Position Paper
Medicaid Program

Aging Life Care Managers® … coordinating services to optimize health and quality of life.

The Aging Life Care Association® (ALCA) is an organization of practitioners who use a holistic, client-centered approach to caring for older adults or others facing ongoing health or other challenges of aging and/or disabilities. ALCA is committed to maximizing the independence and autonomy of clients and strives to ensure the highest quality and most cost-effective health and human services. Members help clients and their families cope with challenges faced by people with disabilities and older adults through education, advocacy, counseling, and service delivery.

Medicaid Program

Medicaid is a jointly funded federal and state program that covers health costs and long term care costs according to means-tested criteria. The program is authorized under Title XIX of the Social Security Act of 1964.


ALCA supports:

  1. The availability of Medicaid funding (through Section 1115 waiver programs when necessary) which will cover comprehensive services (including both institutional and community-based care) for those with significant physical, mental, or cognitive impairments.
  2. Utilization of Medicaid to cover long term care expenses for those with limited assets until such time as another mechanism may be implemented to cover long-term care expenses.
  3. Sufficient payment to medical providers to encourage quality care that is extensive and widely available throughout the country.
  4. The timely processing of applications, change of status, and request for services within Medicaid organizations.
  5. Medicaid rules designed to keep seniors and those with disabilities at home or in the community whenever such care is practically possible.


ALCA supports:

  1. The principle that the Federal Government should match state expenditures for Medicaid and opposes attempts by to shift more of the proportional financial burden to the states.
  2. The matching funds formulas should not penalize states that utilize higher than average Medicaid dollars.
  3. The use of Section 1115 Medicaid waivers only when used to enhance benefits or extend eligibility criteria.


Eligibility requirements for Medicaid should be clearly written, easily understood and be fair to the client, family or institution

ALCA supports:

  1. Medicaid policies that give equal standing to physical, mental or cognitive impairments.
  2. Financial eligibility requirements for Medicaid, which allow Medicaid households to retain sufficient resources and income to meet basic living expenses, that is normal to their locality. Such eligibility limits should be adjusted periodically to keep pace with inflation.
  3. The spousal impoverishment rules that allow sufficient resources to the non-Medicaid spouse.
  4. The expansion under the Affordable Care Act (ACA) of the Medicaid program to provide a health care insurance safety net with as much choice as possible for individuals who cannot otherwise afford health insurance.

Resolutions Approved by the NAPGCM Board of Directors October 13, 2004.
Reviewed, changed and updated by Public Policy Committee, September 28, 2008.
Reviewed and approved by NAPGCM Board of Directors October 23, 2008
Reviewed and updated by the Public Policy Committee, November 4, 2013
Reviewed and approved by the Board of Directors on November 17, 2013