From DC: Impact of Medicaid Unwinding, CMS Guidance Update, and House Hearing on SSA Funding

November 22, 2024

From DC is Justice in Aging's weekly roundup of national news and resources about issues impacting older adults. To receive From DC in your inbox as soon as its published, sign up for our mailing list.

Here’s what we’re watching in Washington:

Millions of Dually-Eligible Medicaid and Medicare Enrollees Lost Coverage During Medicaid Unwinding

A recent NORC study found that 17% of individuals (1.6 million) dually enrolled in Medicaid and Medicare lost full Medicaid coverage from April 2023 to June 2024 during the Medicaid Unwinding period. This group includes older adults and people with disabilities who have high medical needs and significantly lower income and assets than their Medicare-only counterparts. Only 2.1% of those who lost Medicaid have re-enrolled despite likely being eligible.

Individuals who lost Medicaid eligibility (including eligibility for a Medicare Savings Program) before June 30, 2024 may need to take steps to maintain their Medicare Part D Low-Income Subsidy (LIS) for next year. People who are not eligible for LIS may want to choose a lower-cost prescription drug plan during Open Enrollment, which ends December 7.

Learn more in Justice in Aging’s fact sheet on LIS and Medicaid Unwinding. Also see Justice in Aging’s other resources on Unwinding for dually-eligible individuals and CMS's Unwinding guidance.

CMS Releases Revised Guidance for Nursing Facility Surveyors

The Centers for Medicare and Medicaid Services (CMS) recently published updated surveyor’s guidelines that explain and expand upon federal nursing facility regulations. Surveyors use the extensive guidelines to determine whether nursing facilities have violated the law. Advocates can similarly cite these guidelines on residents’ behalf.

CMS’s revised long-term care surveyor guidance will become effective on February 24, 2025. The revisions affect topics including:

Admission,
Invalidity of third-party (e.g., adult children) agreements to be responsible for nursing facility expenses,
Resident assessment,
Inappropriate psychotropic medication,
Evictions, and
Infection prevention and control.

Justice in Aging will provide further information about these revisions in the coming weeks. Learn more about our nursing facility advocacy in our resource library.

House Committee Holds Hearing on Funding for SSA

This week, the House Committee on Appropriations held a hearing to discuss the Social Security Administration’s (SSA’s) 2025 budget request. Social Security Commissioner Martin O’Malley testified at the hearing, urging Congress to invest in the agency to address customer service challenges.

Justice in Aging supports increased funding for SSA, which would improve service levels for older adults and people with disabilities on or applying for Social Security and Supplemental Security Income (SSI). Read more about Justice in Aging’s advocacy to improve the SSI program.