The House GOP Health Plan Would Be The Biggest Change For Seniors In A  Half-Century

House Republicans have proposed a major rewrite of the Affordable Care Act that would increase the cost of health insurance for older workers and profoundly change the Medicaid support system for the most vulnerable. It would be the biggest change in government assistance for long-term care since the creation of Medicaid a half century ago.

The proposal would retain the basic structure of the law but redesign individual insurance subsidies and sharply reduce the federal payments to the Medicaid program. The likely bottom line for seniors: Higher premiums and out-of-pocket costs for those aged 60 and older who are not yet enrolled in Medicare, and reduced benefits for low-income seniors who are receiving long-term services and supports from Medicaid.

Congress Should Not Kill End-Of-Life Talks Just As Physicians And Patients Are Having Them

We may be about to have a new debate over “death panels.” If we do, it would be a tragedy for tens of millions of Americans and their families.

You may remember this small piece of the Affordable Care Act that garnered outsized attention back in 2010. It allowed Medicare to pay physicians for having end-of-life conversations with their patients. The program, which the Obama Administration delayed for years in the face of conservative political pressure, finally came on line last year. And Kaiser Health News reports that it is catching on more quickly than expected.

Medicare’s Cruel Paradox: It Is A Costly Subsidy For Seniors, But They Can’t Live Without It

Which statement is true? 1) Medicare will impose huge burdens on future taxpayers by providing trillions of dollars in government-funded health care to older adults. 2) Many seniors face massive, unaffordable out-of-pocket health costs in old age, even with that government assistance.

The answer is: Both.  And that’s the challenge policymakers must confront as they debate what to do about the Medicare program as 77 million Boomers move inexorably into old age.

Stop Talking About Obamacare. It is Bad For Our Health

As the debate over remaking the US health system heats up, I’d like to make a modest request: Let’s stop talking about Obamacare.  Drop the partisan, misleading, counterproductive, and increasingly irrelevant hot button label. Instead let’s talk about the pros and cons of what are likely to be some complex and far-reaching changes to the way Americans get their medical care. No more toxic labels.

The very word Obamacare drives policymakers into a frenzy.  Yet, it mischaracterizes the current state of the individual health insurance market: Day-by-day, the law enacted in 2010 is already being changed, so whatever it is, it is no longer Obamacare. And the very word forces lawmakers into their partisan corners and makes it impossible for them to design a sustainable, well-functioning system.

Should Congress Cut ACA Insurance Premiums for Young People By Raising Them For Those 50+?

A proposal by congressional Republicans aimed at reducing health insurance costs for young people would substantially boost premiums for those over age 50, according to a new analysis by the actuarial firm Milliman Inc. The proposal could result in up to 18,000 older adults losing health coverage and increase the cost of federal insurance subsidies by $6.7 billion, if the government continues to offer Affordable Care Act-type subsidies.

The GOP plan would change a provision of the ACA intended to cap insurance costs for older adults who are not yet 65, when they become eligible for Medicare. The law bars insurance companies from charging them more than three times what young people pay for the same coverage. The proposal would allow insurers to charge them up to five times as much.

Could Congress Boost Medicaid Long-Term Care Benefits For Some By Curbing Spousal Annuities?

Is Medicaid’s long-term care benefit a zero-sum game where limited resources are shifted from one beneficiary to another? For instance, could the government significantly increase long-term care benefits for some by barring people from using spousal annuities to qualify for Medicaid?

Or should resources be expanded to provide all eligible seniors and younger people with disabilities the care they need?

What Medicaid Block Grants Would Mean For Seniors

The Trump Administration and congressional Republicans seem to be moving full speed towards capping federal payments for Medicaid–a design sometime called block grants. But they may be missing a key piece of the story: Two-thirds of the program’s dollars go to the frail elderly and younger people with disabilities.

The stereotype of a Medicaid beneficiary is a poor mom and her kids. And, in fact, three quarters of the program’s recipients are children and non-disabled working-age adults. But that isn’t where most of the money goes.

It Costs More To Care For Frail Older Adults Than To Raise Kids

It costs families more to care for a frail older adult than to raise a child for the first 17 years of her life. Yet, while the government routinely provides a broad range of assistance and free services for children, it offers only limited benefits for those needing long-term supports and services—and mostly only for those who are impoverished and very ill.

The other day, the federal government released a headline grabbing report: The average out-of-pocket cost of raising a child from birth to age 17 is about $234,000. Among families where an older adult has severe long-term care needs and uses paid care, out-of-pocket costs average $140,000, according to research by my Urban Institute colleague Melissa Favreault. That enormous cost is generally spread over much less time, typically four years in contrast to 17.

Which Tom Price Will Advise Donald Trump On Medicare

Georgia Congressman Tom Price, President-elect Donald Trump’s nominee to run the Department of Health and Human Services, is a bundle of contradictions when it comes to Medicare.

He certainly is not alone. Trump and congressional Republicans have sent their own very mixed signals about Medicare. The House GOP very much wants to turn the program into what it calls premium support, where the federal government gives seniors a fixed amount of money to buy health insurance on the private market.  While this idea would not necessarily eliminate fee-for-service Medicare (though it could), it would certainly increase participation in managed care plans, known as Medicare Advantage.

Nursing Homes Can Continue to Require Residents To Agree To Binding Arbitration

It looks like nursing homes will continue to be able to require residents and their families to agree in advance to arbitrate disputes with the facilities, despite an attempt by federal regulators to curb the practice.

Late last year, the Centers for Medicare and Medicaid Services (CMS) issued a major rewrite of its nursing home regulations. Most of those rules were backed by both the industry and consumer groups but one became a flashpoint. It barred nursing homes from requiring patients to agree to binding arbitration at admission, though facilities and residents could still agree to use the process after a dispute arises.