The Medicaid unwinding process — in which states are redetermining who is eligible for Medicaid — has significantly affected older adults and people with disabilities, Damon Terzaghi, director of Medicaid HCBS for the National Association for Home Care & Hospice, explained to McKnight’s Home Care in a podcast. He also addressed the heavily criticized 80/20 provision in the proposed Medicaid Access Rule. Terzaghi called the provision “a noble cause that is poorly executed.”
The number of older adults and people with disabilities losing Medicaid is growing by the week, said Terzaghi, who is calculating national disenrollment figures for these groups. The latest figures? Twenty-three states have disenrolled over 6% of older adults and people with disabilities since April. The main reason for the disenrollments, Terzaghi speculates, is procedural reasons such as incorrect paperwork or documentation. Older adults and people with disabilities have more complex eligibility criteria compared to other Medicaid groups. Besides the unwinding, another serious Medicaid concern is the 80/20 provision in the proposed Medicaid Access Rule. The provision, if it becomes a reality, would force home- and community-based services providers to use 80% of Medicaid payments on wages, which is not tenable for most. A final rule is expected at the end of 2023 or beginning of 2024.
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