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

Issue Brief & Fact Sheet: What’s at Stake for Older Adults When States Eliminate Retroactive Medicaid Coverage?

By | Affordable Care Act, FACT SHEET, Health Care, ISSUE BRIEF, Long Term Care, Medicaid

Retroactive Medicaid coverage is a key financial protection that helps older adults and others who develop sudden illnesses or long term care needs access the care they need right away. It is a smart policy intended to protect low-income people from crushing medical debt in instances where they need emergency medical or long-term care and cannot apply for Medicaid immediately. But several states are eliminating this protection through Medicaid demonstration waivers approved by the federal government.

A new Justice in Aging issue brief—Medicaid Retroactive Coverage: What’s at Stake for Older Adults When States Eliminate This Protection?—discusses typical situations that cause older adults to need Medicaid retroactive coverage, and how the policy helps them access care, while protecting them from financial hardship. The issue brief also delves into how states are using waivers to eliminate this coverage, which states are doing so, and how older adults, their families, and health care providers are harmed when the coverage is eliminated. A companion fact sheet provides a higher level view of the issue.

 

FAQ: Low-Income Subsidy (“Extra Help”) for Dual Eligibles Receiving Home and Community-Based Services

By | FACT SHEET, Health Care, Health Care Defense, Home & Community Based Services, Medicaid, Medicare, REPORTS

The Affordable Care Act (ACA) enables full-benefit dual eligibles who receive certain Medicaid home and community-based services (HCBS) to receive Medicare Part D covered drugs at no cost. This requirement is called institutional cost-sharing, and was designed to put people who receive HCBS at home on an equal footing with those who are in institutions (who are also not charged any co-pays). Unfortunately, despite the institutional cost-sharing requirement, pharmacies still ask dual eligibles to pay co-pays for covered drugs.

Justice in Aging created an FAQ, Low-Income Subsidy (“Extra Help”) for Dual Eligibles Receiving Home and Community-Based Services, to give advocates working with dual eligibles the tools they need to prevent these co-pays. The FAQ discusses whom the cost-sharing rule applies to, the length of the cost-sharing protection, and what to do if a dual eligible HCBS-enrolled individual is prompted for a co-pay at the pharmacy or is entitled to a refund. Advocates should review the FAQ and make sure to their HCBS-enrolled dual eligibles are not paying any co-pays for their Part D drugs.

Issue Brief: D-SNP Look-Alikes – A Primer

By | DUAL ELIGIBLES, ISSUE BRIEF, Medicaid, Medicare, REPORTS

More dual eligibles—individuals with Medicare and Medicaid—are enrolling in a certain type of Medicare Advantage plan as a result of aggressive marketing efforts targeting dual eligibles. This type of plan, known as a Dual Eligible Special Need Plan (D-SNP) Look-Alike, threatens to undermine promising advancements in integrated care for duals made possible by the Affordable Care Act (ACA). D-SNP look-alikes are not subject to the regulations governing D-SNPs and therefore have no responsibility to coordinate Medicare and Medicaid benefits. Because they are marketed aggressively almost exclusively to duals, they draw dual eligibles away from coordinated options and place responsibility on the consumer to navigate two separate delivery systems, potentially exacerbating disruptions and gaps in care.

Justice in Aging created this issue brief, Dual Eligible Special Need Plan Look-Alikes – A Primer, to help educate advocates working with dual eligibles about the impact of these plans on dual eligibles and to request that advocates report experiences with D-SNP look-alikes to Justice in Aging and CMS.

This new issue brief:

  • Outlines some key requirements of D-SNPs;
  • identifies the basic characteristics of D-SNP look-alikes;
  • discusses problems look-alikes are causing for dual eligibles; and
  • proposes ways to restrict them in the Medicare market.

Issue Brief: 10 Year Check-Up: The Affordable Care Act Has Enhanced Access to Quality Health Care for Low-Income Older Adults

By | Health Care, ISSUE BRIEF, Language Access, Medicaid, Medicare, Nursing Homes, REPORTS

As the U.S. Court of Appeals for the 5th Circuit prepares to decide the constitutionality of the Affordable Care Act (ACA) this week, it’s time for a check-up on how the law has expanded affordable coverage for low-income older adults. Our new issue brief, 10 Year Check-Up: The Affordable Care Act Has Enhanced Access to Quality Health Care for Low-Income Older Adults, discusses all the ways this landmark legislation has improved the health and economic security of older adults. The brief also discusses how the ACA has become so ingrained in the overall health system, that without the law, the system itself would collapse.

The issue brief provides a detailed look at how the ACA has expanded affordable coverage through Medicaid to more people and made it possible for more older adults to age at home and in their communities instead of in nursing facilities. Under the ACA, older adults also are protected against being charged more for pre-existing conditions and being denied essential health benefits. Low-income older adults who receive both Medicaid and Medicare get better care coordination and more help with prescription drugs. Additionally, the ACA expanded Civil Rights protections for LGBTQ and limited English proficient seniors, and stepped up oversight of nursing facilities, among other protections.

This paper shows how, after 10 years, the ACA is woven deeply into every health care program on which older adults rely. Without it, more older adults would lose their coverage, pay more for premiums and prescription drugs, be at greater risk of institutionalization, and lose many ground-breaking consumer protections. We must continue to work together to strengthen and protect this foundational program.

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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