Why Is Congress Having Such A Hard Time Replacing The Affordable Care Act?

For seven years, “repeal and replace” worked as a great glib political alliteration (see, I can do it too). It was key to Republicans winning control of Congress in 2012 and helped Donald Trump take the White House in 2016. But actually doing it, well, nobody knew it could be so hard.

But why is it so tough? In short, because reducing insurance premiums, which most Americans favor, requires controlling medical costs, which most Americans oppose. And without solving the medical cost problem, lawmakers can’t really fix the insurance problem.  So Democrats try to mask rising premiums with ever-increasing government subsidies while Republicans would reduce insurance costs by effectively blocking sick people from buying coverage, thus creating a low-cost risk pool of mostly healthy people.

What This Week’s Congressional Action On Health Care And Social Services Will Mean For Seniors

Congress took two big steps this week that could have a major impact on seniors and younger people with disabilities. The one that got the most attention, of course, was the Senate’s failure to pass a replacement for the Affordable Care Act. The second, which was barely noticed, was a series of key decisions by House Republicans on how much money senior service programs will receive next year. These choices will have a significant impact on older adults and younger people with disabilities in 2018 and in the future.

A Bipartisan Group Proposes A Package of Modest, But Important Long-Term Care Financing Reforms

The Bipartisan Policy Center, a Washington (DC) based group that develops consensus policy solutions,  has proposed a series of reforms aimed at helping families finance long-term care for themselves and their loved ones. The proposal aims to encourage more people to buy private long-term care insurance, including through Medicare,  and would provide a new Medicare respite benefit for family caregivers.

BPC’s latest proposals come about 18 months after the group suggested a package of initial financing ideas, including better access to workplace-based long-term care insurance and general support for the concept of public catastrophic insurance. This week’s proposals were relatively modest.  And the group failed to agree on the details of a catastrophic program. Still, while the new report falls well short of fixing the nation’s long-term care financing problem, it does address some key issues.

On-Demand Services Can Help Seniors Ease Age In Place But Be Aware of Their Limits

The uberization of senior services is all the rage. You can download an app and order up a home visit from a doctor. You can get home delivered groceries or prepared foods. And, of course, you can get a ride.

While these services were designed primarily for the young and overworked, there are real potential benefits for older adults and others with disabilities who are aging in place. The most obvious: They have the potential to deliver critical supports to people with mobility issues.

Middle-Age Adults and Frail Seniors Would Pay More For Medical and Long-Term Care Under The Senate Health Plan

Senate Majority Leader Mitch McConnell’s health care plan would substantially increase costs for people age 50-64 who buy insurance in the individual market and for the frail elderly and younger people with disabilities who receive Medicaid long-term care benefits.  In some ways, the Senate plan would be marginally better than the House-passed health bill. In others, it would be much worse.  But in almost all respects it would fall far short of current law.

Let’s start with individual insurance for middle-aged consumers who are not yet 65 and eligible for Medicare. The McConnell plan, which is now being revised, would make several important changes to the Affordable Care Act (ACA) marketplace subsidies, many of which would directly affect those aged 50-64.

Proposed Federal Medicaid Caps Will Hurt Seniors. Here’s Why.

The Senate’s version of the House-passed American Health Care Act will almost certainly include a fundamental change in the way the federal government contributes to Medicaid. Over time, that new structure would result in deep cuts in the federal contribution to Medicaid and ultimately reduce long-term care benefits for frail older adults as well as younger people with disabilities. These changes may give states important new flexibility in how they provide these supports and services. But they may also mean that states will slow or even reverse their shift toward delivering assistance in community settings and revert to providing care in nursing homes.

If You Need Long-Term Care, It Matters Where You Live

If you or a loved one needs long-term care, where you live matters…a lot. A new report by AARP shows wide variation in the quality of supports and services among states—whether delivered at home or in a nursing facility. While it found important improvements across states, it also identified significant shortcomings, even in the highest-rated states.

The best states to get care: Washington, Minnesota, Vermont, Oregon, and Alaska. Washington and Minnesota have been consistent leaders in the AARP reports, which began in 2011. The worst states: Tennessee, Mississippi,   Alabama, Kentucky, and Indiana.  However, Tennessee, along with New York, showed the greatest improvement since AARP’s last report in 2014.

How Long-Term Care Helped Wreck British PM Theresa May’s Election Campaign

You probably know by now that last week’s snap election was a disaster for UK Prime Minister Theresa May and her Conservative Party. But you may not know that one issue that cost the Tories their strong parliamentary majority was a proposal that came to be known as the “dementia tax.”  It is a story that has some important lessons for the US.

In the run-up to the election, May proposed major changes in the way the UK provides long-term care.  The Tory manifesto’s aim was to make public support for services more broadly available to low-income people and provide more equal assistance to those living at home and in residential care. But that was not how it played to voters. Hence: the dementia tax.

Pages: 1 2

Trump Backs Paid Leave for New Parents, But Ignores Those Caring For The Elderly

The Trump Administration believes that caring for babies is so important that employers should give their parents up to six weeks of paid leave. It apparently doesn’t believe it is as important, or as disruptive to work life, to care for aging parents or other relatives in need of personal assistance.

That, at least, is the message it is sending in Trump’s 2018 budget. In a fiscal plan otherwise filled with cuts to government-funded social supports, the president proposed allowing states to use their unemployment insurance systems to fund paid family leave.  The US is the only developed country in the world without a paid leave program.

Americans Remain Baffled By Long-Term Care Financing, But Would Like A Medicare Benefit.

Americans age 40 and older continued to be flummoxed by the challenges of long-term care financing, but increasingly believe that Medicare ought to provide such supports and services. According to a new poll by the Associated Press-University of Chicago NORC Center for Public Affairs Research (AP-NORC), support for a Medicare long-term care benefit has grown significantly over the past five years. And for the first time since the survey began, a majority of Republicans favor Medicare long-term care.