Posts Tagged ‘providers’

Affordable Care Act (ACA) Facts: Part 2 in a Series

Thursday, February 24th, 2011

Affordable Care Act (ACA) Facts: Follow this Series

There is a lot of speculation and discussion about what affect health care reform legislation, the Affordable Care Act (ACA), will have on seniors and more specifically, Medicare. We decided to do a series of blog posts about the facts; this is our second post, so please see Fact # 1 in a post dated, Feb 8, 2011.

Fact # 2 The ACA will reduce Medicare spending growth, extend Medicare solvency and is projected to reduce the budget deficit.

While Medicare spending will continue to grow, over the next 10 years the healthcare law will slow the overall rate of growth. Average spending per person will grow at about 2% per year, according to the Congressional Budget Office (CBO) this is compared to the current rate of 4% per person per year. This slight decrease will be a result of reductions in waste, fraud and abuse.  The CBO also projects that the ACA will save Medicare about $400 billion over 10 years and will extend the solvency of the Medicare Trust Fund until 2026.

What you need to know:

In 2011, the ACA will slow payment increases that are made to Medicare providers such as, hospitals, nursing homes and home health agencies. Please note that doctors are not included in that group. The ACA does not reduce payments to your primary care doctor.

Also in 2011, payments to Medicare Advantage (MA) will be reduced. Approximately 25% of seniors are enrolled in MA plans, HMOs or PPOs offered by private insurance companies, the other 75% have traditional Medicare. The ACA will gradually lower payments made to MA plans, which on average cost 13% more than original Medicare. Another change that ACA makes to Medicare Advantage (MA) plans is that those plans will not be able to charge you more than what you would pay if you were on original Medicare for services such as kidney dialysis, chemotherapy, or skilled nursing home care.

Because of these laid out in the Law, MA plans may cut some of the extra benefits they offer that are not covered by traditional Medicare and some may increase their premiums. Please note that MA plans cannot cut any basic benefits under Medicare, such as doctor visits and hospital care. You will also have the same right to switch out of your MA plan to original Medicare, the new law will not affect your right to Medicare benefits.

Another way that Medicare savings will occur according to statements in the Affordable Care Act, is for higher income individuals to pay higher prescription drug premiums. This will affect about 5% of Medicare recipients in 2011, single people with incomes above $85,000 and couples with adjusted gross incomes above $170,000.

The ACA states that in 2014 a Payment Advisory Board will be created. This board of experts will recommend specific ways to reduce Medicare costs without cutting benefits or increasing out-of-pocket costs.

Information in this blog was gathered from the Affordable Care Act,  Congressional Budget Office, Centers for Medicaid and Medicare and the National Council on Aging.

For more information check out the following links:

A brochure from Medicare:

http://www.medicare.gov/Publications/Pubs/pdf/11467.pdf

Webpage from the National Association of States United for Aging and Disabilities (NASUAD):

http://www.nasuad.org/affordable_care_act/nasuad_materials.html

Answers from the National Association of Area Agencies on Aging (n4a):

http://www.n4a.org/advocacy/health-care-reform/

Straight Talk for Seniors from the National Council on Aging:

http://www.ncoa.org/public-policy/health-care-reform/straight-talk/

NJ’s Budget Impact on Seniors

Wednesday, May 26th, 2010

May 26, 2010

New Jersey’s budget is in the midst of a heated debate. Governor Chris Christie has proposed the new budget and made many cuts. There have been many groups affected by the cuts that have reacted with press releases, meetings and rallies. NJFA and its partners have done much research and speaking out about the impact on our most vulnerable populations, including seniors.

Some of the proposed cuts included PAAD, NJ’s prescription drug assistance program, seniors would have been forced to pay a $310 deductible and face a co pay increase for brand name drugs from $7 to $15. Thanks to the efforts of many groups, the message of the impact of these cuts got to the legislators and they were successful in getting Gov. Christie to remove those cuts from the budget and keep the PAAD program the way it had been.

While that victory feels pretty good there are still many issues regarding the budget and seniors. The Senior Freeze program, a property tax reimbursement program, will not be given out in 2011, that is approximately $1,000 that many low to middle income seniors rely on to help make ends meet. Another item in the proposed budget that will affect the low income senior in NJ is the addition of a $5 co pay for medical day care services with a monthly cap of $25 and the elimination of medication administration as a criteria for medical day care attendance. Many caregivers rely on medical day care as part of a senior or disabled persons care plan, this will be a hardship for those who need it most.

A decrease in the provider reimbursement rate for the PCA program, a home care program that services 29,000 disabled persons and seniors, has been a hot topic in regard to Gov. Christie’s budget. The cut, which decreases the rate by approximately $2, has been the subject of budget hearing testimony due to the fact that this will cause many providers to withdraw from this vital service, leaving many clients in need without services.

With the Elder Index NJFA highlighted an issue regarding some of our most vulnerable seniors and that is the NJ SSI State Supplement which is just $31 a month and has been since 1986, a payment that is meant to help disabled persons make ends meet on a fixed income and just doesn’t cut it at that level. Recently a budget item has come to our attention that is equally troubling, the spousal supplement for caregivers of disabled persons is due to be eliminated in the proposed budget. Again, many of the cuts in this budget are affecting seniors, the disabled and their caregivers, many of whom are already living on the edge.

NJFA and many of our partner organizations have put out press releases, op eds and fact sheets, sending them to newspapers, legislators and community groups, hoping to get the word out about the proposed budget cuts and their impact on seniors. NJFA encourages everyone to contact their representatives in the legislature to make their voice heard.

You can find contact information for your local representatives at www.njleg.org

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