Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

Low Obamacare Premiums to Soften Blow for Those Losing Medicaid

Ganny Belloni
March 16, 2023, 5:44 PM

CMS will take active role during Medicaid eligibility checks

All states required to take 14 months to complete checks

One-third of the millions of individuals expected to lose Medicaid coverage as eligibility checks resume this spring will qualify for Affordable Care Act coverage with low or no premiums, a top Medicaid official said.

The Department of Health and Human Services believes the majority of those whose Medicaid eligibility will be redetermined will remain eligible, and the government is actively collaborating with states to make sure beneficiaries don’t lose coverage because of administrative issues, Daniel Tsai, director of the federal Center for Medicaid and CHIP Services, said Thursday in an interview with reporters

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https://news.bloomberglaw.com/health-law-and-business/low-obamacare-premiums-to-soften-blow-for-those-losing-medicaid

#AffordableCareAct #DepartmentofHealthandHumanServices #CenterforMedicaidandCHIPServices #DanielTsai #Medicaid #CMS

Medicaid Access Increases Use of Care, Study Finds

Excerpt from: The New York Times (click for full article)

 

Come January, millions of low-income adults will gain health insurance coverage through Medicaid in one of the farthest-reaching provisions of the Obama health care law. How will that change their finances, spending habits, use of available medical services and — most important — their health?

New results from a landmark study, released on Wednesday in The New England Journal of Medicine, go a long way toward answering those questions. The study, called the Oregon Health Study, compares thousands of low-income people in Oregon who received access to Medicaid with an identical population that did not.

It found that those who gained Medicaid coverage spent more on health care, making more visits to doctors and trips to the hospital. But the study suggests that Medicaid coverage did not make those adults much healthier, at least within the two-year time frame of the research, judging by their blood pressure, blood sugar and other measures. It did, however, substantially reduce the incidence of depression, and it made them vastly more financially secure.

CMS Chief Expresses Optimism About Federal Exchange Enrollment

Excerpt from: Kaiser Health News (click for full article)

 

But other signs, such as the number of insurance carriers applying to sell policies in Illinois' health insurance marketplace, suggest cause for concern. Meanwhile, Modern Healthcare reports on the downside of the Obama administration's shorter application form for purchasing insurance through the exchanges.

Health Care for 1972?

Excerpt from: Health Policy Forum (click for full article)

 

The fact is that roughly 70 percent of Americans over the age of 65 will need some form of long-term care, on average for three years. Yet most people, when asked, think they will never need this kind of care. To make matters even worse, many individuals mistakenly believe that Medicare will pay for long-term services and supports even (it does not). The result is a public that is woefully underprepared and ill-equipped to prepare for what are probably inevitable health needs.

This gap in knowledge and awareness has contributed to our current “non-system” of financing long-term care, in which people are left to fend for themselves to pay for services or spend down to near poverty levels to qualify for Medicaid; for only then is public help available. This is neither a sustainable nor a dignified policy. We need to develop a better model that will ensure that all Americans can age with dignity, choice, and independence. But what would that look like? As a physician, I believe we have perfected the health care delivery model for 1972. What we need today and into the future is an updated toolbox for financing long-term care that serves the needs of a 2013 population. In 1965, the average life expectancy was 69 years old. If an older person experienced a major health event—a heart attack or stroke, for example—they might have recovered, but they probably did not live much longer beyond that event. Today, with advances in medicine and technology and the increased number of intensive care units and critical care units, people are living longer than ever before, but with functional impairments and multiple chronic conditions. The delivery model we have today is not designed to meet these growing care needs, and the financial strains on individuals and families are significant.

How the Arts Can Change Care for Elders and People with Disabilities

Excerpt from: Forbes (click for full article)

 

Yesterday morning, a veteran of the decades-long effort to improve the way we deliver and pay for long-term supports and services asked me a question. Why, he wondered, should he believe that recent attempts to reform long-term care could succeed when so many previous initiatives have failed.  Last evening, I may have found an answer.

My wife and I went to see a powerful play called How to Write a New Book for the Bible.  It is an unsparing look at the real-life experiences of the author, Bill Cain, who cared for his mother during the last year of her life. Cain, a Jesuit priest and writer, absolutely nailed the reality of caregiving— the pain, the intimacy, and even the humor.

But the play got me thinking about my friend’s question: How is it different this time? The answer may be that caregiving is finding its way into the arts and popular culture in ways that it never has before.  And that may both reflect changing public opinion and drive policy reform in ways traditional lobbying cannot.

Medicaid’s Looming Long-Term Care Crisis

Excerpt from: Hawaii Reporter (click for full article)

 

As we work to rein in wasteful spending and improve retirement security, our nation cannot afford to overlook Medicaid’s long-term care financing crisis.

We’re completely unprepared for the coming “age wave.” More than 15 million Americans will be 85 years or older in 2040. While seven in 10 seniors will need some type of long-term care (LTC) during their lives, only one in 10 has private LTC insurance coverage. Almost 14 million seniors could suffer from Alzheimer’s in 2040, and the annual rate for a private nursing home room continues climbing, reaching $81,030 in 2012.

