Advocates for People with Disabilities Urge Repeal of Medicaid Cap

Advocates for people with disabilities say the cap New York put on Medicaid spending in 2011 doesn’t keep pace with growing health-care needs and they’re urging lawmakers to finally repeal it.

Gov. Andrew Cuomo’s 2021 to 2022 budget proposal calls for extending the Medicaid cap for two more years.

But according to Heidi Siegfried – director of health policy at the Center for Independence of the Disabled New York – the cap is arbitrary, unrelated to growth in Medicaid enrollment, and unresponsive to medical needs.

“It’s really affected people with disabilities,” said Siegfried, “who rely on long-term home care in particular to stay out of nursing facilities and to get the services they need to remain in their home.”

She said lawmakers in both the state Assembly and Senate have introduced legislation to repeal the Global Medicaid Cap.

With the pandemic, Medicaid enrollment in New York has increased by more than 700,000 in the past year. And Siegfried noted that last year Cuomo wanted to limit eligibility for home care under the program.

“Even before the increase in enrollment,” said Siegfried, “we saw that the services that we rely upon are the services that are really being targeted for cuts. And it was driven by the Medicaid global spending cap.”

The cap also allows the state’s Division of the Budget to unilaterally cut the Medicaid budget in mid-year without legislative oversight to keep spending under the cap.

Siegfried pointed out that the federal government generally picks up about half of Medicaid costs in the state, and during the pandemic that has been increased.

“And in the most recent relief bill that was signed by President Biden,” said Siegfried, “they put an additional increase for Medicaid if the state would spend it to improve home and community-based services.”

She added that, with few exceptions, home care is less expensive than forcing people into long-term care facilities.

Defensores de personas con discapacidades dicen que el limite que Nueva York impuso al gasto de Medicaid en 2011 no sigue el ritmo de las crecientes necesidades de atencion medica y estan pidiendo a los legisladores que finalmente la anulen.

La propuesta de presupuesto del gobernador Andrew Cuomo para 2021 a 22 exige extender el limite de Medicaid por dos anos mas.

Pero segun Heidi Siegfried, del Centro para la Independencia de los Discapacitados de Nueva York, el limite es arbitrario, no esta relacionado con el crecimiento de la inscripcion en Medicaid y no responde a las necesidades medicas.

“Realmente ha afectado a las personas con discapacidades” dice Siegfried “que dependen de la atencion domiciliaria a largo plazo, en particular, para quedarse fuera de los centros de enfermeria y obtener los servicios que necesitan para permanecer en su hogar. ”

Ella dice que los legisladores tanto de la Asamblea estatal como del Senado han introducido una legislacion para derogar el limite global de Medicaid.

Con la pandemia, la inscripcion a Medicaid en Nueva York aumento a mas de 700 mil en el ultimo ano. Y Siegfried senala que el ano pasado Cuomo queria limitar la elegibilidad para la atencion domiciliaria en este programa.

“Incluso antes del aumento en la inscripcion, vimos que los servicios en los que confiamos son los que realmente estan siendo objeto de recortes. Y esto fue conducido por el limite de gasto global de Medicaid”, dice Siegfried.

El limite tambien permite a la Division de Presupuesto del estado recortar unilateralmente el presupuesto de Medicaid, a mediados de ano, sin supervision legislativa para mantener el gasto por debajo del tope.

Siegfried senala que el gobierno federal generalmente asume aproximadamente la mitad de los costos de Medicaid en el estado, y durante la pandemia eso se ha incrementado.

“Y en el proyecto de ley de ayuda mas reciente, el cual fue firmado por el presidente Biden,” dice Siegfried, “puso un aumento adicional para Medicaid por si el estado lo gastara, para mejorar los servicios basados en el hogar y la comunidad.”

Ella agrega que, con pocas excepciones, la atencion domiciliaria es menos costosa que obligar a las personas a ingresar a centros de atencion a largo plazo.

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