Across U.S., 12.3 million people qualify as dually eligible for Medicare and Medicaid
Washington, D.C. - On Thursday, February 10, U.S. Senate Special Committee on Aging Chairman Bob Casey (D-PA) and Ranking Member Tim Scott (R-SC) held a hearing entitled “Improving Care Experiences for People with both Medicare and Medicaid,” which examined the challenges people with both Medicare and Medicaid face in navigating two distinct health care programs as well as opportunities to improve care for this population. Casey and Scott introduced their bipartisan PACE Expanded Act which would increase the availability of Program of All-Inclusive Care for the Elderly (PACE) nationwide to expand access to programs that enable people with Medicare and Medicaid to receive all of their benefits through a single organization, rather than navigating separate Medicare and Medicaid coverage.
“There are millions of Americans eligible for both Medicare and Medicaid, but the systems are so fragmented and complex it often leads to gaps in care,” said Chairman Casey. “My bill with Senator Scott, the PACE Expanded Act, would streamline services and enable people with a high level of need to stay in the community rather than receiving care in a nursing home. Older Americans and people with disabilities shouldn’t face obstacles to get the care they need, when they need it, in the setting they prefer.”
“Individuals who are eligible for both Medicare and Medicaid have some of the greatest health needs in our nation, yet they are often left with fragmented care,” said Ranking Member Scott.“As ranking member of the Senate Aging Committee, I’m committed to ensuring our most vulnerable populations receive the care they need. Expanding PACE to more seniors in need will help do just that.”
People who qualify for both Medicare and Medicaid often have complex medical conditions, behavioral health needs, cognitive or physical disabilities and are living in poverty. They are twice as likely to use a skilled nursing facility and 10 percent more likely to have an inpatient hospital stay than Medicare-only beneficiaries. The COVID-19 pandemic has further highlighted the vulnerabilities of Medicare-Medicaid beneficiaries. Data show there were more than twice as many COVID-19 cases and hospitalizations among Medicare-Medicaid beneficiaries compared to Medicare-only.
During the hearing, the Committee heard from Jane Doyle from Bartonsville, PA. Both Jane and her mother have both Medicare and Medicaid. Jane shared how important it was for her mother to receive care at home. She testified, “Our family viewed this a great alternative to a nursing home for our mother, as it would allow her to stay independent and involved with us.” The PACE Expanded Act would enable more people to get care in their communities.
Read more about the PACE Expanded Act here.