Research shows many Americans mistakenly believe they have LTC coverage through Medicare when they do not. The misinformation puts their retirement plans at risk. Without change, millions of middle-class baby boomers will turn to a welfare program, Medicaid, to finance these needs.

Kaiser Health Tracking Poll: April 2013

Excerpt from: Kaiser Family Foundation (click for full article)

 

As the federal government, state governments and other stakeholders gear up for public information campaigns tied to the October start of open enrollment in the ACA’s health insurance exchanges, Americans report that thus far they have been relying most heavily on their own personal networks and the news media for information about a law that continues to be only dimly understood by many. The most commonly cited sources of information in Kaiser’s April Health Tracking Poll are friends and family (named by 40 percent), “newspapers, radio or other online news” (36 percent), and cable news (30 percent).

Thus far, about one in ten Americans report getting any information from a health insurance company, their doctor, an employer, or a non-profit, and few name any of these as their most important source of information. About the same share (9 percent) report having gotten information from “federal agencies such as the Department of Health and Human Services,” with little difference across demographic groups. Eight percent say they have gotten some ACA information from “state agencies such as your state Medicaid office or health department,” a share which doubles among African Americans (17 percent). The poll provides a rough baseline before more intensive public information and consumer assistance begins.

REPORT: Home Care Continuity Improves ADL Performance

Excerpt from: Phi National (click for full article)

 

Home care consumers who experience a low level of care continuity with their home health aides are less likely to see improvements in their activities of daily living (ADLs) than those with moderate to high continuity, a report published in Home Health Management & Practice found.

The study, conducted by the Visiting Nurse Service of New York (VNSNY), analyzed the correlation between care continuity and ADLs for more than 16,000 VNSNY consumers.

According to the researchers, consumers with low care continuity were 14 to 15 percent less likely to improve their ADLs than consumers who have a high continuity of care.

"In cases where a patient sees a different aide from the one who normally visits, the new aide must acquaint themselves with the patient's routine, tastes, and preferences," the authors write.

Americans Seriously Unprepared for Long-Term Care, Survey Finds

Excerpt from:PBS Newshour (click for full article)

 

It's a classic case of denial. Roughly half of Americans above the age of 40 believe "almost everyone" is likely to require long-term care as they age. Just a quarter think they will need it for themselves.

The truth: 70 percent of Americans older than age 65 will need some form of long-term care.

That gap means most Americans are doing very little to plan and save for the assistance they'll desperately need in old age, according to a new poll from the The Associated Press-NORC Center for Public Affairs Research.

"It's rather surprising," said Jennifer Agiesta, director of polling for the Associated Press. "Very few people have arranged to pay for or even to think about their own needs. Most haven't even taken the basic step of talking to family members about their preferences."

The problem will only become worse as America grays, with the number of seniors expected to nearly double by the time the last of the baby boomers turn 65. In 2030, seniors are expected to make up 19 percent of the U.S. population -- up from 12 percent in 2000.

Long-term care in aging US: Not for me, poll says

Excerpt from: KWQC (click for full article)

 

We're in denial: Americans underestimate their chances of needing long-term care as they get older - and are taking few steps to get ready.

A new poll examined how people 40 and over are preparing for this difficult and often pricey reality of aging and found two-thirds say they've done little to no planning.

In fact, 3 in 10 would rather not think about getting older at all. Only a quarter predict it's very likely that they'll personally need help getting around or caring for themselves during their senior years, according to the poll by the AP-NORC Center for Public Affairs Research.

That's a surprise considering the poll found more than half of the 40-plus crowd already have been caregivers for an impaired relative or friend - seeing from the other side the kind of assistance they, too, are likely to need later on.

"I didn't think I was old. I still don't think I'm old," explained retired schoolteacher Malinda Bowman, 60, of Laura, Ohio.

As Session Enters Home Stretch, THCA Urges BudgeConferees to Prioritize Funding for Texas Seniors' Medicaid Nursing Home Care

Excerpt from: Wall Street Journal (click for full article)

 

With Senate and House Conferees now named to help guide, shape and direct the final state budget towards ultimate passage, the Texas Health Care Association (THCA) encouraged the lawmakers to ensure Texas nursing homes and the vulnerable patients under their care receive the priority required to help cope with the operational instability caused by 2011's $58 million state Medicaid cut and the new $51 million federal Medicare cut, now in effect.

"As we enter the home stretch of the legislative session, we believe the most significant piece of unfinished business is ensuring Texas' most vulnerable frail, elderly and disabled Medicaid-dependent nursing home patients can continue to access the quality care they deserve by making sure state nursing homes remain operationally stable in the face of deep Medicaid and Medicare cuts," said Tim Graves, President of THCA.

"We look forward to working with Conferees in a constructive, positive manner to ensure they are appropriately aware how their local facilities are increasingly struggling with shrinking resources in the face of growing numbers of patients requiring the type of 24/7/365 care that can only be found in their local skilled nursing facility," the THCA leader continued.