“Two-thirds of the people who use Medicaid are poor children, but two-thirds of the money is for long-term care for seniors, whether in a facility…
Nancy Pelosi wrong on Medicaid’s role for children, elderly
During an appearance at a fiscal policy summit in Washington, House Minority Leader Nancy Pelosi, D-Calif., delved into who – and what — the Medicaid program pays for.
Medicaid, the federal-state program that serves many poor Americans, is one of several mandatory spending programs putting pressure on the federal budget.
At roughly 6:48 in this video, Pelosi said, “Two-thirds of the people who use Medicaid are poor children, but two-thirds of the money is for long-term care for seniors, whether in a facility or at home.”
Is this accurate? No — as Pelosi’s office quickly clarified after PolitiFact inquired.
Pelosi “misspoke,” said Henry Connelly, Pelosi’s deputy communications director. Connelly clarified that she should have said that “children are close to half of Medicaid enrollees” and said she “inverted” the statistic about long-term care spending.
“It’s not that two-thirds of Medicaid goes to long-term care, it’s that two-thirds of long-term care is paid for by Medicaid,” citing data posted by the Alliance for Retired Americans. (To be precise, according to the group, the share of long-term care costs paid by Medicaid was 62 percent in 2015.)
Let’s take a closer look at the actual data for age and long-term care spending.
Children accounted for 48 percent of Medicaid beneficiaries in 2013, not the two-thirds Pelosi initially said. The percentage may have changed somewhat following the expansion of Medicaid under the Affordable Care Act, but experts said they did not expect there to have been a dramatic shift.
Here’s the full breakdown:
As for long-term care costs as a share of Medicaid spending, it’s quite a bit less than the two-thirds Pelosi cited. In 2016, various types of long-term care accounted for 21.4 percent of all Medicaid spending.
Our ruling
Pelosi said, “Two-thirds of the people who use Medicaid are poor children, but two-thirds of the money is for long-term care for seniors, whether in a facility or at home.”
Her office acknowledged that she misspoke. She overstated both the percentage of Medicaid beneficiaries who are children, and the percentage of Medicaid spending devoted to long-term care.
We rate the statement False.
PolitiFact Rating: 
Our Sources
Peter G. Peterson Foundation, Fiscal Summit video, May 10, 2018
Kaiser Family Foundation, "Medicaid Enrollment by Age," 2013
Kaiser Family Foundation, "Distribution of Fee-for-Service Medicaid Spending on Long Term Care," 2016
Kaiser Family Foundation, "Total Medicaid Spending," 2016
Kaiser Family Foundation, "Medicaid and Long-Term Services and Supports: A Primer," Dec. 15, 2015
Kaiser Family Foundation, "Fact Sheet: Medicaid Pocket Primer," June 2017
Alliance for Retired Americans, "Medicaid Factsheet 2015," Dec. 2, 2015
Email interview with Gail Wilensky, head of Medicare and Medicaid for President George H.W. Bush, May 10, 2018
Email interview with Henry Connelly, deputy communications director for Nancy Pelosi, May 10, 2018
