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Upton: Trump budget DOA; no cuts to Medicare, Medicaid

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ST. JOSEPH, April 13, 2019 | comments
Upton: Trump budget DOA; no cuts to Medicare, Medicaid
The Herald Palladium
April 13, 2019

ST. JOSEPH — Congressman Fred Upton said Friday that President Donald Trump’s budget, released a few weeks ago, is dead on arrival.

“We worked as a delegation bipartisan-wise to make sure that the money for the Great Lakes was restored, but the ideas on some Medicare and Medicaid cuts ain’t gonna happen, not on our watch,” he told the close to 100 people at the 12th annual Tri-County Legislative Forum on Friday at the Campus for Creative Aging in St. Joseph, sponsored by Region IV Area Agency on Aging.

In addition, Upton, R-St. Joseph, said he supports reauthorizing the Older Americans Act, which expires Sept. 30, and supports home and community-based services, such as Meals on Wheels and caregiver support, which are provided through state area agencies on aging.

“I always support this. I look forward to seeing this thing get through the hurdles,” said Upton, who left after a few minutes to attend a funeral.

During the presentation, one of the main topics was the MI Choice Medicaid Waiver program, which allows older adults and adults with disabilities who need nursing facility-level of care to have it be provided in the home through a network of community-based service providers.

Advocates say it makes sense because not only do the older adults want to stay in their homes as long as possible, it costs less money.

Keeping seniors at home through the MI Choice program costs $78.20 per day, which is 58 percent less than the Medicaid nursing home daily rate of $187 per day, said Lynn Kellogg, CEO of the Region IV Area Agency on Aging. She said 15,000 older adults and adults with disabilities in Michigan are in the MI Choice program, with more than 3,200 people on the waiting list.

State Rep. Aaron Miller, R-Sturgis, said he’s seen how his own grandparents have thrived while remaining at home.

“The thing that over the years that’s baffled me is the fact that we will pay Medicaid dollars to put somebody in a nursing home and yet we won’t pay much lower to do that (at home),” he said.

Right now, only 40 percent of Michigan’s Medicaid long-term care dollars are being spent on at-home care, which is much lower than the 57 percent national average.

Miller said he would like to increase how much Michigan spends on at-home care to at least match the national average. 

“It would not only save lives, as far as that value that you can’t put on a grandmother or grandfather staying at home, but it also saves dollars. It seems like a no-brainer,” he said.

Miller said one of the biggest problems with making changes is term limits, because legislators are just beginning to understand what’s going on and then they are out of office. State legislators are limited to three two-year terms, with Miller in his third term.

First-time state Rep. Pauline Wendzel, R-Watervliet, said she lives across the street from grandparents in their late 80s who still climb ladders and have made it very clear that they don’t want to be put in a nursing home.

“This program, from what I’ve learned so far, seems fantastic. I’m in full support of it,” she said.

State Sen. Kim LaSata, R-Bainbridge Township, also voiced support for the program.

“I advocate for the waiver constantly,” she said. 

LaSata added that the state needs to provide more funding for the caregivers. She said it’s a very difficult job with low pay.

Kellogg said that even though the MI Choice program is for people on Medicaid, many people find themselves on it when they get older.

“If people have been retired for 10, 20 years, you have a huge percent of that population that has never been on Medicaid,” she said.

But long-term care costs a lot of money and many people find that they have to go on Medicaid to get the care they need. And they need the MI Waiver program if they want to get that care in their homes.

Kellogg said that nationally, $364.9 billion is spent annually on long-term care, with 52 percent of it paid for by Medicaid, 16 percent out-of-pocket, 11 percent by private insurance and 20 percent other sources. 

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