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

see full article at :

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

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

De cit Reduction: What Disability Advocates Need to Know

Excerpt from: The ARC (click for full article)

 

The Arc succeeded in helping to protect Medicaid in last year’s deficit reduction law, the Budget Control Act. Now there is mounting pressure to find an alternative to cuts mandated by the Budget Control Act
or to find additional cuts in the federal budget to reduce the deficit further. We must renew our efforts to protect the four major programs that impact people with intellectual and developmental disabilities (I/DD) — Medicaid, Medicare, Social Security, and Supplemental Security Income (SSI) — in addition to the many discretionary programs that people with disabilities rely on to be a part of their community.

Disability advocates must remain engaged throughout the coming months to minimize cuts to these programs and protect eligibility and services that are vital to the lives of people with disabilities. Advocates must urge Congress to provide sufficient revenues to fund critical services and supports needed by individuals with I/DD to live and work in the community.

Pressure for Entitlement Cuts Is on Medicare, Medicaid

Excerpt from: Bloomberg Businessweek (click for full article)

 

Democrats say Social Security is off the table. So if Republicans are successful in pushing for changes to entitlement programs in U.S. budget talks, the pressure for cuts will be on Medicare and Medicaid.

Republicans propose raising the Medicare eligibility age. Other options for squeezing money out of the health care program for the elderly include additional co-payments and an increase in premiums paid by high-income recipients. In February, President Barack Obama proposed saving about $70 billion over 10 years by revising the formula for federal matching of state Medicaid expenditures, along with other changes.

“There are things that we can do with entitlements that don’t hurt beneficiaries,” Senate Majority Leader Harry Reid, a Nevada Democrat, told reporters in Washington yesterday without giving specifics.

Efforts to Curb Social Spending Face Resistance

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

 

President Obama’s re-election and Democratic gains in Congress were supposed to make it easier for the party to strike a deal with Republicans to resolve the year-end fiscal crisis by providing new leverage. But they could also make it harder as empowered Democrats, including some elected on liberal platforms, resist significant changes in entitlement programs like Social Security and Medicare.

As Congress returned Monday, the debate over those programs, which many Democrats see as the core of the party’s identity, was shaping up as the Democratic version of the higher-profile struggle among Republicans over taxes.

In failed deficit reduction talks last year, Mr. Obama signaled a willingness to consider substantial changes in the social safety net, including a gradual increase in the eligibility age for Medicare and limits in the growth rate of future Social Security benefits. An urgent question hanging over the new round of deficit talks is which of those changes Mr. Obama and Congressional Democrats would accept today.

How to Protect Your Client From Losing SSI and Medicaid Benefits

Excerpt from: The Legal Examiner (click for full article)

 

A professional trustee should always be utilized. Family members often want to serve as trustee. The trustee must be familiar with SSI law, Medicaid law, tax law, have investment expertise, and be familiar with fiduciary standards. The trustee must also be able to say "no" to requests for inappropriate trust distributions. Many states require corporate trustees in all but the smallest of Special Needs Trusts. Most states require an individual trustee to be bonded, which is often difficult, if not impossible. Where an individual serves as a trustee, it is inevitably a question of when, not if, the trust will blow up in everyone's face. Family members can be appointed as Trust Protectors and given the right to remove and replace the corporate trustee with another trustee. This gives the family members comfort.

Essentially, the trustee makes distributions to third parties who provide goods and services, rather than to the trust beneficiary. A distribution to the trust beneficiary would reduce the SSI payment dollar-for-dollar. Payment to third party providers for goods and services are not considered income, unless they provide food or shelter, in which event the SSI payment is reduced by approximately one-third, but Medicaid continues.

The Arc at the Table with President Obama to Discuss Tax Cuts for the Middle Class, Budget and Medicaid

Excerpt from: The Arc Blog (click for full article)

 

The Arc’s CEO Peter Berns participated in a small meeting with President Barack Obama, Vice President Joe Biden, and senior economic advisors about the President’s goal to stop middle class tax increases and to raise revenues to help invest in the nation and reduce the deficit.  The discussion centered on the urgency of passing a plan to avert raising taxes on the middle class and to raise revenues to finance the federal government without allowing drastic cuts to programs that people with intellectual and developmental disabilities (I/DD) and other vulnerable groups rely on, like education, housing and employment.  These cuts are scheduled to take place on January 1, 2013, along with the expiration of a variety of tax provisions.  Without a deal this year, The Arc is very concerned about the future of Medicaid and Supplemental Security Income, along with Social Security and Medicare.

“I think everyone agrees that raising taxes on the middle class will hurt families, and that it would be particularly troubling to those that have a loved one with I/DD.  These families report that they already don’t have the money they need for the care and support their loved ones need to live a decent life in the community. What will they do if they suddenly have a bigger tax bill come January 1st?”  Berns said.

“We welcome the President’s framework for generating revenue and protecting low income families,” Berns added.  “Medicaid, Medicare, Social Security, and Supplemental Security Income, which are lifeline programs for people with disabilities, should not be at risk in these budget negotiations.  This approach from President Obama would help keep our nation’s commitment to people with disabilities.”

Deficit Reduction: What Disability Advocates Need to Know

Excerpt from: The Arc (click for full article)

 

The Arc succeeded in helping to protect Medicaid in last year’s deficit reduction law, the Budget Control Act. Now there is mounting pressure to find an alternative to cuts mandated by the Budget Control Act or to find additional cuts in the federal budget to reduce the deficit further. We must renew our efforts to protect the four major programs that impact people with intellectual and developmental disabilities (I/DD) - Medicaid, Medicare, Social Security, and Supplemental Security Income (SSI) - in addition to the many discretionary programs that people with disabilities rely on to be a part of their community.

