In a study in the journal Health Affairs, that expansion of home-based care can save states money over the long run. The paper looked at Medicaid data from 1995 to 2005. States incurred extra cost when they spent to create new social service programs to care for people at home, but that expense, over time, paid for itself because it was cheaper to care for people at home. Policymakers often cite the "woodwork effect" as a reason to worry about expanding home-based care. This is the argument that if states provided people what they want — home-based care — then…
In 1999, the U.S. Supreme Court ruling in Olmstead v. L.C. said that the unnecessary institutionalization of people with disabilities is a form of discrimination. State Medicaid programs are required to provide alternatives so that the elderly and disabled can choose to get their care at home, instead of in state institutions or nursing homes. But the Supreme Court said there were limits. A doctor, representing the state, has to determine that the person is capable of living at home. The person has to want to get that care at home. And a state when considering its responsibility to move…
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