The Future of Medicaid

It is a question I am being asked with increasing frequency when people call our office about needing Medicaid now or planning for the possibility of needing it in the future.  “Will there even be Medicaid coverage if and when I need it?”  Specifically, I am talking about the Medicaid programs that cover long term care.

My answer is that I don’t have an answer – meaning that it is impossible to predict the future – what will change or won’t change about Medicaid.  What I tell people is what I know- that I have guided clients for 30 years under the current system which has yet changed in a major way.

That’s not to say that over the years there haven’t been some changes.  For example, the last substantive changes to Medicaid coverage occurred 20 years ago.  That’s when the look back was extended from 3 years to 5 years and the method of calculating the Medicaid penalty was altered.

While the subject of Medicaid cuts – along with other federal budget cuts – has ramped up with a new presidential administration and Congress, there are very few details about how this might be accomplished.  Because Medicaid is a combination federal and state program but administered at the state level, this would likely be done via cuts in federal funds provided to the states.  With less money it may be up to individual states to figure out how to manage their programs with less money.  It is possible that outcomes could look very different from state to state.

So, what can people do now to prepare themselves?  My answer to that question is to proceed under the assumption that the current system will be with us until it isn’t.  That’s the only thing we can do.  We can only guide clients and help them navigate the Medicaid rules and regulations that currently exist.  In other words, we will continue to work with and under the current system unless and until that system is replaced or modified and then we’ll have to figure it out from there.