There is growing bipartisan recognition of the urgent need to reform health care for the more than 12 million people who qualify for both Medicare and Medicaid.
Noting the COVID-19 pandemic’s outsize impact on the “dual-eligible” population, a bipartisan group of senators in November asked for input from experts and stakeholders to better understand how to help improve the coverage and care experience for the low-income, older adults and people with disabilities who receive health care through both Medicare and Medicaid. The group of senators include Bill Cassidy (R‑LA), Thomas Carper (D‑DE), Tim Scott (R‑SC), Mark Warner (D‑VA), John Cornyn (R‑TX), and Robert Menendez (D‑NJ).
On Friday, Arnold Ventures’ Complex Care team responded to the senators’ request. In the team’s letter, AV outlined policy ideas that would help reduce the bifurcation between Medicare and Medicaid and ensure that the dual-eligible population receives adequate care.
Beyond bipartisan support from senators, likely voters across the political spectrum also view reform surrounding health care delivery for people with complex care needs in a positive light, according to 2022 research conducted for Arnold Ventures.
More than 70% of Democrats, nearly 70% of Independents, and more than 60% of Republicans support reforming complex care in a way that focuses on standardization and coordination.
Individuals enrolled in both programs have more health challenges than those with Medicare or Medicaid only. These health conditions are exacerbated by the way the programs — which were not designed to work together — interact. Generally, navigating Medicare and Medicaid, which operate separately and cover different services and benefits, can be extremely difficult for patients, leading to poor health outcomes and high costs to the system.
The polling found people sympathize with the issues faced by the dual-eligible population. Eighty-four percent of likely voters say it would be “very difficult” to navigate the Medicare and Medicaid programs simultaneously.
The Complex Care team at Arnold Ventures is dedicated to improving the care experience and outcomes for dual-eligible individuals by advancing policy to reduce fragmentation and increase accountability. Models that integrate Medicare and Medicaid offer a promising solution to addressing this fragmentation. While several such models exist, few are permanent or scalable, and only half of all dual-eligible individuals even have access to one of these models.
In the senators’ request, the bipartisan group recognizes that work is still needed to increase the level of integration offered, expand enrollment in integrated options, and ensure that the mix of services available through integrated models meets the needs of the patients they serve.
“We applaud the senators’ interest in the dual-eligible population and consideration of evidence-based policy approaches to improving their care,” said Arielle Mir, vice president of health care at Arnold Ventures.
Read our letter to Sens. Cassidy, Carper, Scott, Warner, Cornyn, and Menendez in response to the request for information below.
For more, read: Dual-Eligibility Facts & Figures.