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Independent Living News & Policy from the National Council on Independent Living

Action Alert: Contact Your State Medicaid Director Today in Support of PAS Programs

CIL Directors:

I am writing as the President of a CIL with a large Personal Care Assistance (PAS) program but the reality is, my concern should be that of our customers at all small and large CILs, whether or not you operate a PAS program.

I truly support the Affordable Care Act (ACA), but an unintended consequence may be loss of providers and personal care workers (PCWs) who on fixed Medicaid reimbursement rates will not be able to retain workers over 30 hours a week. We know Medicaid rates will not rise, so the options are to purchase insurance that the organization cannot afford and be penalized $3,000 per person over 30 hours a week, or reduce the hours a PCW works (decreasing income and negatively impacting consumer choice).

There will be a Medicaid Directors’ meeting in Nevada in a couple of weeks. We would like to see the majority of the CILs in the country contact their State’s Medicaid Director about this issue and pressure them for answers so it becomes a key discussion point in Nevada. Our customers should be concerned because those covered by Medicaid will either:

  • lose their provider organization because of cost,
  • have a reduction of hours of service, or
  • be approved for less hours of support to stretch the dollars.

Please find below a sample letter for your Medicaid Director. Please call me with any questions at 414-226-8301.

Sincerely,

Lee Schulz
IndependenceFirst

Kelly Buckland
NCIL Executive Director

Sample Letter for Your Medicaid Director

RE: Affordable Care Act Employer Mandate and Medicaid

Dear State Medicaid Director:

We need your assistance to address a significant threat to Medicaid caregiver services. The Affordable care Act (ACA) employer mandate takes effect on January 1, 2015, for most of this State’s employers and for all in 2016. Caregiver providers providing Medicaid services may be forced to close operations, curtail caregiver working hours significantly, or reduce base pay to minimum wage levels when this law takes effect.

The payment rates from Medicaid are not sufficient enough to provide both a reasonable base hourly pay and health insurance benefits to the full-time employees (30 hours per week) who provide care. At the same time, employers that do not offer ACA-compliant health insurance to full-time employees will face a $2,000 per employee annual penalty.

Caregiver providers need to find some solutions for this unfunded mandate. We recognize that the State is not able to simply increase payment rates to cover these new costs. At the same time, the options of cutting worker pay or working hours are also harmful to Medicaid, the workers, and persons with disabilities in need of a caregiver.

We ask that you join a National effort to convince Washington to delay the application of the ACA employer mandate to Medicaid caregiver providers. Already the White House approved two delays to permit employers to make the changes necessary to comply with the ACA requirements. However, a further delay is needed to address the unique concerns that affect Medicaid and caregiver providers, given the limited availability of funding to cover the cost of compliance.

Please ask your Governor, the State’s Congressional delegation, the Centers for Medicare and Medicaid Services, the US Treasury Department and the President to support a delay of 12-24 months to provide the time needed to design and implement appropriate changes to the Medicaid program and service delivery, so that no harm comes to Medicaid beneficiaries and caregivers.

Thank you for your time and consideration.

Comments

  1. Codie McGeever says:

    Please support a delay of 12-24 months to provide the time needed to design and implement appropriate changes to the Medicaid program and service delivery, so that no harm comes to Medicaid beneficiaries and caregivers.

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