This spring, “Mark,” a 65-year-old man from California, lost the toes on his right foot. Doctors had no choice but to amputate them after he developed complications from a staph infection. With a monthly income of US$1,499 from Social Security, Mark relies on Medicaid to pay for the nursing facility where he currently resides and for the rehabilitation sessions that are, as he put it, teaching him “how to walk again and do things without the use of [my] right foot.”
The Graham-Cassidy bill, now approaching a Senate vote, would hit older Americans hard, threatening their right to health, including the ability to live safely, with dignity, and as independently as possible. It would drastically cut federal funding for Medicaid. It would also allow insurers to charge premiums based on age and impose lifetime caps on coverage. Perhaps most harmful, the bill would open the door to allowing insurers to charge higher premiums for people with pre-existing conditions.
In a letter urging US Senators to reject the legislation, the AARP noted that 25 million Americans age 50 to 64 have pre-existing health conditions. This provision along with others would likely put health insurance out of reach for millions of older Americans. The bill would also eliminate existing subsidies for purchasing private insurance, which could leave many more older Americans without insurance: currently some 6 million people age 50 to 65 buy their health insurance on exchanges, and more than half qualify for tax credits to help them afford it.
Long term care poses a major financial challenge for older Americans, and older women in particular. Older women have higher rates of poverty than older men; almost twice as many older American women live in poverty as older men. At present, Medicaid covers stays in nursing facilities that exceed 100 days. Medicaid cuts would hit older women particularly hard; 70 percent of nursing home residents are women.
Human Rights Watch has warned about the harms older Americans and others would face under previous attempts to remove the Affordable Care Act in the US. The Senate needs to recognize that the accessibility of health care for older Americans would suffer under the Graham-Cassidy bill. As Mark told us: “Medicaid was not important to me until I got sick. I think that’s the way it is with a lot of elders. They won’t know it is a problem until it’s too late.”