Powerful Republicans are pushing the twin ideas of capping the federal contribution to Medicaid and eliminating federal regulation of the program. These changes would do profound damage to the Medicaid benefit for long-term care, whether it is provided at home or in nursing facilites. This plan would turn Medicaid from a federal entitlement into a block grant. Over time, states would be responsible [...]
As Medicaid budget pressures grow, more states are turning long-term care over to private managed care companies. USA Today reports that six states now require both frail elderly and younger adults with disabilities to enroll in insurance-run Medicaid managed care plans. Another 10 states are planning to either create or expand these programs, according to the story. The reason, of course: money. States pay the [...]
President Obama's 2012 budget is the latest indication of the growing pressures government-provided aging services will face in coming years. And as tight as his budget is, spending on assistance for poor and frail seniors is likely to end up much lower than Obama proposed. With congressional Republicans vowing to cut $100 billion from domestic spending over the remaining seven [...]
In an important speech for those interested in the future of the CLASS Act, federal Department of Health and Human Services Secretary Kathleen Sebelius said today that the program must be self-supporting but conceded that, as designed, it may not meet that goal. "The program must be able to pay for benefits over the long-term with the premiums it takes [...]
A new study by the highly respected Center for Retirement Research at Boston College concludes that premiums for coverage under the CLASS Act--the new voluntary national long-term care insurance program included in the 2010 health reform law--are likely to be unaffordable for many middle class families. The analysis, by center director Alicia Munnell and co-author Josh Hurwitz, projects an average monthly [...]
Prepare yourself for big new cuts in government support for elder care. In his State of the Union address last evening, President Obama called for a five-year freeze on a narrow slice of the federal budget. Unfortunately, programs subject to the freeze would include many that are critically important to the frail elderly and younger people with disabilities--especially those living in [...]
The news for critical long-term care services and supports provided by the states--either through Medicaid or other funding--keeps getting worse. The toxic combination of a still-slow economy, huge structural budget pressures on all levels of government, and growing demands for aging and disability services is leading to ongoing cuts in both critical benefits to individuals and payments to providers. The latest evidence comes from [...]
In the decade between 1999 and 2008, almost 3,000 nursing homes closed while the number of skilled nursing facility beds shrunk by nearly 100,000, or about 5 percent, according to a new study in the Archives of Internal Medicine. In a nation with more nursing homes than McDonald's, and at a time when long-term care can be provided in other settings, that may not be [...]
For the second time, President Obama has bowed to conservative critics and backtracked on a plan to allow Medicare to pay physicians for end of life consultations with their patients. He should be ashamed. In late November, the government adopted new rules that included discussion of advance directives as one of many services physicians could provide during routine annual physicals for their Medicare patients. [...]
The Obama Administration has decided to pay doctors for discussing end of the life issues with their Medicare patients. You may recall that this would have been permitted by the 2010 health law, but the provision was dropped in the face of withering criticism by opponents of health reform, who dubbed these important conversations "death panels." The new rules are an important first step. Doctors absolutely [...]