The proposed bill also rolls back expanded Medicaid coverage, which currently provides affordable health care to  2,161,100 New Yorkers, including many 50- to 64-year-olds.

New York is one of twelve states that improved its Medicaid program to help people dually eligible afford their  Medicare premiums and cost sharing, benefiting 850,000 New Yorkers. The proposed Medicaid cuts put this help
at risk.

AHCA includes a huge tax cut, totaling $117 billion, for wealthy individuals that will harm Medicare’s financing in  the short and long term, putting people with Medicare at risk for benefit cuts.

AHCA opens the door to premium support (or vouchers) which would likely put the 20% of New Yorkers ages 50-64  at risk for paying higher out-of-pocket costs once they enroll in Medicare.

Older New Yorkers can’t afford to pay more for health care. The median personal income among New Yorkers ages  65 and older in 2015 was $21,500.

There would be fewer resources to fund Medicare.

Among the other  harms this bill will cause:
  • People with pre-existing conditions - many of whom are ages 55 - 64 - won’t be able to find plans that cover the services they need. Without essential health benefits standards, pre-existing conditions protections that benefit 8.6 million New Yorkers would exist in name only. Repeal of essential health benefits would drive a race to the bottom, with insurers dropping coverage for everything from chemotherapy to high-cost drugs to discourage enrollment by sicker, more costly enrollees. So people with pre-existing conditions wouldn’t be able to find the coverage they need at any price, much less an affordable one. The fact that insurers have to sell them coverage is meaningless if they can’t find a plan that covers the treatment they need.
  • Plans will be able to impose annual and lifetime limits on coverageincluding for  New Yorkers who get health coverage through their jobs. The ACA prohibited plans from imposing annual or lifetime limits on coverage – but only on coverage of essential health benefits. Plans can still impose annual or lifetime limits on services not classified as essential health benefits (say, adult dental coverage). That means that if essential health benefits standards are repealed, plans could once again impose annual and lifetime limits on everything from emergency services to inpatient care to prescription drugs, even for kids. 
  • Before the ACA, 6.4 million New Yorkers with private health insurance – the large majority with employer plans – had policies that imposed lifetime limits on coverage. Repealing essential health benefit requirements means going back to a time when thousands of New Yorkers with health coverage through their jobs were one major illness away from medical bankruptcy.
Individual market plans won’t cover substance use treatment, mental health treatment, maternity care, or other key services.

Please see this Fact Sheet  by Justice in Aging on how the AHCA harms older adults for more information.

Please pick up the phone today!  Help save these crucial benefits - not just the ACA but Medicaid that has been a lifeline to health care for over 50 years!
Contact EFLRP at 212-613-7310 or 

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