Access to timely medical care and healthy food is a matter of life and death for people with chronic health conditions. Medicaid and SNAP work together to keep Pennsylvania’s older adults and people with disabilities safe in their homes, rather than being institutionalized. However, proposed Medicaid and SNAP cuts would cause people with disabilities and older adults to lose access to services that protect their health and independence.
Medicaid covers more than 737,000 seniors and people with disabilities in PA.
- Medicaid increases the diagnosis and early treatment of chronic conditions and provides comprehensive, high-quality, and cost-effective care.
- Seniors and people with disabilities represent only 27% of Medicaid recipients in PA, but 78% of state Medicaid spending is directed toward their care. These groups have more extensive health care needs and may require Long-Term Services and Supports (LTSS) at home or in facilities.
- Home and Community Based Services (HCBS) allow people to continue to live in their homes, engage in regular activities within their communities, and receive the same high-quality care they would receive in a nursing home. These services include hands-on assistance with bathing, toileting, eating, getting out of bed, walking, and more.
- These vital services would be among the first to be reduced, capped, or eliminated because they are optional, while nursing home care is mandatory. There is a very real risk that older adults and people with disabilities will be left with no other option but to enter nursing facilities, forced into isolation and deprived of community access. Nursing homes are also more expensive than HCBS and will increase the financial burden on states and taxpayers.
Cuts to Medicaid would reduce access to care for seniors and people with disabilities.
- Medicaid funding cuts would likely force states to reduce provider payment rates, which risks closures of hospitals and nursing facilities. Funding cuts would also reduce the number of providers who accept Medicaid, worsen quality of care, and further exacerbate the direct care workforce shortage.
- Medicaid makes Medicare affordable for nearly 500,000 Pennsylvanians enrolled in both programs. Cuts to Medicaid could increase low-income seniors’ out-of-pocket costs by thousands of dollars and place dental, vision, hearing, and other care out of reach.
- Many direct care workers can only afford health insurance through Medicaid. Without their own health coverage, caregivers may be forced to look for jobs outside of the nursing sector, leaving seniors and people with disabilities without vital care.
Medicaid and SNAP work together to keep Pennsylvanians healthy.
SNAP benefits are currently 100% federally funded. If the federal government starts requiring states to share costs and states cannot afford to pay the required amount, food assistance would be reduced by the percentage by which they miss the match. Under a 10 percent cost-share requirement, PA would have had to pay $427 million last year. If the state could only have funded half that amount, or $214 million, it would have been forced to cut SNAP in half.
- 44% of SNAP households include an elderly or disabled person. In Pennsylvania, SNAP puts food on the table for more than 280,000 seniors.
- Seniors who receive SNAP are less likely to skip needed medication due to cost than eligible non-participants.
- SNAP is associated with fewer nursing home and hospital admissions, especially among seniors, and less frequent visits to a doctor’s office or emergency room.
Block grants, per capita caps, and other structural changes are all cuts to benefits. Under block grants or per capita caps, states would receive a fixed amount of federal funding, regardless of medical necessity and rising poverty, food insecurity, or health care costs. These limits would be particularly devastating for people who have high health care needs. Proposals would shift the cost burden to states, which would in turn be forced to reduce eligibility or services.
Work requirements are cuts by another name.
There is no effective way to “exempt” older adults and people with disabilities from work requirements. Although work requirements often contain exemptions for people with disabilities, these carve-outs create more problems than they solve. Identifying what qualifies as a “disability,” ensuring that people know how to request an exemption, and creating a process that is accessible to request such an exemption has been proven expensive and unworkable.
- Exemption processes have proven complicated, expensive, and near impossible to administer fairly. Researchers found that people who reported they had a disability lost SNAP benefits at the same rate as people without a disability under SNAP’s existing work requirements.
- New paperwork requirements would overwhelm PA’s County Assistance Offices. Even eligible children and seniors would be at risk of gaps in access to benefits as red tape slows down processing across the whole program.
