PUBLICATIONS

Justice in Aging publishes frequent issue briefs, reports and advocate’s guides that help on-the-ground advocates assist low-income older adults and persons with disabilities deal with often complex challenges related to federal and state benefits programs. Many of the issue briefs are also reflected in our ongoing, free webinar trainings. To ensure that you receive updates on the latest reports or trainings, sign up for our health or income network alerts.

Issue Briefs & Fact Sheets

Fact Sheet: Medicaid Funding Caps Would Harm Older Americans

By | FACT SHEET, Medicaid, REPORTS, Uncategorized | No Comments

On February 16, 2017, Republicans released their latest proposal outlining their ideas to repeal and replace the Affordable Care Act. This proposal radically changes the Medicaid program by capping the amount states will receive in federal funding to deliver healthcare to low-income individuals. These capped proposals, either block grants or per-capita allotments, aim to catastrophically cut Medicaid and eliminate important consumer protections currently in place.

States will be forced to make difficult choices regarding what services they can deliver and what populations they will be able to serve, placing increased pressures on state budgets. Crucial programs that allow seniors to age at home rather than receiving care in institutional settings are at risk.

This latest replacement proposal does not come close to the improved coverage and affordability offered through the ACA for older adults. The plan will increase the cost of care and limit access to health care for older adults, especially low-to-middle income older adults. Specifically, the plan decreases tax credits, reintroduces high-risk pools for the most sick, and increases the availability of health savings accounts that provide little benefit for low to middle income consumers.

Justice in Aging has developed a new fact sheet showing how cuts to Medicaid through capped Medicaid funding would hurt older adults. For more detailed information on how capped funding would impact older adults, see our issue brief.

Fighting Improper Billing of Dual Eligibles: New Strategies

By | ISSUE BRIEF, REPORTS | No Comments

Doctors, hospitals, and other providers often bill dual eligible Medicare beneficiaries and Qualified Medicare Beneficiaries (“QMBs”) for services that should be covered under Medicare or Medicaid. This practice of improper billing is illegal and can cause low-income beneficiaries to go into debt, skip needed medical care, or end up without sufficient funds to pay for necessities like food and rent.

Justice in Aging has created several new resources that advocates can use to stop providers from billing their clients improperly. Today we’re releasing all of our improper billing resources together as a toolkit on our website. In the Improper Billing Toolkit, you’ll find a new issue brief including a chart of improper billing regulations organized by state, several model provider letter templates, including California-specific letters, all of the trainings we have presented on the topic, as well as resources from CMS on improper billing.

Improper billing of QMBs has been a persistent problem across the country that Justice in Aging and other advocates have been working to stop. We’ve worked with CMS to improve its provider education efforts and internal processes, and provided advocates with previous trainings and resources. We’ve made progress but more remains to be done.

That’s why we created this robust toolkit for you to use to help your clients and to share broadly with other advocates.

Medicaid Funding Caps Would Harm Older Americans

By | Health Care, ISSUE BRIEF, Medicaid, REPORTS | No Comments

Recent months have seen increased discussion of proposals to cap federal Medicaid spending. Under these proposals, the federal government would provide limited funding through either block grants or per capita payments to states, and states would have broad discretion to set their own Medicaid standards.

A new issue brief from Justice in Aging explains how these proposals would harm older Americans. The caps would result in a dramatic reduction in federal funding for Medicaid, and these crippling cuts would be exacerbated by the loss of longstanding federal protections. Potential consequences include loss of services, cutbacks in eligibility, unaffordable health care costs, and diminished quality of care.

The issue brief provides careful analysis of both the “cap” proposals and the protections of existing Medicaid law. Many of the proposals tout the “flexibility” of giving almost complete discretion to states. As the issue brief highlights, however, consumer protections in current Medicaid law are vital to older Americans’ health and financial security.

Section 1557: Strengthening Civil Rights Protections in Health Care

By | Affordable Care Act, Health Care, ISSUE BRIEF, REPORTS | No Comments

So many health care protections are at risk in the months ahead, including Section 1557, the provision in the Affordable Care Act (ACA) that specifically applies civil rights protections to health care settings.

This ACA provision has already been targeted, as a nationwide preliminary injunction issued on December 31 by a Federal District Court in Texas prohibits the Department of Health and Human Services (HHS) from enforcing the provisions in the implementing regulations that pertain to transgender discrimination and discrimination based on termination of pregnancy. The temporary order leaves the rest of Section 1557 intact, although some in the new administration and the new Congress would like to go further, seeking to repeal Section 1557 as part of a broader ACA repeal effort.

