Category

REPORTS

Fact Sheet: Medicare Plan Enrollment Changes for Dual Eligibles and Low-Income Subsidy Recipients in California

By | CA Health Network Alert, FACT SHEET, Health Care, Medicaid, Medicare

The Centers for Medicare and Medicaid Services (CMS) issued new rules that limit enrollment and disenrollment from Medicare Advantage and Part D prescription drug plans for low-income Medicare beneficiaries. Previously, dual eligibles – individuals with Medicare and Medi-Cal coverage – and beneficiaries who receive the low-income subsidy (LIS) to make Part D prescription drug coverage more affordable could make enrollment changes any time throughout the year. The new rule, which became effective January 1, 2019, limits enrollment changes to once per quarter.

Justice in Aging has created a factsheet that explains these changes in detail and how they impact low-income Medicare beneficiaries in California.

Report: Older Women & Poverty

By | Economic Security, Health Care, Health Care Defense, Health Disparities, Health Equity, Long Term Care, Medicaid, Medicare, Nursing Homes, Oral Health, Safety Net Defense, SENIOR POVERTY, Social Security, Special Report, Supplemental Security Income

Because of structural inequities that impact women more than men, a significant percentage of older women are struggling to stay out of poverty.

There are 7.1 million older adults living in poverty in the United States, with nearly two out of three of them being women. Women like Venorica, who is working three jobs at the age of 70, and Vicky, who once ran a successful business with her husband, are struggling to stay afloat.

A new Justice in Aging report surveys the reasons more women are aging into poverty than men, discusses the support systems that are in place to help older women, and recommends ways we can strengthen and expand those support systems. The brief is accompanied by videos of women telling their own stories. Older women have cared for us and worked hard all of their lives. It’s imperative that we enact policies so they don’t have to struggle to make ends meet.

READ THE REPORT
WATCH THE VIDEOS HERE

Issue Brief: Medicaid Work Requirements and Family Caregivers

By | Health Care, Health Care Defense, ISSUE BRIEF, Medicaid, REPORTS, Safety Net Defense, SENIOR POVERTY

Medicaid Work Requirements can cause family caregivers to lose their health coverage, putting their health and the health of the older adults they care for in jeopardy.

With Thanksgiving on the horizon, our thoughts are on families and the 40 million family caregivers who provide care to an adult family member. Medicaid is an important source of health insurance coverage for those family caregivers who do not have access to other affordable coverage options. However, many states are in the process of designing or implementing policies that require family caregivers and others who are eligible for Medicaid to work a certain number of hours per month or qualify for an exemption to maintain their health coverage.

Implications for family caregivers

Low-income family caregivers may be unable to work sufficient hours at a paid job because of their caregiving responsibilities and may not qualify for the state’s exemptions. As a result, many will lose access to health care they need to maintain their own health, harming both their own well-being and the well-being of the older adults they care for.

A new Justice in Aging issue brief provides a state-by-state survey of how Medicaid work requirements apply to family caregivers and explains the harms they will cause to family caregivers and the older adults they care for.

READ THE BRIEF

Issue Brief: Medicaid Enrollees Put at Risk When State Medicaid Programs Assume Support from Family Caregivers

By | Health Care, Health Care Defense, ISSUE BRIEF, Medicaid

A new Issue Brief reveals how states’ assumptions often deprive Medicaid recipients of needed assistance.

Under Medicaid law, all assistance by friends and family members must be voluntary. This brief, based on a review of over 100 administrative decisions in several states, shows how Medicaid programs violate this law to the detriment of people on Medicaid. Medicaid programs often deny services based on family assistance that is not available. This puts lives at risk, increases the chances that a beneficiary will have to be institutionalized, and forces families to make impossible choices between caring for a family member and going to work.

The issue brief outlines states’ responsibility to respect the voluntary nature of assistance, examines how some states approach the issue, and suggests public policy responses to ensure that states authorize adequate assistance.

Rachel Gershon, of the University of Massachusetts Medical School’s Center for Health Law and Economics co-authored this paper with Justice in Aging attorney, Eric Carlson. The paper is part of a post-fellowship project with Justice in Aging and the Borchard Foundation Center on Law and Aging. 

Fact Sheets: New Resources on How Trump’s Public Charge Impacts on Older Adult Immigrants

By | CA Health Network Alert, Economic Security, FACT SHEET, Health Care, Medicaid, Social Security

Advocates are preparing to respond to a new “public charge” rule from the Trump Administration that would put immigration status at risk if an immigrant seeks access to an array of programs that support health, nutrition, and economic stability.

