Protecting America's Seniors and People with Disabilities: Why It Is Important to Preserve the Maintenance of Effort Requirement in the Affordable Care Act 

A Series of State Fact Sheets from Families USA—Spring 2011

For 5.9 million seniors and 8.8 million people with disabilities, Medicaid is a vital safety net that helps them get the critical health care services they need. Medicaid covers services that other programs, including Medicare, do not cover, such as the home health aide and personal attendant services, as well as nursing home care. The Affordable Care Act includes an important protection that prohibits states from reducing their Medicaid eligibility levels or changing the rules to make it harder for people to enroll in Medicaid. This protection is referred to as the “maintenance of effort,” or MOE, requirement. This Affordable Care Act provision acts as a bridge to 2014, ensuring that important health coverage remains in place until the new law is fully implemented.

Right now, many states are considering making cuts to Medicaid. On January 7, 2011, governors from 28 states sent a letter to President Obama and congressional leadership asking Congress to remove the maintenance of effort requirement. Stripping this important protection from the law would allow states to cut Medicaid eligibility, which could place many of the 14.7 million seniors and people with disabilities who rely on Medicaid at risk of losing the health coverage they depend on. And the consequences extend beyond beneficiaries—their families, their communities, their states, and their states’ economies would also be harmed.

NOTE: On May 12, 2011, Families USA released a national report and 51 state reports with new data on how cutting Medicaid will harm seniors and people with disabilities who need long-term care.