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Protect Medicaid: Vulnerable Seniors & Children with Disabilities

Where AARP Stands on Medicaid


Essential Care

En español | For nearly 60 years, AARP has been fighting to ensure older Americans have affordable health care and access to the services they need to stay at home as they age.

Right now, there is legislation in the House of Representatives that would cut Medicaid by $880 billion, jeopardizing essential care to millions of Americans, including seniors, children, and adults with disabilities. The bill would shift hundreds of billions of dollars in costs to states and taxpayers, take health care away from millions of families, and cut services that help seniors and people with disabilities live independently in their homes and communities for as long as possible.

For more than 50 years, Medicaid has provided essential care to millions of Americans, including 17.4 million children and adults with disabilities, and low-income seniors. During times of economic downturn, hardworking Americans who’ve lost jobs turn to Medicaid for their care.

Medicaid is jointly financed by states and the federal government. Under this financing arrangement, the federal government guarantees that it will share, with states, the costs of all medically necessary health care and needed long-term care (such as assistance with bathing, dressing, toileting) for eligible individuals. Under the current system, federal funding increases in response to increases in enrollment due to unemployment, outbreaks of epidemics, natural disasters, the cost of care, and the services people use.

Health Care Reform Debate

The proposed American Health Care Act includes per capita caps — a fixed amount of funding for each Medicaid enrollee. Once the per capita amount is set by the federal government, it would not change, even if a state’s actual program costs were greater than the allotted amount. If a state’s costs exceeded the cap, it would have to use its own funds to make up the difference or, more likely, cut services for low-income residents, including children and adults with disabilities and seniors.

These caps would put an enormous financial burden on states and state taxpayers, take health care away from millions of families, and cut services that help seniors and people with disabilities live independently in their homes and communities.

Our Medicaid Values

  • Ensure adequacy and affordability. Medicaid should remain a vital safety net that guarantees adequate and affordable health care and long-term services and supports that meet the needs and preferences of beneficiaries and recognize and assist their family caregivers. Medicaid should also cover a range of home- and community-based services to allow individuals to live as independently as possible.
  • Ensure quality, efficiency and program integrity. Medicaid should improve the quality and efficiency of care for beneficiaries and maximize value for the program. Program waste, fraud and abuse should be identified and eliminated, and the process should not unduly burden beneficiaries.
  • Provide sufficient and responsive federal funding. Federal funding should be sufficient to account for the complex needs of beneficiaries and changes in state circumstances that affect program enrollment and costs.  
  • Provide state flexibility and accountability. States, with federal guidance and oversight, should have flexibility to innovate and strengthen their programs in ways that do not cause harm to beneficiaries.