Under federal law, state Medicaid programs are required to cover nursing home care. But state officials decide how much to pay facilities, and states under budgetary pressure could decrease the amount they are willing to pay or restrict eligibility for coverage.
“The states are going to make it harder to qualify medically for needing nursing home care,” predicted Toby S. Edelman, a senior policy attorney at the Center for Medicare Advocacy. “They’d have to be more disabled before they qualify for Medicaid assistance.”
Daughters Will Suffer From Medicaid Cuts
House Republicans’ proposal to slash federal spending on Medicaid by some 25 percent over 10 years, shifting costs to states that could not afford them, would be devastating, because nursing homes, home care and community-based programs for the elderly account for almost two-thirds of Medicaid spending. One of the few ways that adult children can get help with caregiving duties is Medicaid’s support for seniors, which many middle-class people qualify for after spending most of their income and assets on long-term care. Cutting Medicaid could make it more difficult to qualify, so more adult children would have to care for their parents.
The stresses, which are already significant, would become extreme. The researchers at Boston College found that these caregivers spend an average of 77 hours per month with their parents, the equivalent of about two weeks of full-time work. That time is money. Calculations based on the American Time Use Survey indicate that caregivers effectively forfeited $522 billion in 2012 due to such duties; that is more than double the total cost of formal care, at $211 billion. Women caregivers were more likely than men to retire because of these demands, and those who kept working reduced their workweeks by three to 10 hours on average. Beyond this sacrifice, caregivers spend 35 percent of their own budget on parental care, surveys indicate.
