Illustration by Bloomberg View

By the Editors 2012-09-09T22:30:27Z

As the dust settles from the political conventions in Florida and North Carolina, one issue important to the health care of older Americans is rising into the sunlight and finally getting some of the attention it needs.

We dont mean Medicare; for months, the campaigns have taken regular shots at each other on that.

We mean Medicaid, the program generally thought of as health insurance for poor families. Yet one-third of Medicaids budget -- about $120 billion -- goes to fund long-term care for the disabled and frail elderly, most of it in nursing facilities.

People who need custodial care often fall back on Medicaid after theyve used up their own resources and can qualify for the programs very low income and wealth limits.

Even though President Barack Obama and his Republican challenger, former Massachusetts Governor Mitt Romney, have said little specifically about long-term care, its clear from their general views on Medicaid that they differ on how much to continue this support. Obama intends to preserve Medicaid as an entitlement program -- which means it promises to pay all acceptable expenses that arise for qualified beneficiaries. He even plans to expand the program, starting in 2014, to cover 11 million more Americans, including people with income as much as 138 percent of the federal poverty level.

Presumably, then, if Obama is re-elected, support for nursing-home care would continue -- though it could be squeezed a bit by budget constraints, especially after 2020 when the federal government stops financing 100 percent of Medicaids expansion.

Romney has endorsed his running mate Paul Ryans proposal to change Medicaids structure entirely, so that it would no longer be an entitlement program at all. Instead, the federal government would give the states block grants to spend on health care as they please. (The idea is to make the program work better by giving states more control.)

These grants would increase every year at a rate of 1 percentage point more than inflation, but this would be significantly less than Medicaids budget is expected to expand under the current structure along with the changes set in motion by the 2010 health-care law. By 2022, the difference would add up to a budget cut of about $1.26 trillion, a new analysis by Bloomberg Government shows. That would mean considerably less money for long-term care -- and everything else Medicaid pays for.

Read the rest here:

Insurance That Would Serve Seniors Better Than Medicaid