July 2015

ISSUE BRIEF: MEDICAID PROGRAM

ACCSES Supports an Appropriate Array of Long-Term Care Services, Supports and Settings underMedicaid Consistent with Informed Choice and Person-Centered Planning

Federal and state governments should maintain public support and adequate funding of Medicaid and Medicare, two of the largest programs in the country that assist people with disabilities to maintain healthy, functional, and independent lives. Medicaid should continue to cover benefits that include the full array of services necessary to maintain function and independent living, not simply serve acute health care needs. The bias in health care should be toward home and community-based care with access to service delivery programs rather than institutional care, consistent with the principles of informed choice and person-centered planning. People with disabilities should have access to health care practitioners who understand their unique needs and challenges and who practice in facilities that are accessible. Rehabilitation and habilitation providers should be entitled to receive appropriate and timely reimbursement in order to meet the needs of the people they serve.

All federal policies shall support the rights of people with disabilities to make individual choices that affect their lives, including living, working, and functioning in the community. The federal government must help to ensure that long-term services and supports for people with disabilities are person-centered and available in the community. The federal government must continue to have a strong role in assuring and funding community-based residential supports for people with disabilities. People with disabilities must have access to assistive technology in order to maximize their ability to live independently and function in the community. There must be accessible and safe transportation available for individuals with disabilities.

ACCSES Supports Medicaid Improvements:

We support reasonable and adequatefunding for the full array of long-term services, supports and settings to meet the needs and choices of individuals, including those who require intensive levels of care. The Centers for Medicare and Medicaid Services (CMS) should offer adequate funding for assistive technology to help individuals transition from institutions to the community.

To that end, ACCSES requests that Congress:

  • Eliminate the institutional bias in Medicaid, rebalancing services to favor home and community-based long-term services and supports which are generally less costly;
  • Promote adoption of the State Balancing Incentives Program;
  • Take greater advantage of the popular “Money Follows the Person” demonstration grants to move eligible Medicaid beneficiaries from inpatient facilities into community-based settings;
  • Increase access to assistive technologies and devices that provide greater beneficiary independence, help avoid institutionalization and prevent costly secondary conditions;
  • Involve stakeholders at the state and local level in the Medicaid reform discussion;
  • Oppose policies that would have a devastating impact on Medicaid beneficiaries and family caregivers, straining state budgets and enabling states to end care to millions of seniors and people with disabilities, who account for two-thirds of Medicaid spending, such as:

the conversion of Medicaid from an entitlement program to a fixed federal payment (Block Grant) program with reduced federal payments, shifting Medicaid costs to states already struggling with increased budget deficits;

the application of arbitrary, global or other spending caps well below current spending levels; and

the repeal of the “Maintenance of Effort” requirements that would allow States to reduce Medicaid enrollment and eligibility.

For more information, contact Leann Fox, ACCSES Director of Government Affairs at (202) 349-4279 or . To learn more about ACCSES visit