How will health law affect you?
By: H. Amos Goodall, Jr.
In a historic vote Sunday, the House of Representatives passed H.R. 3590, the Patrient Protection and Affordable Care Act. President Obama signed it into law Tuesday.
Here's a look at aspects of the law that particularly affect older adults. A more complete analysis is on my Web site at www.centrelaw.com.
Medicare
The law will
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extend the life of the Medicare trust fund which, without intervention, was projected to be depleted by 2017.
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along with pending passage of the Reconsiliation Act of 2010 (H.R. 4872), will eliminate the Medicare Part D coverage gap by 2020 (including providing a $250 rebate to Medicare beneficiaries who reach the doughnut hole in 2010).
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reduce payments to Medicare Advantage (Part C) plans to make them equal (on average per beneficiary) to payments through traditional Medicare. Currently, Medicare Advantage plans receive $135 per beneficiary per month more than traditional Medicare . Individuals and couples in traditional Medicare pay higher premiums to subsidize these higher payments to private insurance plans.
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prohibit cuts to guaranteed Medicare benefits. The only benefits that the private Medicare Advantage plans can eliminate are optional extras such as health club memberships, vision or dental.
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slow the rate of growth in Medicare premiums by new care delivery models focusing on quality rather than quantity; reducing avoidable, dangerous and needless hospital readmissions caused by poor care or lack of follow-up; reducing fraud and abuse; and trimming future increases to hospitals and rehabilitation providers.
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Reduce out-of-pocket expenses for prevention and wellness services for Medicare beneficiaries and provide a free annual check up for Medicare beneficiaries.
Long-term care
The law will:
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require nursing homes to disclose owners, operators, suppliers, financial backers and others with whom they do business so they can be held accountable for the care residents receive.
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require reports on nursing home staffing, including information on the hours of care residents receive; staff turnover rates; and spending on wages and benefits.
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require criminal background checks on employees of long-term care facilities.
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establish the Community First choice option, allowing states to provide community-based services to Medicaid-eligible individuals with disabilities who require an institutional level of care. Participating states will receive a 6 percent increased "federal match."
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provide spousall impoverishment protection to home-and communith- based waiver program participants.
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create Community Living Assistance Service and Supports - a new national long-term care insurance program through voluntary payroll deductions that would provide a cash benefit to individuals who are unable to perform activities of daily living. The Congressional Budget Office projects that this provision alone will reduce the deficit by $57.8 billion over 10 years, including federal and state Medicaid savings of $4.4 billion.
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create health Home, a state option for Medicaid enrollees with chronic conditions (including mental health condition, substance use disorder, asthma, diabetes, heart disease or obesity) to designate a provider or team of health care professionals as their health home.
Elder Justice
The law will:
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establish an Elder Justice Coordinating Council to make recommendations on activities of federal, state, local and private agencies relating to elder abuse, neglect and exploitation.
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dedicate funding for adult protective services and state demonstration grants to test a variety of methods to detect and prevent elder abuse.
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establish elder abuse, neglect and exploitation forensic centers to develop forensic expertise and provide services.
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provide grants to support the Long-Term Care Ombedsman Program and training programs for national organizations and state long-term care ombudsman programs.
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Authorize grants to enhance long-term care staffing through training, recruitment and incentives for individuals seeking or maintaining employment in long-term care, either in a facility or a community based long-term care entitiy.
End-of-life
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There are no end-of-life provisions are included in H.R. 3590.