Introduction

Recently, congressional Republicans have offered a wide array of proposals that would significantly cut the Medicaid program. These proposals have come in different forms, including a proposal to convert the program to a block grant with much less federal funding, straightforward cuts in the program, and global caps on spending. The latest proposal enables the states to significantly reduce Medicaid eligibility and enrollment.

Since Medicaid was established to serve those with nowhere else to turn, deep cuts would cause great harm to the children, families, seniors, and people with disabilities who rely on the program, particularly those who need nursing home and other long-term care.

While most seniors and many people with disabilities are enrolled in Medicare, many of them also rely on Medicaid. For them, Medicaid pays for things Medicare doesn’t cover—like the costs of long-term care. Nationally, Medicaid is the largest payer of nursing home and other long-term care, covering 49 percent of all such costs. It is often the only avenue that seniors and people with disabilities have to get the long-term care that they need.

To assess the human impact of proposed Medicaid cuts on the frail seniors and people with disabilities who need support for long-term care, Families USA looked at the most recently available Medicaid enrollment and population data. We used these data to develop estimates of enrollment patterns today.2 We found that more than 16 million seniors and people with disabilities—one out of every four—rely on Medicaid. These individuals—and their families—will be at risk of losing care that they depend on today if Congress enacts Medicaid cuts like those in many of the Medicaid cutback proposals now being discussed.

Updated direct care workforce projections: This report includes data from PHI National on the growth needed in the direct care workforce to meet demand from 2006 to 2016. PHI plans to release updated workforce data covering 2008 to 2018 in June.