Disability advocates must remain engaged throughout the coming months to minimize cuts to these programs and protect eligibility and services that are vital to the lives of people with disabilities. Advocates must urge Congress to provide sufficient revenues to fund critical services and supports needed by individuals with I/DD to live and work in the community.

The bottom line is that our work is far from over, and Medicaid continues to be at risk. This analysis aims to educate advocates about the current fiscal situation and its potential impact on people with I/DD.

No Cuts to Social Security Benefits: VITAL PROGRAM FOR PEOPLE WITH DISABILITIES MUST BE PRESERVED

Excerpt from: Consortium for Citizens with Disabilities (click for full article)

 

Millions of people with disabilities and their families rely on the Social Security disability, retirement,
and survivors programs to meet their basic needs. The CCD Social Security Task Force strongly
supports taking steps sooner rather than later to achieve the long-term financial solvency of the Social
Security system. It is vitally important to take steps to strengthen the long-term financing of the Social
Security system so that it can continue to provide the critical income support on which many of the
most vulnerable members of our society depend. Social Security benefits, however, are already very
modest and should not be cut in any way. This is especially the case given that very modest increases
in FICA (Federal Insurance Contribution Act) contributions could solve Social Security’s long-term
financing shortfall.

Social Security’s disability programs are particularly critical to people with disabilities and their
families. Their basic structure is effective and should be preserved. Any efforts to change the Social
Security disability programs must protect and expand the effectiveness of these income support
programs, as well as protect access to the corresponding health coverage provided through Medicare
and Medicaid. Additionally, because the intent of the Social Security disability programs is to provide
income support for people who lack the capacity to work at a substantial level, the existing definition
of disability is appropriate. The current definition is strict, providing benefits only to individuals with
the most significant impairments. The current structure also provides sufficient flexibility to allow for
policies that promote employment for beneficiaries who are able to do some work.

What Do the Election Results Mean for Seniors?

Excerpt from: Elder Law Answers (click for full article)

 

Now that the votes are counted (almost all of them, anyway) and President Obama has a second term, what does it mean for seniors? While President Obama's re-election means Medicare and Medicaid as we know them will likely be preserved at least for the next four years, many challenges are still ahead.  

One of the biggest outcomes of the election is that the Affordable Care Act (ACA – a.k.a. "Obamacare"), which candidate Mitt Romney had promised to repeal, will almost certainly remain as law and be fully implemented.  The law is already beginning to close the gap in Medicare’s prescription drug coverage known as the "doughnut hole," as well as providing free preventative care for Medicare recipients. The ACA also included a number of provisions aimed at improving long-term care and helping recipients remain in their homes rather than be forced into nursing homes, and these will continue to be carried out.

There may be some issues ahead, however.  Before the end of the year, Congress will try to avoid going over the "fiscal cliff," which is what will happen if it fails to act on continuing at least some of the Bush-era tax cuts and fails to prevent automatic spending cuts that it agreed to as part of last year's deficit reduction deal.  Many economists believe that the combination of the two could send the fragile economy back into recession.  Lawmakers are now trying to agree on a "grand bargian," alternative spending and revenue measures that will will help reduce the deficit while not damaging the economy. 

Although Medicare and Medicaid will likely maintain their current structures, cuts may be made during these negotiations or later. The President still has to deal with a Republican majority in the House of Representatives, many of whom want to cut spending and entitlement programs.

Social Security hearing tip: Don’t be browbeaten by the judge

Excerpt from: Disability Tips (click for full article)

 

Do not guess the answer to the judge’s question; and do not accept the what the judge tells you about your history if you do not remember the answer yourself.  

Why? While the judge is not trying to suggest the wrong answer, the judge may hear between 7 to 14 cases that day. There is a reasonable possibility that the judge may get something wrong about the facts of your case. If you accept the judge’s answer, and it is wrong, it may be very difficult to walk back your answer and still preserve your credibility.

It is fine to disagree with the judge if you know the suggested answer is wrong. If you do not know, or if you cannot remember during the stress of the hearing, it is also perfectly acceptable to say, “I don’t remember.” However, do not guess!

Your lawyer should have a summary of all of the critical facts and dates in your case. If the issue is important enough, your lawyer can jog your memory with leading questions or refer to exhibits in your file which answer the judge’s question.

Your Legal Corner: Disability and the personal injury claim

Excerpt from: NewJersey.com (click for full article)

 

Before, during and after hurricane Sandy, I could think of only one word … patience. As we were bombarded with repetitive information preparing for the pending storm … patience. When learning how to operate a generator or battery back- up sump pump or simply taking the dogs out amid torrential rain during the storm … patience.

Similarly, if you have been in an accident or have been harmed in some way and now await a personal injury award; when the personal injury claim finally settles, in many instances this case is not necessarily complete ... patience. Before signing off and accepting that personal injury award, it is extremely important to discuss with your attorney whether or not a special needs trust is required.

Settlement funds which are transferred directly to a “disabled” plaintiff may cause the loss of monthly means tested benefits and no matter how extensive the settlement amount received is; the account will eventually run dry.

A special needs trust may be needed if you are a disabled person within the meaning of the Social Security Act. Discuss the possibility of a special needs trust if you are presently receiving SSI, Medicaid, Food Stamps, Section 8 Housing, Veterans Benefits, Waiver Programs, or any other type of means tested benefits. Means tested benefits are those which require the recipient to have income below a certain level in order to continue to receive specific benefits. Once the recipient is above the amount permissible the benefits are extinguished.