The State of America’s Direct Support Workforce Crisis 2022

The longstanding direct support workforce crisis, exacerbated by the COVID-19 pandemic, has led to closures of critically needed services and a denial of access to community-based supports.
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Capitol Correspondence - 03.16.21

ANCOR Joins Coalition Letter Supporting Bill with Creating Automatic FMAP Increase During Economic Downturns

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As part of our work with the Partnership for Medicaid, ANCOR has joined 18 other health care organizations in a letter supporting the Coronavirus Medicaid Response Act. This legislation would create an automatic federal medical assistance percentage (FMAP) increase to state Medicaid programs during an economic downturn, as well as maintenance of effort requirements to ensure states maintain support for vulnerable populations in hard times. The legislation is designed to ensure that in future crises, the Medicaid safety net remains strong.

As written in the letter:

“Medicaid is the lynchpin of the health care safety net. Vulnerable populations, in addition to the providers and organizations that support them, rely on the promise of Medicaid to achieve access to quality, affordable health care. In the face of economic instability and uncertainty caused by COVID-19, the Medicaid program fulfilled its purpose by providing a lifeline to millions of Americans whose livelihoods were threatened by the pandemic. Data from the Kaiser Family Foundation indicates that Medicaid enrollment has grown by more than six million individuals since February 2020,1 meaning more that 77 million Americans are relying upon Medicaid to meet their health care needs.

By its nature, Medicaid is a countercyclical program; Americans who lose their jobs or who cannot access or afford health care coverage can turn to Medicaid in most states to fulfill their needs. This flexibility, while indispensable, carries a cost. Medicaid comprises large portions of state budgets. As evidenced by the COVID-19 crisis, states may spend more on Medicaid to meet the needs of their constituents while simultaneously seeing decreases in revenue-raising measures related to economic restrictions and shutdowns.

Absent federal support, increased Medicaid expenses place additional strain on already strapped state budgets, especially during an economic recession. […]

By making that support automatic, your legislation would offer immediate certainty to states and Medicaid populations in the face of crises with unknown duration and scope. This stability is consequential to protecting access to care and other vital services for communities served by the Medicaid program.”

Related read: Congress has generally been thinking through how to strengthen the public health response to future crises. We recommend that members interested in this issue read the segment in this article by Politico Pulse on Senator Patty Murray’s (D-WA) proposal to “ help fund the on-the-ground response to the pandemic and improve preparedness for future public health crises.”