The Centers for Medicare & Medicaid Services issued guidance allowing states to condition Medicaid eligibility on fulfilling work and “community engagement” requirements. Under this policy, states can require adults to work in order to receive Medicaid if they are under age 65 and not disabled under the Social Security Administration’s strict definition. Although states are required to exempt some individuals who cannot work based on their health conditions, and encouraged to allow caregiving hours to count as work, all of these individuals will still be subject to onerous reporting requirements. This presents a significant barrier to health care access for many of the nearly 9 million adults ages 50 to 64 who rely on Medicaid, as well as nearly 5 million people with disabilities and chronic health conditions who do not receive Social Security Disability or Supplemental Security Income, and family caregivers. Learn more with our factsheet!
Older adults and their families strive each day to pay for health care and medicine, keep food on the table, have a roof over their heads, and have enough cash on hand to pay the utilities, get where they need to go and meet other basic needs. As families work together to meet these challenges, they are supported by a broad range of federal programs that provide Americans with the means to thrive as they grow older and remain at home and in their communities.
This issue brief discusses how these various programs work, who is eligible for them, and how they support the health and economic well-being of older Americans. For a quick overview, check out the fact sheet.
The Centers for Medicare & Medicaid Services (CMS) published a major revision of federal nursing facility regulations on October 4, 2016, providing new and expanded requirements for nursing facilities that participate in Medicare or Medicaid. This was the first major revision since the regulations were issued more than 25 years before. This article provides a comprehensive guide to the revised regulations, focusing on care planning and person-centered care; admission, transfer, and discharge procedures; grievance procedures; resident rights, choice, safety, and self-determination; staffing, medications, and quality of care; and protections from abuse, neglect, and exploitation. The article also discusses advocacy and enforcement issues raised by the new rules and subsequent CMS rulemaking activities under the administration of President Donald Trump, which are likely to result in modification of the rules. Read the article by Justice in Aging’s Eric Carlson and the National Consumer Voice for Quality Long-Term Care’s Lori Smetanka and Nancy Stone in the Spring 2018 issue of National Academy of Elder Law Attorneys (NAELA) here.Read the article
As of January 1, 2018, dental benefits were fully restored to adult Medi-Cal recipients. Restoration means that older adults will again have access to gum treatment, root canals on back teeth, and partial dentures. This is a big win for older adults and their overall health. This webinar, Oral Health Coverage for Low-Income Older Adults, provides an overview of the restoration of benefits and Denti-Cal coverage more broadly. The webinar also covers other dental coverage options available to older adults, how different coverage options work together, and barriers older adults face in accessing dental care.
On October 2, 2017, the Centers for Medicare and Medicaid Services (CMS) initiated changes in the Provider Remittance Advice and the Medicare Summary Notice (MSN) to show more clearly that Qualified Medicare Beneficiaries (QMBs) may not be charged for Medicare deductibles and co-insurance. Unfortunately, CMS will be temporarily suspending these system changes as of December 8 because of significant unforeseen issues affecting provider payments. CMS is working to address the problem and reinstate the new systems sometime in 2018.
The temporary suspension of the system improvements does not affect the rights of QMBs. QMBs do not owe deductibles and co-insurance for any Medicare Part A or Part B services.
The suspension also does not affect another change, instituted in November, that enables providers to confirm QMB eligibility before serving individuals, using the same systems through which they check other insurance coverage.
To learn more about these developments, read our fact sheet.
For more information on QMB protections, see the CMS QMB Program webpage. For tools that advocates can use to assist QMB clients who have been improperly billed, go to Justice in Aging’s Improper Billing page.
Last night the Senate passed a tax bill that will take health care away from 13 million Americans including older adults and people with disabilities. Further, it will severely impact the economic security of millions of older Americans and people with preexisting conditions—all for the benefit of the wealthiest 1% of Americans and large corporations.
This tax bill, if passed as is by the House, will explode the deficit by at least a trillion dollars, leading these same Republicans to carry out their calls for massive cuts in Medicaid, Medicare, Social Security, and other critical programs that older adults and their families need, while offering little to no tax relief for struggling low and middle income families.
The Joint Committee on Taxation estimates that even considering economic growth, this bill will cut revenue by $1 trillion. This will force immediate cuts to Medicare and other programs under sequestration. The CBO projects cuts of $25 billion to Medicare in 2018 alone.
The repeal of the individual mandate will cause premiums to spike for those with preexisting conditions, especially impacting older adults age 55-64 who are enrolled in health insurance through the Affordable Care Act. Many will not be able to afford health care. An estimated 13 million Americans will lose their health care, including 5 million people who would not get Medicaid even though they qualify.
This full-fledged attack on people who are already struggling is unconscionable and will cause lasting harm not only to today’s seniors, but to tomorrows’ seniors as well. This includes our grandparents, our parents, ourselves, and our own children.
We call on the House to halt this rushed process, and urge Congress to start over to ensure that any changes to the tax code will not drive up deficits or reduce access to health care for older adults, people with disabilities, and their families.
Republican leadership in both the Senate and House are pushing forward on tax proposals that would give a huge tax break to the wealthiest Americans and corporations and allow Congress to pay for it by cutting funding for critical programs needed by everyone else.
The Senate is expected to vote this week on its version of the plan.
Both Senate and House bills would explode the deficit and make it harder for older adults to afford health care—all while benefitting the wealthiest 1% and big corporations. We created a new fact sheet, Republican Tax Bills Will Hurt Older Adults, for advocates to use this week in their advocacy. The fact sheet outlines how exploding the deficit will force cuts to programs and health coverage for older adults, and how the wealthy 1% and corporations will benefit at the expense of older adults. Please use this fact sheet in your conversations with partners and policy makers and share widely.
Now is also the time to call your Senators and tell them to vote NO on this tax plan. Dial 202-224-3121 and ask to be connected.
Today, Justice in Aging and Center for American Progress are holding a joint briefing on what the tax bills mean for seniors. There’s also a National Call-in Day on Wednesday focused on people with disabilities and their families.
Congress is moving very quickly, aiming to have a bill signed into law by the end of the year. Advocates’ voices are needed to stop this reckless process that jeopardizes health care for millions. Our new fact sheet outlines the threats to health care for older adults and their families in both the House and Senate bills.