As we read about the political maneuvering and posturing in our nation’s capital, it’s often easy to dismiss all the noise because “it doesn’t affect us.” One case in point involves the cuts to Medicaid that were included in the legislation nicknamed “One Big, Beautiful Bill.” (We wrote about that bill here on the Blog last summer.)
Unless we either are on Medicaid or have loved ones who are, we might be tempted to ignore what experts call the “ripple effects” of the proposed cuts planned for upcoming years. We might assume only the poor will be affected. But according to this recent article from NextAvenue, that attitude is a serious error. In her article, health reporter Ashley Milne-Tyte explains that the cuts to Medicaid are going to have an adverse impact on all of us – from patients in the ER to those in need of long-term care. There’s a care crisis brewing.
We think this is an extremely sobering analysis. Take a look and see if you agree.
Harvard Geriatrician Warns Medicaid Cuts Will Affect Everyone
Reporter Milne-Tyte introduces us to Dr. Sharon Inouye, Harvard University geriatrician and professor of medicine. According to the NextAvenue article, her patients “are usually among the most vulnerable: everyone is on Medicare, and some are also on Medicaid.”
“But,” the article continues, “there’s one thing she’s clear on: the $911 billion reduction in Medicaid spending that is expected to occur over the next decade as part of the HR1 bill (or ‘one big, beautiful bill’ as President Trump calls it) won’t just hit those on Medicaid.
“A lot of people think it’s only the poor that are going to be affected by these changes,” Dr. Inouye told NextAvenue. “Wrong, wrong, wrong. It’s going to be everyone.”
Emergency Rooms Will Face Critical Overload
How is this possible, you might ask, if you’re not on Medicaid yourself? Take emergency rooms as a prime example.
“ERs are already overloaded with patients and have long waits for care,” Milne-Tyte writes. She also emphasizes a facet of the ER with which many of us are unfamiliar.
“Older adults are routinely boarded in the emergency room for days, sometimes even weeks, before they can get a hospital bed,” Harvard’s Dr. Inouye told NextAvenue. “And it’s been shown that being boarded in an emergency room is associated with a high mortality rate.”
Cuts in Care Are Making it “Hard to Age” in the U.S.
Dr. Inouye warns that this state of affairs in the ER will only intensify “when you add millions of people who are no longer on Medicaid because of a number of provisions introduced by the bill.” These new rules include work requirements, more stringent reporting, a higher bar to prove eligibility, and more administrative red tape. Those who fall off Medicaid will gravitate to emergency rooms when they need care, making ERs even more overcrowded.
NextAvenue spoke with Leanne Clark-Shirley, CEO of the American Society on Aging, who is blunt on the impact of the Medicaid cuts. “We are making it so hard to age in this country at a time when more of us than ever before will be aging,” she says.
Majority of Seniors Will Need Long-Term Care and Support
Reporter Milne-Tyte also spoke with Julie Robison, a professor at the University of Connecticut School of Medicine. Robison told NextAvenue that Medicaid cuts will affect older adults because of their impact on the caregiver workforce.
“While few of us want to think about depending on others for care,” Milne-Tyte observes, “most older people – regardless of income level – will need support at home, or elsewhere.”
She cites a 2021 government study which confirms that this is not just a problem for low-income senijors. The study “showed that more than half of older adults in the top earnings quintile would require long-term services and supports at some point.”
“Crisis” in the Caregiver Workforce Will Only Intensify
“You might hire someone to help you with meals or taking a bath. Lots of people need those supports,” Robison tells NextAvenue. But “a lot of the workforce who supplies those services are people who will be affected by the Medicaid cuts or [new] immigration policies.”
Milne-Tyle writes, “Robison and other experts on aging fear a future in which there won’t be enough staff – either home health aides or nursing home staff – to help older adults of all income levels when they need care. ‘There is already a crisis in the workforce for those jobs,’ [Robison] says.”
Medicaid Cuts Will Undercut Hospitals, Especially in Rural Areas
According to the NextAvenue article, smaller hospitals are also facing dire labor shortages and rising costs thanks to the new Medicaid rules.
She cites the example of 72-year-old Ron Rosenthal, an almost-retired business owner from rural Maryland. Rosenthal “has thought about the potential difficulty of hiring aides in the future, should he and his wife need them,” Milne-Tyte relates. “But for now, what worries him most about the Medicaid cuts is their effect on his small, local hospital.”
