Over the past few months, we’ve been sharing regular updates about what’s happening at the legislative level, including how proposed federal and state policies would affect the clients we serve. A big thank you to everyone who reached out to their representatives to advocate for the services that organizations like ours provide for people living with severe mental illness.
In follow up to these updates, we want to share what we know about the legislation that was passed at the federal level earlier this month and how it might impact our clients and our work at Guild. Here’s what we know so far:
Eligibility will be reduced.
The number of people who will be eligible for Medicaid support will change. Adults who are undocumented will no longer be covered by Medicaid, and people who are newly applying for Medicaid will have to undergo a more stringent application process. Our understanding as of now is that individuals who are currently receiving Medicaid support will retain eligibility and continue to go through regular re-eligibility evaluation. Right now, this evaluation is done annually, but it looks like that may shift to twice annually.
Work requirements will be added.
Individuals will now have to fulfill certain work requirements in order to qualify for Medicaid support. This will be especially challenging for many of our clients. Folks who are on Medicaid disproportionately experience disabilities or other barriers to their ability to bring in an income. Adding a work requirement provision will mean they have to document that they are, at minimum, looking for employment. We anticipate that this will be experienced as a significant hardship for many of our clients and are working to prepare our staff to help clients navigate this challenge.
Cost sharing will be increasing.
The amount of money that people on Medicaid will be responsible for covering out of pocket is going to increase under this new legislation. Currently, if someone is on a prescription that’s covered through Medicaid, the cap they’re required to pay on their own is $3. That cap is increasing to $35 per prescription — a significant amount of money for many of the clients we work with at Guild. Another area that will see cost sharing changes is emergency room visits. The out-of-pocket cap is currently $35 per visit. Under this new federal legislation, that cap is changing to 5% of a person’s annual income, which could pose significant financial challenges for our clients.
How will this impact Guild clients and staff?
All of this means that the pressure placed on the clients we serve will likely continue to compound, and we are putting plans in place internally to anticipate these pressures so we can best serve the people that Guild was created to support. As we learn and understand more the effects this legislation will have on the people we serve, we will continue to update our supporters and community partners.
Rest assured, we are not going anywhere — in fact, we anticipate an increased need for the kind of services that Guild provides. Your support of our work during this time of change will be critical to our ability to best serve our clients. There are a lot of moving pieces, but we’re in this together.