Families, lawmakers urge faster action for thousands on Medicaid waitlist
INDIANAPOLIS (WISH) — An Indianapolis woman on Tuesday said the state’s Medicaid funding shortfall led to her grandmother being denied coverage at the end of her life.
Josephine Malone died on Oct. 3 at the age of 103.
Her granddaughter, Jo Lynn Garing, said Malone had severe dementia and congestive heart failure and was already in hospice care when she applied for coverage through the Medicaid PathWays for Aging program. Garing said she applied at the end of April, around the same time the Family and Social Services Administration began putting applicants on a waiting list.
Garing said Malone was denied coverage because she was in an assisted-living facility rather than a nursing home. She was put on a waiting list and had still not received coverage when she died.
The waitlist is one of several actions the FSSA took in response to a nearly $1 billion funding shortfall. Officials there said 8,964 people are currently on the waitlist for the PathWays for Aging waiver, which is meant for Medicaid-eligible people aged 60 and older who are in need of assistive care. Another 4,634 are on the waitlist for the related Health and Wellness waiver.
Garing said she had major trouble getting information from the FSSA about the status of her grandmother’s application.
“To be perfectly honest, we didn’t have a lot of conversations (with FSSA) because you call and you don’t get any information,” she said. “How many vulnerable people are here in Indiana who don’t have an advocate, who don’t have someone who thinks, I’m going to call my state rep and see if she can help.”
The lawmaker Garing called for help, Rep. Carey Hamilton, D-Indianapolis, said she has had no better luck than patients getting information from the FSSA despite her position as a member of the General Assembly. She said she blames stories like Malone’s on a lack of transparency from the FSSA about the process surrounding its cost-cutting measures. She said the conversation should be first and foremost whether there should be a waitlist in the first place.
“I really believe we have to bring this conversation out in the open, the sooner the better,” she said. “Too much time has gone by. Too many families are suffering.”
Garing said Malone’s meager savings were exhausted and her family could not afford to pay for the care she needed out of pocket. She said memory care frequently costs $5,000 to $10,000 per month. In her case, the facility where she was living reduced her rent for the final months of her life to help her stretch out her funds. Dan Kenyon, the executive director of the Indiana Assisted Living Association, said cases like Malone’s not only prevent people from moving into the care facilities they need but also prevent them from moving out of lower levels of care, thereby taking up beds needed for others.
Hamilton said Democrats will prioritize Medicaid funding when the budget session begins in January. The budget lawmakers approve won’t take effect until July 1, so Hamilton said the state budget committee should authorize a cash infusion from the state’s budget reserve in the meantime. Garing said she hopes lawmakers move faster on a permanent fix and think hard about the impact to Medicaid users as they consider their options.
FSSA officials told News 8 it’s not possible for them to tell an individual applicant when they might be able to move to the next step in the process because so many variables are involved, including who else is on the waitlist. The FSSA last week increased the number of people it was moving off the waitlist each month to 1,700, up from 925.
A spokesperson for Senate Republicans said Medicaid negotiations are ongoing.