3 Critical Things Left Out Of The Health Care Reform Debate

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2013-10-28 17.26.27The political battle on health care reform rages on. But the debate totally misses some important features of the Affordable Care Act that directly affect elders.

Maybe people who oppose the Supreme Court decision don’t want to look as if they are against elders so they avoid discussing a number of the real benefits to seniors that are part of the bill.

Who am I talking about that will benefit? It could be your own aging parents. The ACA requires many broad changes that will be directly and immediately helpful to our elders.

Here are just three of the many things the National Senior Citizens’ Law Center reports about what is in the Affordable Care Act (ACA) and the effect on seniors. I add my own comments.

1. The Elder Justice Act

If we want to stop seeing so many horrifying stories of elder abuse, both physical and financial, we need a national coordination of effort to fight elder abuse. Now, it’s here, in the ACA. The Act will establish grants to create centers for developing forensic expertise to collect evidence relating to elder abuse, neglect or exploitation. It will enhance training of staff in nursing homes. It will strengthen the enforcement ability of Federal and State entities to prosecute elder abuse cases, among other things. This Act has a far reaching effect on combating elder abuse, a $2.9B a year problem in the U.S.

2. Community First Choice Option

This provision is for participating states who want the 6% increase in Federal Medicaid funding to pay for community-based attendant services for elders who would otherwise have to go to a nursing home or other care facility. This is the only kind of attendant care support available through Medicaid that has the purpose of keeping people out of nursing homes, a far more expensive option than staying at home. Is anyone really in favor of forcing people into nursing homes because they can’t pay for the hours of attendant care that allow them the independence of staying in their own homes? Typically, it costs three times as much to put someone in a nursing home as it does to care for them with attendants at home.

3. Improving seniors’ access to home-based primary care physicians and nurses

Through the Independence at Home demonstration, the ACA will pay physicians and nurse practitioners to provide home-based primary care to targeted chronically ill individuals for a three -year period. This is plain common sense. I was once a visiting nurse myself. I can testify from first-hand experience that doctors and nurses who focus on keeping folks relatively healthy at home instead of allowing them to deteriorate and need expensive care in hospitals or nursing homes are doing us all a favor. Preventive care and monitoring seniors at home heads off complications of chronic illness. This will keep the cost of care down in the long run. If Medicaid eligible seniors go to nursing homes, the taxpayers are footing the bill. It’s over $95,000 per year, on average, for a shared room in a nursing home.

The poorest and sickest in our society have been addressed in these parts of the ACA. Yet all the attention in every debate or report I see or hear about the ACA is on the individual mandate, the effect on insurance companies, the IRS, the tax question and penalties for not buying insurance, etc. How about our aging parents?? You notice that no one is debating the benefits to them.

I often write in this blog about the cost of elder care, the burden of adult children becoming caregivers for aging loved ones, and the struggle we have as a society to deal with the increasing longevity and vulnerability to abuse in our senior population. Regardless of your politics, you can’t miss how urgent these problems are becoming. Without legislation to try to repair these problems, they just keep growing on a massive scale. And you will pay for them, as you are already doing, but the bill will increase significantly.

We do not have any other legislation at this time that addresses these specifics. The Elder Justice Act, for example, drafted originally in 2007, did not pass the legislature until the ACA passed.

What alternatives do we have? Many of our aging parents in this country are in desperate need of the help this law ensures. It is my hope that attending to the needs of our aging population is not viewed as a political issue. It is simply a national issue we cannot ignore.

Until next time,

Carolyn Rosenblatt, R.N., Elder Law Attorney

AgingParents.com

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