If implemented, this rule would harm older immigrants, their families, and caregivers. The rule would make it much more difficult for U.S. citizens and residents to welcome aging parents or other family members into the country. Seniors and their families may be afraid to go to the doctor or get helping paying for food or rent. Additionally, many immigrant older adults work as caregivers for very low pay. This rule would make it harder for them to access benefits like Medicaid and SNAP (Supplemental Nutrition Assistance Program).

Justice in Aging has a new fact sheet that provides an overview of the harms to older adults, their families, and caregivers that the Trump Administration’s changes to the “public charge” rule pose.  A California fact sheet provides an overview of these harms looking at California-specific data and programs.

Fact Sheet: SSA Clarifies Handling of Medicare Part A Conditional Applications

By | FACT SHEET, Health Care, Medicare, Social Security
Many people do not have enough work history to qualify for premium-free Medicare Part A benefits, however there is still an option for low-income individuals to get their Medicare Part A premiums paid.

A new Justice in Aging fact sheet details how they can enroll in the Qualified Medicare Beneficiary (QMB) Program to get their Medicare premiums paid through their state Medicaid program. Enrolling in QMB can be confusing for people without Part A coverage and often requires visits to both the Social Security Administration office and the state’s Medicaid program offices. A further complication is that many Social Security offices have used conflicting and incorrect procedures or provided misinformation to applicants. Read More

Advocate Guide: Accessibility in Medicaid Managed Care

By | Advocate's Guide, Health Care, Medicaid, mltss

States require managed care plans who serve Medicaid enrollees to establish and maintain an internal grievance and appeal and fair hearing system. As states begin to incorporate new federal regulations into their Medicaid rules, there’s opportunity for advocates to help shape those rules to ensure that older adults and people with disabilities have equal access to the grievance and appeal and state fair hearing systems, as mandated by Section 504 of the Rehabilitation Act (“Rehab Act”), the Americans with Disabilities Act (“ADA”), and Section 1557 of the Affordable Care Act (“ACA”).

Disability Rights Education and Defense Fund (DREDF), Justice in Aging and National Health Law Program (NHeLP) collaborated on a new Advocates Guide to Accessibility in Medicaid Managed Care Grievances, Appeals, and State Fair Hearing. This new Advocates’ Guide, provides guidance on how the federal framework can be made fully accessible to Medicaid beneficiaries who are older and/or have disabilities.

Links to three accessible versions of the guide can be found below.

 

White Paper: An Oral Health Benefit in Medicare Part B: It’s Time to Include Oral Health in Health Care

By | Health Equity, ISSUE BRIEF, Medicare, Oral Health

Oral health is an integral part of overall health. Oral health problems can adversely affect one’s ability to maintain optimal nutrition, self-image, social interactions, and mental and physical health. Oral health problems can lead to chronic pain, tooth loss and serious infections. Poor oral health can even worsen chronic medical conditions such as heart disease and diabetes.

Older adults need timely and affordable access to dental care in order to maintain their health and well-being, yet, there is currently no mechanism for most older adults to access care. Contrary to what many believe, Medicare does not include an oral health benefit. Most older adults cannot afford to purchase private oral health insurance or pay out-of-pocket for the care they need. As a result, 70 percent of Medicare recipients have limited or no dental coverage, and fewer than half see a dentist each year.

A new White Paper, An Oral Health Benefits in Medicare Part B: It’s Time to Include Oral Health in Health Care discusses how a Medicare Part B dental benefit would close disparities in dental use and expense between the uninsured and insured and among older adults with few financial resources and limited oral health education. The paper also details how such a benefit could be structured and the legislative changes that would need to happen before such a benefit could be established.

Oral Health for Older Adults in California: Advocacy Guide

By | Advocate's Guide, Health Care, ISSUE BRIEF, Oral Health

New Advocacy Guide: Oral Health for Older Adults in California

Oral health affects overall health – this is particularly true for older adults. Yet, access to oral health treatment is limited and complicated by factors such as lack of dental coverage, complicated rules, and lack of dental providers. To assist California advocates in connecting their clients with oral health treatment, Justice in Aging has developed an Advocacy Guide for Oral Health for Older Adults in California.

The Guide includes a summary with advocacy tips on the following topics:

  • Why oral health matters
  • The state of oral health for older adults in California today
  • Health insurance coverage options for older adults including Medicare, Denti-Cal, and other forms of coverage
  • Unique barriers sub-populations of older adults encounter in accessing oral health including dual eligibles and nursing facility residents
  • Treatment alternatives for individuals without dental coverage
  • Additional resources

It is our intention that this Guide will help advocates navigate the system and empower them to identify and address systemic barriers to care.

Visit Justice in Aging’s Oral Health page for additional resources and help us celebrate #OralHealthMonth by forwarding this resource to your networks.

How Medicaid Work Requirements Will Harm Older Adults & Family Caregivers

By | FACT SHEET, Health Care, Health Care Defense

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!