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As we begin the year, federal discussions surrounding Medicaid are making headlines. While these conversations can feel uncertain, it’s important to focus on what directly impacts caregiving services in Colorado and beyond. This report highlights key takeaways from federal and state-level advocacy efforts and what caregivers need to know about potential changes to Medicaid funding and services.

The Headline

It’s going to be a bumpy ride for Medicaid discussions, but the majority of what you’re seeing in the news won’t affect caregiving services directly.

Key Takeaways

  1. Medicaid Cuts Likely Won’t Impact Caregiving Services: Most proposed cuts focus on other areas.
  2. Home and Community-Based Services (HCBS) Are Safe: These programs have bipartisan support because they’re cost-effective and in high demand.
  3. Long-Term Services and Supports (LTSS) Remain a Priority: Policymakers on both sides support these programs.
  4. Rate Changes Could Happen in Some Areas: Isolated rate adjustments are possible, but long-term trends suggest recovery and potential increases.
  5. Advocacy Works: Caregiver and stakeholder advocacy continues to protect and expand HCBS.

What’s Happening with Medicaid?

Federal Medicaid discussions are focusing on specific areas. Here’s what caregivers need to know:

  • Medicaid Expansion Population: Potential funding reductions target adults without disabilities covered under the Affordable Care Act. These cuts won’t affect HCBS users.
  • Work Requirements: Proposals for Medicaid work requirements don’t apply to people using HCBS because of their disability status.

Federal Spending and Medicaid Proposals

Some proposals to limit Medicaid contributions, like block grants or spending caps, have been floating around before, but they remain politically unpopular. Past advocacy efforts successfully blocked these measures, and they’re unlikely to gain traction now.

State Budget Impacts

Even if federal funding changes, states typically protect HCBS programs. Here’s why:

  • States focus on cutting optional benefits (e.g., dental or vision) rather than HCBS.
  • Some states adopt managed care models to reduce costs, which can also benefit family caregivers.
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What’s Happening in Colorado?

Good news for Colorado caregivers:

  • Several states (like Arizona, California, and Minnesota) are increasing rates, and this trend could influence Colorado.
  • Studies in Missouri, Oregon, and Pennsylvania may guide future advocacy for Colorado.
  • Colorado continues to support caregivers through Medicaid, with potential for expanded family caregiver roles.

Why Advocacy Matters

Advocacy is powerful and it works. Here are some success stories:

  • California (2009–2011): Advocacy delayed or reversed major HCBS rate cuts.
  • Missouri (2023–2024): Advocates minimized disruptions from rule changes.
  • National (2017): Public outcry stopped Medicaid block grants from becoming law.

These examples prove that caregiver voices shape policies and protect essential services.

Advocacy Matters

Looking Ahead

As federal discussions continue in 2025, we’ll stay focused on protecting the services that support caregivers and families.

Thank you for everything you do to care for your loved ones and strengthen our community.

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