NHeLP’s 5 Ways Health Reform Helps Older Adults and Individuals with Disabilities

Executive Summary

Health reform improves both Medicaid and Medicare, programs that are critical for older adults and persons with disabilities. NHeLP?s Top 5 Ways Health Reform Helps Older Adults and Individuals with Disabilities provides a short summary of some of the improvements already in place and others coming in 2014, and dispels some common myths about Medicare?s future.

1. ALREADY IN PLACE:  Improvements to Medicare
The ACA has made numerous improvements to Medicare to benefit older adults and individuals with disabilities.  The ACA has already reduced the cost of Part D medications for many enrollees, and will completely eliminate the Part D coverage gap (also known as the ?donut hole?) by 2020. The ACA has also established free annual wellness visits for Medicare enrollees ? more than 32 million Medicare enrollees benefited from free preventive care in 2011.
2. ALREADY IN PLACE:  Improved access to home- and community-based services
Home- and community-based services (HCBS) allow individuals to receive supports in their home setting so that they are not forced into nursing homes or other institutions. The ACA expands access to HCBS services by providing states with new options to start more HCBS programs and apply for increased funding for HCBS services.
3. ALREADY IN PLACE:  Better coordination for Medicare and Medicaid
The ACA created a new Medicare-Medicaid Coordination Office (MMCO), which will help improve coordination of benefits for the 9 million individuals who are enrolled in both programs. The MMCO is also developing projects that will combine both Medicare and Medicaid into one unified health benefit with additional requirements for care coordination and assistance for consumers.
4. COMING SOON:  Health Care Homes
Older adults and persons with disabilities often have complex health care needs which involve a number of different medical providers and settings. The ACA promotes a new team-based model where a central care management team will coordinate between these diverse providers and assist individuals in managing their own care. This model of care will be patient centered and has the potential to increase quality while reducing costs.
5. COMING SOON:  Protecting the future of Medicare
Some critics have suggested that the ACA ?cuts Medicare.? This is false. The ACA actually protects the future of Medicare by reducing wasteful spending.  For example, the ACA will save $500 billion by reducing Medicare fraud and abuse and reducing overpayments Medicare has made to private managed care plans. These cuts are not targeted at the benefits enrollees depend on. The next time you hear someone say that the ACA cuts Medicare by $500 billion, you will know that in reality the ACA saves Medicare money to ensure the program maintains all of its benefits.
Here?s how NHeLP is working to make health reform a reality:
  • NHeLP serves as one of the lead organizations for the Campaign For Better Care (CBC), a coalition to improve health care for older adults with chronic conditions.
  • CBC Website: www.campaignforbettercare.org
  • NHeLP has drafted coalition comments to promote home- and community-based service expansions. Comments available at:  https://healthlaw.org/images/stories/Campaign%20for%20Better%20Care%20comments%20-%20Community%20First%20Choice.pdf
  • NHeLP meets regularly with the new Medicare-Medicaid Coordination Office to ensure Medicare and Medicaid improvement efforts contain strong consumer protections.
  • NHeLP litigates to ensure access to home- and community-based supports and services.

 

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For almost 50 years, the National Health Law Program has fought to expand access to quality health care to low-income individuals and underserved communities. Today we are pleased to launch a newly designed website for our future work to make health care a reality for all people. Please take time to peruse our new site, and sign up for our email updates to learn about us, watch the work we do, and become engaged.

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