Medicaid issues, not Medicare issues, get fixes in Biden budget

WASHINGTON – Medicaid issues are proving a winner on President Joe Biden’s social agenda, even as divisions force Democrats to pause on sweeping improvements to Medicare.

Biden’s budget plan released Thursday would fulfill a campaign pledge to help poor people excluded from Medicaid expansion in the South due to partisan battles, and it would give low-income seniors and people with disabilities more options to stay out of nursing homes by getting support in their home. It also calls for 12 months of Medicaid coverage after childbirth for low-income mothers, seen as a major step in addressing national maternal health gaps that disproportionately affect black women.

But with Medicare, Democrats couldn’t reach consensus on prescription drug price negotiations. Polls show broad bipartisan support for allowing Medicare to negotiate lower prices, but a handful of Democratic lawmakers – enough to block the bill – echo the pharmaceutical industry’s arguments that it would hold back investments that boost the drug industry. ‘innovation. Advocacy groups express their outrage at this omission, with AARP calling it “a monumental mistake”.

Not getting a prescription drug deal has consequences. Without the expected savings from falling drug prices, Medicare dental coverage for the elderly is suspended, as is vision coverage. The Biden framework calls for covering hearing aids, which are much less expensive. Also on hold is a long sought after limit on drug costs for Medicare beneficiaries. Discussions continue around a more limited approach to drug price negotiations, according to a senior Democratic House official, who spoke on condition of anonymity to describe a fluid situation.

While traditionally Medicare has been politically favored, Medicaid has long been seen as the stepson of health care programs because of its past links with social assistance. Just a few years ago, former President Donald Trump and a Republican-led Congress tried unsuccessfully to put a funding cap on the federal state’s program.

In this battle, “many people have realized the importance of Medicaid to their families and communities,” said Judy Solomon of the Center for Budget and Policy Priorities, a nonprofit organization that advocates for low-income people. “I think there has been a new appreciation of Medicaid, and we are seeing it.”

As Medicaid has grown to cover over 80 million people, nearly one in four Americans has become politically central to Democrats. Biden’s Medicaid provisions have a strong racial justice dimension, as many people who would benefit from access to health insurance in the South or expanded coverage for new mothers across the country are black or Hispanic. .

Scaling up Medicaid has been the political priority of Democrats in the Deep South states for years, citing the poverty and poor health that plagues much of the region. The decision of some Republican-led states to reject the Medicaid expansion under Obama’s health care law meant that 2 million poor people were essentially excluded from coverage in a dozen states, and 2 more. millions unable to afford even subsidized plans. Texas, Florida and Georgia are among Medicaid’s reluctance.

Georgia Sens. Raphael Warnock and Jon Ossoff campaigned to close the Medicaid coverage gap, and it was their election that put the Senate in Democratic hands this year. Warnock made getting Medicaid to solve his signature issue.

“Georgians have come forward in historic numbers to change the shape of our federal government, and many have done so in the hope that Washington would finally come full circle on the Care Act promise to afford affordable and make care coverage. health care accessible to hundreds of thousands of people. Georgians who are currently uninsured, ”Warnock, the state’s first black US senator, said in a statement on Thursday.

Achieving great achievement is most urgent for the freshman, as he risks re-election next year as part of a quest for a full six-year term. Several Republican opponents, including former great footballer Herschel Walker, are fighting to face him.

As part of the Biden Blueprint, eligible uninsured people in states that have not extended Medicaid could receive subsidized private coverage through HealthCare.gov at no cost to them. The fix is ​​only funded for four years, a budget gimmick meant to make cost estimates seem lower. Biden would also extend until 2025 more generous financial assistance that is already provided to consumers who purchase “Obamacare” plans.

Another major piece of Biden’s framework would allocate $ 150 billion through Medicaid to home and community care for the elderly and people with disabilities. That’s less than half the money Biden was originally looking for for his long-term care plan, but it will help reduce wait lists for services while improving wages and benefits for aides home.

The plan “marks a historic shift in the way our country cares for people with disabilities and elderly Americans,” said Senator Patty Murray, D-Wash., Chair of the health, education, labor committee. and pensions. “Getting this essential care won’t be just for the lucky few who can get off a waiting list. “

About 4 million people receive home and community services, which are less expensive than nursing home care. It is estimated that 800,000 are on waiting lists for such services.

The coronavirus pandemic has underscored the importance of a viable home care option for the elderly, as nursing homes have become deadly incubators for COVID-19.

In a sort of coda, the Biden executive also provides ongoing funding for Medicaid in the U.S. territories, including Puerto Rico. This would permanently re-authorize the popular Children’s Medicare Program, or CHIP, preventing periodic nail biting for nearly 10 million children. And that takes 12 months of continuous eligibility for children on Medicaid and CHIP, relieving families of the hassle of paperwork.

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