Wexton Seeks to Restore Autonomy, Dignity to Nursing Home Residents on Medicaid

In July, freshman Representative Jennifer Wexton, D-Va., introduced the Personal Needs Allowance Modernization Act to improve the financial security of Medicaid beneficiaries living in nursing facilities. 

Currently, Medicaid beneficiaries who are eligible for nursing care must contribute almost their entire personal income to the cost of the nursing facility. The personal needs allowance is the monthly sum of money that nursing home residents may retain to pay for personal expenses.  

The PNA Modernization Act would double the federal floor for the monthly Personal Needs Allowance to $60 for an individual and $120 for a couple, and would index the amount to inflation. 

The current federal floor of the Personal Needs Allowance is only $30 for an individual and $60 for a couple — a disturbingly low amount for Medicaid beneficiaries to cover basic monthly personal expenses like clothing, their phone bill, a magazine subscription, or even toiletries. 

Raising the allowance grants these residents the freedom to age with autonomy and dignity. 

The federal floor of the PNA has not been raised since 1988 and is out of touch with today’s economic realities. Adjusting for inflation, the PNA’s current value of $30 would be worth only $14 in 1988, a drop of over 50% in purchasing power for those who rely on it. 

“The paltry Personal Needs Allowance of just thirty dollars a month strips too many of our seniors and disabled Americans of their financial freedom and personal dignity, forcing them to rely on friends and family to cover basic expenses for items like socks, underwear, toothpaste, and adult diapers,” Representative Wexton said. “Congress has sat on its hands for decades while these individuals essentially live in poverty. Let’s deliver this much needed increase for these vulnerable populations and pass the PNA Modernization Act.” 

Eliot Fishman, senior director of health policy for Families USA welcomed Wexton’s interest in the issue and vowed to support the bill.

“The current PNA, at $30 for an individual and $60 for a couple, has not been raised since 1988; and it is not indexed to inflation,” Fishman said. “This is not enough for the simple daily expenses of adults who deserve our respect and gratitude. The Personal Needs Allowance should be enough to support the day-to-day dignity of the hundreds of thousands of our fellow Americans who rely on Medicaid in nursing homes. The bill would double the current PNA for individuals and couples to $60 and $120, respectively, and index the amount to inflation.”

Robyn Grant, director of public policy and advocacy for the National Consumer Voice for Quality Long-Term Care said publicity surrounding Wexton’s bill is also helping to clear up a common misconception about Medicaid.

“People think if you’re in a nursing home and Medicaid is covering your stay, that Medicaid pays for everything you need,” Grant said. “We all need to think again. 

“Many basic items such as clothing, including socks, shoes, and underwear, are not included, and residents must use their PNA to make such purchases,” she said. “When taken out of a PNA of $30 or even a slightly higher amount, that leaves little to nothing to pay for other necessities, such as a haircut. Or imagine not being able to afford a birthday card to send to a grandchild or things that bring a little joy to your day like your hometown newspaper. This strips nursing home residents of dignity and makes many feel embarrassed and humiliated. Congresswoman Wexton’s bill would help restore that dignity so residents no longer feel like second-class citizens.” 

Wexton’s bill has been endorsed by Families USA, National Consumer Voice for Quality Long-Term Care, Justice in Aging, the Virginia Poverty Law Center, the National Academy of Elder Law Attorneys, and the Medicare Rights Center. 

The full text of the bill can be found here.