https://www.forbes.com/sites/howardgleck...t-seniors/
Not sure how these will impact you, either directly or indirectly, but this is what is on the table in order to secure tax cuts in the upcoming GOP budget…
1. The biggest direct risk could come from cuts to Medicaid home-based care or other optional services. States are required only to provide Medicaid LTSS in nursing homes. Other benefits are provided through voluntary waivers. Congress or HHS could limit those home-based services. Home based LTSS ultimately sales money because the alternative, a nursing home, costs $8-9k per month, but its currently on the chopping block.
2. Congress also could extend the so-called lookback rule to limit Medicaid LTSS eligibility. Most states have both an income and asset test to determine whether someone is qualified to receive Medicaid LTSS. In most states, recipients are limited to no more than $2,000 in financial wealth. And Medicaid bars applicants from dropping below that limit by giving away or otherwise transferring funds within the last five years. Congressional Republicans may extend that look-back to 10 years or more.
3. States also could be forced to require heirs of Medicaid LTSS recipients to repay the program. For example, if someone receives $50,000 in Medicaid LTSS during their lifetime, their children would have to repay that $50,000 after their parent dies.
4. Directly cut the basic formula. The minimum basic federal contribution, called the Federal Medical Assistance Percentage or FMAP, is 50 percent. Removing that floor would cut federal spending by about $500 billion over 10 years. Reducing the rate for those who became eligible for Medicaid under the Affordable Care Act would save about $560 billion.
5. Cap the dollar amount the feds contribute. Currently, the federal contribution rises automatically as health and long-term care costs increase. With a cap, the feds would contribute a fixed dollar amount. The states would have to absorb any additional costs, either by raising taxes, reducing benefits, or cutting enrollment. Including a small adjustment for inflation, such a cap would save about $460 billion.
6. Impose a per-capita cap. This version would be similar to an overall limit on federal contributions, except it would be adjusted to reflect changes in Medicaid enrollment. It would slash the program by about $600 billion.
Bar states from taxing Medicaid providers, such as hospitals, home care agencies, and nursing homes. States use this provider tax to boost their Medicaid spending. This allows them to qualify for a bigger federal match without dipping into their general funds.
