It's budget season again in Washington. Congress and the president are trying to agree on a budget for the federal government for next year, and health care for older Americans is front and center in the debate. In April, the House of Representatives passed a budget plan that calls for big cuts in both Medicare and Medicaid - two programs that seniors rely on for their health insurance. Here's what's at stake if the House budget proposal becomes law:
First, Medicare: Today, Medicare provides guaranteed health benefits to everyone 65 and older who has paid into the system (or whose spouse paid in). Many people with disabilities qualify the same way.
Within the House budget plan, however, no one born after 1956 could get the guaranteed health benefits people with Medicare get today. Instead, starting in 2022, they'd get a voucher to buy coverage from a private insurance company. That voucher would cover less than 40 percent of an average person's health care costs. The rest would have to come out of seniors' pockets. And the value of the voucher would not keep up with health care costs, meaning each year, seniors would pay more and get less.
Today's seniors aren't safe, either. The House budget proposal re-opens the Medicare prescription drug "doughnut hole" that the Affordable Care Act is gradually closing. If it becomes law, nearly 4 million people currently enrolled in Medicare would face higher prescription drug costs this year - costs that will grow to up to $6,000 a year by the end of the decade.
Second, Medicaid: Less attention has been paid to the House budget proposal's plans for Medicaid, but they are just as significant and troublesome. Medicaid is the primary source of coverage for long-term care. It's the main payer for 64 percent of people in nursing homes. Medicaid also covers home-based care for millions of seniors, allowing them to stay in their homes. And it provides health insurance to millions of low-income children and parents.
The program is funded by states and the federal government, but each state runs its own program based on federal guidelines.
The House budget proposal makes $1.4 trillion in cuts to Medicaid over the next 10 years, and by the last year of that period, federal funding would be cut by one-third. These cuts would force states to dramatically reduce the coverage they provide. Long-term care services would be slashed, just as large numbers of baby boomers start to need help.
The burden of providing this help will fall on families and friends, who will have to take time off of work to care for their ailing friends and relatives. No one wants to be a burden on their children, but without the help provided by Medicaid, many would have no alternative.
Supporters of the proposal say these are the tough steps we have to take to bring the deficit under control. But their numbers don't add up. In fact, the House plan barely nicks the deficit. That's because, for all the cuts to health care, it expands tax breaks for businesses and wealthy Americans.
There's no doubt we need to deal with the nation's fiscal problems, and making our health care system more efficient should be part of that solution. But an honest approach starts with making sure everyone pays a fair share, and not with dismantling the health insurance that today's and tomorrow's seniors are counting on.
Pollack is the executive director of Families USA.