Justice in Aging has prepared a brief summary of the extent to which the injunction is likely to impact programs that affect older adults.

Justice in Aging also created an issue brief that discusses how Section 1557 and the HHS implementing regulations affect programs that serve older adults. The brief looks at discrimination protections around language access for beneficiaries with limited English proficiency, sex and gender discrimination, disability discrimination and discrimination based on age and race, with examples of how those provisions could play out for older adults using the Medicare or Medicaid benefit.

Special Reports

Unique Legal Needs of Low-Income LGBT Seniors

The intersection of poverty and discrimination creates an array of unique legal needs for older LGBT individuals. A new Special Report by Justice in Aging, produced in partnership with Services and Advocacy for Gay, Lesbian, Bisexual, & Transgender Elders (SAGE), offers an overview and practical tips for legal aid organizations seeking to serve this population. The Report, How Can Legal Services Better Meet the Needs of Low-Income LGBT Seniors? is accompanied by a short video that highlights the diversity of the LGBT community and the gaps in equality its members face as they age.

READ THE REPORT

Homeless Among Older Adults

More older adults are homeless or at risk of homelessness than at any time in recent history. This special report, How to Prevent and End Homelessness Among Older Adults, created in partnership with The National Alliance to End Homelessness, outlines the problem and recommends policy solutions that can be put in place now to ensure that all older adults have a safe place to age in dignity, with affordable health care, and sufficient income to meet their basic needs.

READ THE REPORT

Advocacy Starts at Home

In this report, Advocacy Starts at Home: Strengthening Supports for Low-Income Older Adults and Family Caregivers, Justice in Aging draws the connection between fighting senior poverty, supporting caregivers, and the services needed to help older adults. The stress and expense of caregiving will touch every one of us at some point in our lives, but it can be devastating for poor families. In the paper, we identify clear solutions that will benefit everyone, while providing poor families with the basic support system they need to ensure that older adults in their families can age at home in dignity.

READ THE REPORT

Articles & Op-Ed

How Legal Aid Programs Can Address the Growing Problem of Senior Poverty

Legal aid organizations can play a critical role in securing the rights and benefits of the increasing number of older adults living in poverty. Justice in Aging attorneys Jennifer Goldberg, Fay Gordon, and Kate Lang authored a Special Feature for Management Information Exchange for Legal Aid (MIE) offering suggestions to help legal aid organizations structure their services to have the most impact, reach older adults with the greatest need, and increase their organizational capacity to serve low-income older adults.

READ THE ARTICLE

Medicaid and Supplemental Security Income Eligibility: Time for a Tune-Up

Medicaid and SSI are two essential programs that fight senior poverty by ensuring that low-income older Americans can meet their basic needs and maintain their health. In operation for 50 years (Medicaid) and 40 years (SSI), these workhorse programs are indispensable for seniors. But as the population ages and income inequality increases, both programs need retooling to improve benefits and increase access for more people who need them.

Justice in Aging attorneys Georgia Burke, Jennifer Goldberg, and Kate Lang published Medicaid and Supplemental Security Income Eligibility: Time for a Tune-Up,” in the spring issue of the National Academy of Elder Law Attorneys (NAELA) Journal.

READ THE ARTICLE

New national center aims to enhance legal services for older adults

Early this year, Justice in Aging will launch the new National Center on Law and Elder Rights (NCLER). We are pleased to introduce the aging network to NCLER, a destination for legal and aging advocates who need legal resources to better serve older adults.

Read more from Justice in Aging attorney Fay Gordon in the op-ed New national center aims to enhance legal services for older adults,” from the January-February issue of Aging Today – the bimonthly newspaper of the American Society on Aging.

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Balance billing: a tragic trend that is hurting our poorest elders

Every time I visit the doctor I get a bill for $15.27. I know I should not be receiving these, but I don’t want to ‘rock the boat.’ The doctor is in walking distance, so I don’t need to take public transportation. That saves me a lot because my income is only $329 a month. I ultimately do not know what I should and shouldn’t pay. I really feel anxious. I do not know what is going to happen with my healthcare.

I received two bills that I know I should not have received. I was sick and I needed the care, so I just paid them.

These stories reflect a growing trend of poor older adults being illegally billed for healthcare services covered by Medicare and Medicaid.

Read more from Justice in Aging’s Eric Carlson and Fay Gordon in the op-ed Balance billing: a tragic trend that is hurting our poorest elders,” from the May-June 2016 issue of Aging Today – the bimonthly newspaper of the American Society on Aging.

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