Preserving & Expanding Access to Vital Services

The Affordable Care Act, along with the coverage and consumer protections it provides, is crucial for older adults. It expands health insurance coverage, access to home and community-based services (HCBS), and prevents
discrimination based on age and disability.

Issue Brief: 10 Year Check-Up: The Affordable Care Act Has Enhanced Access to Quality Health Care for Low-Income Older Adults, July 2019

Medicaid home and community-based services (HCBS) provide caregiving, help with chores, and other supports that enable older adults with disabilities to remain living at home and in the community, rather than being forced to separate from their families and move into nursing facilities. Because most people with disabilities cannot afford to pay for these supports and services out of pocket, they rely on Medicaid to do so.

Organizational Comments: Requesting CMS Rescind an Interim Final Rule That Ended Continuous Coverage Protections for Medicaid Enrollees During the COVID-19 Public Health Emergency, October, 2022

Fact Sheet: Investing in Medicaid HCBS is Good for Medicare, September 2021

Fact Sheet: Why Older Adults Need Bold Investment in Medicaid Home and Community-Based Services, July 2021

Primer: Medicaid Home and Community-Based Services for Older Adults with Disabilities April 2021

Retroactive Medicaid coverage is a key financial protection that helps older adults and others who develop sudden illnesses or long-term care needs access the care they need right away. It is a smart policy intended to protect low-income people from crushing medical debt in instances where they need emergency medical or long-term care and cannot apply for Medicaid immediately. But several states are eliminating this protection through Medicaid demonstration waivers approved by the federal government.

Issue Brief: What’s at Stake for Older Adults When States Eliminate Retroactive Medicaid Coverage? September 2019

Fact Sheet: What's at Stake When States Eliminate Retroactive Medicaid Coverage? September 2019

Medicaid is an important source of health insurance coverage for many of the 40 million family caregivers in the United States who do not have access to other affordable coverage options. However, many states are in the process of designing or implementing policies that require family caregivers and others who are eligible for Medicaid to work a certain number of hours per month or qualify for an exemption to maintain their health coverage. Low-income family caregivers may be unable to work sufficient hours at a paid job because of their caregiving responsibilities and may not qualify for the state’s exemptions. As a result, many will lose access to health care they need to maintain their own health, harming both their own well-being and the well-being of the older adults they care for.

Fact Sheet: Medicaid Work Requirements: Red Tape That Would Cut Health Coverage for Older Adults, April 2023

Issue Brief: Medicaid Work Requirements-The Impact on Family Caregivers and Older Adults, November 2018

Fact Sheet: The Impact of Medicaid Work Requirements on Family Caregivers and Older Adults, November 2018

Webinar: The Impact of Medicaid Work Requirements on Family Caregivers and Older Adults, December 2018

Amicus Brief: United States District Court for the District of Columbia This amicus was filed on behalf of New Hampshire Medicaid beneficiaries age 19-64 who gained coverage under the state’s Medicaid expansion, but now stand to lose that coverage because the federal government approved the state’s request to impose work reporting requirements, May 2019

Check out our Resource Library for comments we have submitted opposing Medicaid Work Requirements.

Non-Emergency Medical Transportation (NEMT) is a federally required Medicaid benefit. Within certain guidelines, each state Medicaid program is given significant discretion in crafting the NEMT benefit for Medicaid beneficiaries. This important program currently serves over 7 million Medicaid enrollees who, due to cognitive and physical changes, may have a reduced ability to drive or use public transportation. The Centers for Medicare and Medicaid Services (CMS) has signaled that it will allow states to make these benefits optional, putting them under threat of cuts or elimination.

Issue Brief: Medicaid Non-Emergency Medical Transportation An Overlooked Lifeline for Older Adults, October 2016

Federal law requires that state Medicaid programs attempt to recover costs  from estates of deceased recipients. Estate claims often force heirs to sell a family home that otherwise would have been passed down. Because home ownership is one of the few ways to build generational wealth for lower-income families, the burdens of estate recovery fall disproportionately on economically oppressed families and communities of color.

Issue Brief: Medicaid Estate Claims: Perpetuating Poverty & Inequality for a Minimal Return