And that leaves out the point that it is pretty hard to substitute for medical expenses, something that has already become a concern with how the COLA is currently calculated. Healthcare costs, as we all know, have risen at close to double the rate of reported inflation for two decades.

And, unsurprisingly, people over the age of 75 will spend more than twice as much on healthcare than their younger counterparts. As anyone who had made even one visit to an assisted living complex or nursing home knows, the vast majority of the eldest of the elderly are female. Women make up 57 percent of those over the age of 65, and more than two thirds of those over the age of 85.

There is no substitution for antibiotics, or statins, no switching to lower-cost over-the-counter vitamins when a doctor hands you a script for a prescription to be filled at the local pharmacy.

But back to that subject of assisted living complexes and nursing homes filled with old, old women:

A Medicaid cut has the potential to kick women in any number of ways. For the elderly, of course, it means a lack of services, or services they will have to pay for out of their now-diminished Social Security checks. More than two-thirds of those over the age of 65 receiving Medicaid are female, many using it to pay for home health care workers or nursing homes.

Needless to say, someone will need to step up the caretaking duties if paid assistance is cut back, as at least some have argued it should be. And who might that someone be? Well, cherchez la femme. The typical caregiver of an elderly relative is a 49 year-old woman.

There are various plans for cutbacks out there. One recently discussed in the New York Times: a Republican initiative to turn Medicaid into a block grants to the states, which could then alter the eligibility requirements to throw more cost back into the elderly person and their family. States could also choose to allow residential nursing facilities to bill families for the difference between the government payment and the rack rate.

And guess who will pay that bill? One hint: in that New York Times story all the family caretakers they interviewed had first names like Wendy and Rena.

According to a study released by the MetLife Mature Market Institute, a woman who takes on a caretaking role can expect to lose $324,000 in lifetime salary, pension, and Social Security earnings. And that's now. Any cut in services offered is likely to cause caregivers to cut back on their work further and multiply their losses down the line. Toss in chained CPI on now reduced lifetime earnings and ... well, you see the problem.

And I didn't even cover the point that the majority of paid caretakers are female, too, and they earn a paltry median salary of a little more than $20,000,, so if anyone tries to cut what Medicaid will pay them, or the hours they work, that too will impact their total lifetime earnings that will, in turn, impact their future benefits, which will then be subject to the stingy chained CPI formula, so they too will be standing in their kitchen one day, enjoying peanut butter for dinner.