Proposed Medicaid Cuts Threaten Care for Thousands of New Jersey’s Most Vulnerable

Nathaly Suquinagua  NJ Urban News

With several proposed cuts being debated, there is growing concern about potential federal reductions to Medicaid. Many New Jersey residents rely heavily on Medicaid to cover their medical expenses and other essential services provided through government assistance.

With that being said, Lori Feldstein is the executive director and CEO of the Goals of Care Coalition of New Jersey (GOCCNJ). This organization has been focused on improving care for people in New Jersey with serious illness, including many seniors. Feldstein’s main goal is to direct the organization’s effort to improve shared decision making between the providers, patients, and their families to ensure that the care will align with the patient’s values and goals. 

“ In New Jersey, we have over 300,000 older adults who are part of the Medicaid program, and we’re very worried about the impact of these cuts on on their life, and particularly as it relates to the home and community based services, and those are the services that help people remain at home and age in place and remain independent,” Felstein said.

One of the major concerns affecting the healthcare system is the state of the direct care workforce, particularly how changes could lead to reimbursements for services. Given the existing workforce shortage across the state, it could further strain nurses, doctors, and staff in long-term care facilities, among others.

Not only with these significant cuts affect the patients, but the family members will ultimately have a financial burden for the patients as well.

The Care Coalition of New Jersey (GOCCNJ) has been advocating for increased access to palliative care, in which a patient has an interdisciplinary team of providers who come in to care for the patient with serious illness who may need psychosocial support as well.

“ So think about a patient like an Alzheimer’s patient, for example, who may be diagnosed and live for many years the stress and the progress, progression of their symptoms all takes a huge impact the stress of the disease itself, but then all of the symptoms associated with the disease take a huge impact on the patient and the family, and Palliative Care provides like that extra layer of support”.  Felstein said

Their main goals are to give the patient a full round of care for anything that the patient might need. With New Jersey being one of the first states that have a Medicaid system covering and reimbursing people, this can cause major setbacks. 

Cathay Rowe from New Jersey Advocates for Aging Well  (NJAAW) has expressed the severe impact of proposed Medicaid cuts on older adults in NJ, which is a nonprofit that focuses on the needs, challenges, and desires of older adults in New Jersey. In addition, they are one of the leads of a new campaign called “Lifelong Strong New Jersey”, where NJAAW is highlighting and prioritizing aging.

“What people don’t realize is how much Medicaid is interconnected to Medicare. Medicaid covers long-term care and nursing homes, but Medicare does not. Home and community-based services, which keep people out of a nursing home or help them recover after a hospitalization that are paid largely by Medicaid, not Medicare. So Medicaid fills in the gaps that Medicare doesn’t cover for 1,000s of people in New Jersey,” Rowe said.

The two programs are deeply interconnected, and Rowe emphasized that one cannot be cut without impacting the other. Medicaid, in particular, plays a key role in making Medicare more affordable for many individuals.

Long-term care and nursing home services are extremely expensive in New Jersey, often exceeding $100,000 per year for a nursing facility. If Medicaid funding is cut, many individuals would lose access to vital home and community-based services that help keep them out of hospitals. These services include home health aides, visiting nurses, and in-home occupational and physical therapy, which are essential for people receiving care through Medicaid, stated to Rowe.

Hamza Habib, a physician, attorney, and the Chief Medical Officer for GOCCNJ, has emphasized that Medicaid serves as a crucial shield for patients with advanced illnesses, including cancer, heart failure, and Alzheimer’s. Reductions in Medicaid could lead to delays in care, increased hospital admissions, and higher costs. 

“I would say in my practice, almost 30 to 40% of patients at certain times are Medicaid patients. For them to not have palliative care or have cuts, that can mean a huge difference like we said, symptom management, pain management, coverage for long term planning, and in a certain way, this can even increase the cost of care for them, because these patients, when they don’t get good outpatient care, they get admitted, which is much more expensive.” Dr.Habib said.

The proposed cuts also include preventive services like screenings. Changes are already being implemented, such as increased scrutiny over how many medications can be refilled and prescribing the best possible medication.

When a prescribed medication isn’t covered by insurance, clinicians are often forced to prescribe alternatives that may come with more side effects, be less effective, or fall short of the standard of care. As these alternative treatments can negatively impact a patient’s well-being and long-term health outcomes. Delaying treatment or using less effective medicine can make a patient’s condition worse over time.

“Medicaid is the safety net that we use, unfortunately, and cutting down that safety net, especially in the times when there’s a lot of economic uncertainty, especially in the times when there are a lot of diseases that can impact people,” Dr. Habib mentioned.

The Care Coalition of New Jersey (GOCCNJ) has conducted several studies to assess which areas of New Jersey specifically require more palliative care services. These studies revealed that certain regions in New Jersey were underserved, particularly counties with lower average incomes compared to others. 

Furthermore, this organization is focused on educating the public about the role of palliative care in improving long-term outcomes, decision-making, and providing support not only to patients but also to caregivers, families, and the broader community. Their purpose is to educate, conduct research, and improve clinical outcomes through high-quality clinical care.

To support the ones impacted the most during this time, advocates encourage the public to contact their representatives and speak out on behalf of anyone impacted by the potential cuts. The impact of proposed cuts goes beyond just the elderly, it also places a significant burden on their families. In many cases, family members are forced to leave their jobs to provide care or spend their life savings on long-term care expenses.

Without the support of Medicaid, individuals often exhaust their financial resources or those of their families just to access necessary care.