Notch Reform Bulletin: A Notch Baby Double Whammy—Failure to Receive Medicaid Services?

Social Security accounts for 90% or more of the income for one-third of all beneficiaries.  For Notch Babies—who receive lower benefits than other Social Security recipients with similar work and earnings records—this can mean living in, or hovering near, poverty.  The federal government and the states, however, have a joint safety net that is supposed to provide desperately needed long-term care services for lower-income seniors—Medicaid. 

Now it appears that safety net is unraveling.  The General Accounting Office (GAO) says that many beneficiaries are not receiving necessary care (see “Medicaid Recipients Not Receiving Services” at http://www.tscl.org/NewContent/101988.asp.)  This is likely to mean that many Notch Babies on Medicaid either may not be getting the Medicaid services they should be getting, or that the care they are getting may be insufficient and inappropriate. 

This is like a harsh double whammy when Notch Babes are at the age when many have chronic health problems.  The problem could get worse.  As health care cost increases far exceed annual Cost-of-Living Adjustments (COLAs), the number of lower-income seniors who turn to Medicaid is growing.  In fact, rapid Medicaid growth in recent years has made the program as large as Medicare, according to the Congressional Budget Office.

Recent proposals by President Bush and the National Governors’ Association would make dramatic changes to Medicaid.  Currently, if a senior’s income is low enough, the states must enroll them.  The federal government kicks in about 60 cents for every Medicaid dollar.  Proposals would change all that and give states the power to decide who is covered, and the federal government would give states a fixed amount of money, allotment, or block grant. 

Like the Medicaid waivers described in our cover story, this is likely to lead to seniors receiving insufficient care if they receive it at all.  This is just the reverse of what the government should be doing at a time when health care costs are increasing eight times faster than COLAs. 

We urge you to contact your Members of Congress and ask them to support measures for reasonable funding increases to cover Medicaid programs.  We also urge you to ask them to support federal guaranteed rights to Medicaid coverage and to oppose allotments or caps that could mean a cruel double whammy for Notch Babies. 

Source: “Income of the Aged Chartbook, 2001,” The Social Security Administration, April 2003. 

October 2003

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