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Now that the House and Senate have introduced bills repealing and replacing the Affordable Care Act, it is clear that both versions include deep cuts to the federal-state Medicaid program. These cuts will jeopardize critical care for older adults and directly affect their caregivers. Should the Senate adopt these changes to Medicaid, this could have devastating consequences for older adults and families in every state.

Most people think of Medicaid as our nation’s safety net health care program, and that it only serves low-income children and mothers, and increasingly low-income working adults. In reality, the majority of Medicaid spending provides services and support programs to help people with disabilities and older adults simply live their lives.

For older adults and their caregivers, Medicaid is the country’s only guaranteed provider of the critical long-term care services that most of us will need as we age. Nearly two-thirds of the long-term care provided in nursing homes is paid for by Medicaid. With nursing home costs averaging nearly $90,000 per year, without Medicaid, millions of older adults and families would be financially overwhelmed.

Medicaid is important to helping our country address the challenges of a rapidly aging nation. The population of older adults is growing at an historic pace, and over 90 percent of older adults say they would rather age at home and communities, where care is often less expensive and more effective. While less expensive than nursing home care, in-home services are often cost prohibitive for families as well.

For more than 30 years, states have increasingly moved toward providing “waiver” services that allow Medicaid-eligible older adults to get the care they need in their homes instead of in institutions. These services, which are often a fraction of the cost of nursing home care, can include, but are not limited to, in-home help with bathing, meal preparation and other daily life activities. Several Medicaid programs have also successfully moved tens of thousands of people from institutional settings back into their homes, offering consumers more independence while saving taxpayer dollars.

Unfortunately, the House and Senate bills would slash long-term Medicaid funding by $834 billion over 10 years by capping the federal government’s share and pushing these costs on to states. States will have to make terrible choices that will hurt those who depend on Medicaid for their health and safety. Older adults could lose the amount of in-home care they receive or be required to pay for services despite being poor enough to qualify for Medicaid. Families seeking care for a loved one will encounter long wait lists for services, and cuts to provider rates will harm the long-term care workforce.

It makes no sense to undermine the only long-term care option available to most Americans just as our country undergoes a transformational demographic shift to an aging nation. If we really want to save federal health care dollars, we should expand the most cost-effective care options instead of eliminating them. Not only do these Medicaid-funded programs preserve the dignity and independence of older adults, they also save tax payers tens of billions of dollars each year in nursing home costs.

Older adults deserve better. We encourage Sens. Steve Daines and Jon Tester to not only reject the House and Senate bills’ cuts to Medicaid, but to start over and engage in a bipartisan, collaborative process to address the real health care challenges that we face. You can help, too. Get in touch with our senators, and tell them to reject any Medicaid cuts that will be devastating to older adults and families in Montana.

Lawrence L. White, Jr. is Missoula Aging Services Governing Board Chair.

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