As Rosenthal tells NextAvenue, the hospital “has gone through difficult times, being a country hospital. It has a significant dependence on Medicaid as well as Medicare.” He adds that he and his wife are financially comfortable, but many county seniors rely on Medicaid.
Smaller Hospitals Will Have to Cut Already-Limited Services
Describing his local hospital, Rosenthal says, “They don’t have the staff nor the specialties that are going to support urgent care for really bad things.” Back in 2009, he suffered a heart attack while driving. Rather than head for the local hospital, “his wife took the wheel and drove him straight to Northern Virginia to be treated in what he says is one of the best hospitals in the Washington DC area.”
But as NextAvenue notes, the couple is less likely to drive that far for care as they age. “They would then be more reliant on the local hospital for care,” says the article. “[Rosenthal] doesn’t know exactly how the cuts will hit, but is concerned that the hospital will have to reduce its already limited services. That, he says, would have an impact on the whole community.”
“Ripple Effects” of Local Hospital Service Cuts Impact Entire Communities
Clark-Shirley of the American Society on Aging agrees funding cuts bring ripple effects.
“There’s food banks, senior centers, nonprofits [in the community] that are places where people right now go for education and training,” she told NextAvenue. “The demand [for them] can only go up in an environment where public dollars are cut to this magnitude.” However, as the article notes, funding for those organizations is itself uncertain.
Wealthy Patients Seek Answers in Concierge Medicine
Harvard’s Dr. Inouye is seeing the healthcare crisis from a unique vantage point: well-to-do friends offering to pay her extra for what is commonly called “concierge medicine.”
As Milne-Tyte states, Inouye describes receiving a number of phone calls “from wealthy people saying, ‘will you be my geriatrician?’” She says the callers want her to be their concierge geriatrician and navigate what they see as the increasingly precarious health care system on their behalf, as they age.
Inouye “routinely declines” these requests.” Instead, she hopes “something good can come out of this mess,” Milne-Tyte writes.
“I hope people will wake up…and we will be able to change our policies and our priorities in this country, and be able to rebuild our system after it’s blown up,” Inouye tells NextAvenue, “to improve efficiency and improve quality and do it in a way that, after things are unbuilt, they can be rebuilt to be better and more efficient and more equitable.”
Will Caregivers Discover Their Strength in Numbers?
Speaking of people waking up, Leanne Clark-Shirley hopes caregivers will use the power of their sheer numbers to affect health care policy.
“We have 63 million caregivers in the US,” she tells NextAvenue. “That is a heck of a collective voice. Caregivers need and want very similar things, they feel similar struggles, they feel similar joys and uplifts.”
As the NextAvenue article concludes, the awareness of caregiving and related issues has increased dramatically in the wake of the COVID pandemic. “Clark-Shirley hopes that as more and more Americans become caregivers, they will unite and speak up to bring about change both for themselves, and the older people they love,” Milne-Tyte says.
Rajiv Nagaich – Your Retirement Planning Coach and Guide
The long-awaited book by Rajiv Nagaich, called Your Retirement: Dream or Disaster, has been released and is now available to the public. Retirement: Dream or Disaster joins Rajiv’s ground-breaking DVD series and workbook, Master Your Future, as a powerful planning tool in your retirement toolbox. As a friend of AgingOptions, we know you’ll want to get your copy and spread the word.
You’ve heard Rajiv say it repeatedly: 70 percent of retirement plans will fail. If you know someone whose retirement turned into a nightmare when they were forced into a nursing home, went broke paying for care, or became a burden to their families – and you want to make sure it doesn’t happen to you – then this book is must-read.
Through stories, examples, and personal insights, Rajiv takes us along on his journey of expanding awareness about a problem that few are willing to talk about, yet it’s one that results in millions of Americans sleepwalking their way into their worst nightmares about aging. Rajiv lays bare the shortcomings of traditional retirement planning advice, exposes the biases many professionals have about what is best for older adults, and much more.
Rajiv then offers a solution: LifePlanning, his groundbreaking approach to retirement planning. Rajiv explains the essential planning steps and, most importantly, how to develop the framework for these elements to work in concert toward your most deeply held retirement goals.
Your retirement can be the exciting and fulfilling life you’ve always wanted it to be. Start by reading and sharing Rajiv’s important message. And remember, Age On, everyone!
(originally reported at www.nextavenue.org)
The post Will Ripple Effects of Medicaid Cuts Trigger a Health Care Crisis? appeared first on Home.
