April 30, 2013

Sequestering Meals on Wheels funds could cost taxpayers far more than it saves. While across-the-board spending cuts that began March 1, called sequestration, are expected to reduce spending on Meals on Wheels programs this year by an estimated $10 million, these savings will be dwarfed by at least $489 million per year in increased spending on Medicaid, both this year and in each subsequent year that sequestration remains in place.

Outside of Washington, waiting lists for Meals on Wheels enrollees have received media attention, but the expected savings have remained largely unquestioned. In reality, cutting Meals on Wheels will very likely increase the federal deficit by increasing the overall cost burden and shifting it to Medicaid, local charities, and other programs.

Overall, Meals on Wheels saves the federal taxpayers money by helping participants live at home instead of living in comparatively expensive nursing homes. The average cost to Medicaid of nursing home care per patient is approximately $57,878 annually.

By contrast, the cost to Medicaid of home care is much lower, approximately $15,371 annually, or $42,507 less than nursing home care. Nationally, according to a survey by the Administration on Aging, as many as "92% [of enrollees] say Meals on Wheels means they can continue to live in their own home."

Based on these estimates, our analysis suggests that sequestering Meals on Wheels funds will actually cost the U.S. taxpayer $479 million dollars over the seven months it will be implemented during this federal fiscal year, which ends September 30 (see the appendix for details of this estimate). Moreover, because sequestration-related cuts are expected to increase in FY 2014 and beyond, if sequestration is not reversed, Medicaid-related costs will increase even more in those years.


A Local Example

For professionals in the field of senior care, the short-sightedness of sequestration cuts is not surprising. Debra Silva, a vice president at Spectrum Generations in Maine, commented in an interview, saying, "[Meals on Wheels] helps keep [seniors] in their home longer and costs far less than sending them to the emergency room or an assisted-living facility."

Many centers are choosing to reduce services to current recipients, as well as restricting the number of new clients. Unfortunately, for some senior recipients, reducing the number of meals a client is receiving can be just as detrimental as denying the service completely.

For one of Spectrum Generations’ clients, Mary Rouleau, who broke her neck last year during a fall, limited mobility makes her dependent on regular visits from her Meals on Wheels program. Because she is unable to complete some basic tasks, including lifting meals out of the oven and preparing vegetables, Mary relies on “sandwiches and TV dinners” in between Meals on Wheels visits.

Mary is just one of the millions of seniors concerned about their food security, in a country where one in 20 seniors is at risk of hunger.



Read the full report.