This letter was also sent to Energy and Commerce Committee Chair Greg Walden along with members of both committees.

March 6, 2017

The Honorable Kevin Brady
Chair, House Committee on Ways and Means
1011 Longworth House Office Building
Washington, DC 20515

Dear Chairman Brady,

On behalf of the millions of members and supporters of the National Committee to Preserve Social Security and Medicare, I write to ask you to reject proposals being considered as part of the Affordable Care Act repeal that would cut funding to Medicaid and jeopardize important services to seniors and individuals with disabilities.

Millions of Medicare beneficiaries rely on Medicaid to help fill in Medicare’s coverage gaps.  Medicare does not pay for most long-term services and supports; consequently, Americans who worked during their pre-retirement years often rely on Medicaid for long-term services and supports when they exhaust their savings.  Medicaid also helps seniors through innovative programs such as the Community First Choice, which allows people in need of long-term care to remain in their homes. Additionally, the Medicare Savings Program administered through Medicaid helps low-income seniors pay for their Medicare premiums, copays, coinsurance and deductibles. 

Proposals to restructure federal Medicaid funding into per capita caps limit federal funding for state Medicaid programs to an arbitrary per beneficiary funding level. This will ultimately shift costs to states by eliminating the guarantee of additional federal funds if state costs increase because of underlying health care costs, demography or complexity of care.  For example, as the baby boom generation nearly doubles the senior population, state Medicaid programs will be unable to keep up with demands for long-term services and supports.  Over time, states will have to make up the funding themselves, cut benefits and/or limit eligibility if federal funds do not keep up with their Medicaid population’s needs. States that expanded their Medicaid programs under the Affordable Care Act will be especially hard hit if the Medicaid expansion is eliminated or reduced as part of Obamacare repeal.

States could address their funding shortfalls in ways that will harm seniors and their families, including:

  • Scaling back nursing home quality, service and safety protections.
  • Asking patients' spouses, children or other family members to cover the cost of nursing home care, exhausting much or all of their savings.  
  • Tightening eligibility criteria to home and community-based services, resulting in more individuals moving into nursing homes.
  •  Limiting the number of people served.

For these reasons, we urge you to oppose proposals in ACA repeal legislation that convert Medicaid to block grants, limit access to the Medicare Savings Program or other Medicaid programs that benefit seniors.


Max Richtman
President and CEO