Lynda Flowers is an AARP Public Policy Institute expert on Medicaid, health disparities and prevention/public health.

Capping Medicaid Funding Could Hurt Millions of People with Disabilities and Poor Seniors

Medicaid is the country’s largest public health insurance program, providing access to needed health care and long-term services and supports  (LTSS) to millions of low-income Americans, including more than 17 million children with disabilities, adults with disabilities, and poor seniors. Right now, states and the federal government share the cost of Medicaid in a way that guarantees services to all who are eligible. Under this arrangement, federal funding increases (or decreases) in response to changes in enrollment, service costs, and …

Closing the ‘Doughnut Hole’ Has Protected Millions of Medicare Beneficiaries From High Drug Costs

Since 2006, Medicare beneficiaries have had access to outpatient prescription drug coverage through Medicare Part D. The standard benefit under Part D includes an annual deductible, an initial coverage period when enrollees pay 25 percent of their drug costs, and catastrophic coverage that limits enrollees’ spending to roughly 5 percent of their drug costs. One of the more striking characteristics of the Medicare Part D benefit is its “doughnut hole,” or coverage gap, where enrollees are required to pay the full …

The Ban on Preexisting Condition Exclusions Helps Older Adults

Most Americans get their health insurance through their employer or through government-sponsored programs like Medicare or Medicaid. People who do not have access to those forms of coverage — for instance, because they are between jobs or are self-employed — typically buy health insurance directly from private insurers on the individual market. Since 2014, the Affordable Care Act (ACA) has provided a critical protection for individuals who seek insurance in this market: It bans insurance companies from considering people’s health …

Building Capacity to Provide Behavioral Health Services to Dual Eligibles

The Centers for Medicare & Medicaid Services (CMS) launched the Financial Alignment Initiative (the Initiative) to improve the quality of care received by low-income adults who are eligible for Medicare and Medicaid — known as dual eligibles. Many of these individuals have unmet behavioral health needs, ranging from mild depression to serious mental illness, like schizophrenia and bipolar disorder. A recent update on the Initiative presented to the Medicare Payment Advisory Commission highlighted four challenges to providing behavioral health services …

Examples of Practices That Support Integrating Care for Dual Eligibles: Some Challenges Remain

The federal government recently released its first preliminary report evaluating its Financial Alignment Initiative. The goal of the initiative is to increase access to high-quality, well-coordinated health care — including long-term services and supports (LTSS) — for low-income adults who are eligible for both Medicare and Medicaid, also known as dual eligibles or duals. Most of the participants receive their care through managed care organizations called Medicare-Medicaid plans (MMPs). The report describes some practices that states seeking to integrate services for …

Shingles Vaccine May Be out of Reach for Some Medicare Beneficiaries

Introduction to Shingles Shingles is a viral infection that causes a painful skin rash. It is caused by the varicella-zoster virus — the same virus that causes chicken pox. Once people recover from chicken pox, the virus remains in their body in an inactive state. In some people, it stays dormant; in others, the virus reactivates and causes shingles. The condition is most common in older adults and people with weakened immune systems. The most common complication of shingles is …