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Affordable Care Act: Fact 4

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Affordable Care Act (ACA) Facts: Follow this Series

This is part 4 of our ongoing series, so please see Fact # 1 in a post dated, Feb 8, 2011, Fact # 2 in the post dated 2/24/11 and Fact # 3 in a post dated 3/8/11.

There is a lot of speculation and discussion about what affect health care reform legislation, the Affordable Care Act (ACA), will have on seniors and their families.

Fact # 4: The law will improve care for older adults in other ways besides changes to Medicare.

There are improvements beyond Medicare that will help you and your family.  In a previous blog post we discussed the long term care changes that will improve for older adults such as changes to Medicaid that will allow people the choice of home and community based care and regulations that will prevent a spouse from becoming impoverished if their spouse is receiving home and community based care through the Medicaid Program.

There are also measures written in the Affordable Care Act (ACA) that will help early retirees. To help offset the cost of employer-based retiree health plans, the new law creates a program to preserve those plans and help people who retire before age 65 get the affordable care they need. By providing financial relief to businesses that provide health coverage to early retirees, health reform will make it easier for early retirees to obtain health care coverage. Health insurance reform will guarantee that you will always have choices of quality, affordable health insurance even if you retire early and lose access to employer-sponsored insurance. It will create a health insurance exchange so you can compare prices and health plans and decide which quality affordable option is right for you.

The ACA also sets up protections for people with pre-existing conditions. The new law provides affordable health insurance through a transitional high-risk pool program for people without insurance due to a pre-existing condition. The Dept. of Banking and Insurance in NJ as already begun working on the high-risk pool program. Insurance companies will be prohibited from denying coverage due to a pre-existing condition for children starting in September, and for adults in 2014. Insurance companies will be banned from establishing lifetime limits on your coverage, and use of annual limits will be limited starting in September.

And if you are concerned for the young people in your life who may be struggling to find a job in this economy, the ACA didn’t forget them either. According to the Law, young people up to age 26 can remain on their parents’ health insurance policy starting in September of 2011.

Information in this blog was gathered from the Affordable Care Act, Centers for Medicaid and Medicare and the National Council on Aging.

Healthcare Reform information from

The White House:

http://www.whitehouse.gov/assets/documents/Pages_from_Health_Insurance_Reform_PDF-4.pdf

Medicare

http://www.medicare.gov/Publications/Pubs/pdf/11467.pdf

National Council on Aging

http://www.ncoa.org/public-policy/health-care-reform/straight-talk-for-seniors-on.html

Healthcare Reform and New Jersey

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Healthcare Reform and New Jersey

As you may know, the Senate is currently debating healthcare reform.  The many amendments that are pending each require 60 votes to pass. We’ve all witnessed much debate and questioning on this topic, what we aim to do here is breakdown some of the key issues as well as, discuss what reform would mean in New Jersey.

First, a new report from the Center for Medicare and Medicaid (CMS) shows that healthcare reform bill could be a cost savings for many. According to a recent White House Blog, the bill could add years to the life of Medicare, lower costs for seniors and slow the rate of healthcare cost growth. Specifically, the report speculates that it can extend the life of the Medicare trust fund by nine years. In regard to their statement about saving seniors money, CMS reports that by 2019, the bill would save seniors nearly $700 per couple, reducing premiums by more than $300 per year and out of pocket costs by another $370 per year. CMS also predicts that as savings from reform kick in national health expenditures are projected to increase at a slower annual rate.

Some of the other areas that experts have indicated additional cost savings in are injecting accountability, competition and choice into the system through the insurance exchange; giving providers incentives to coordinate care; and transforming Medicare payment policies to reward quality of care (not quantity).

That leads us to the “exchange”, otherwise known as the public option. Some say the insurance exchange is a key element in providing coverage to the currently uninsured and making insurance more affordable for those who buy coverage on their own. Simply stated the exchange would be an entity that offers a choice of plan in an organized and competitive market. The exchange could also establish some common rules regarding offering and pricing of insurance coverage and provide the consumer with information to help them understand what is available. Much controversy surrounds the idea of a public, government-run plan being included in the exchange, as amendments are made and voted on, only time will tell if this will be an option or not. A hope expressed by many, including New Jersey Representative Rush Holt, is that the exchange, with or without a government-run plan, will allow more Americans to access coverage that currently is not available to them. That may mean including income-based plans other than Medicaid for those that find themselves above the income guideline for that program, but still can’t afford commercial insurance coverage.

So, you may be wondering, what does that mean for New Jersey? According to the Employers Association of New Jersey (EANJ), 95% of the state’s businesses employ 50 or fewer employees; this represents nearly 1.36 million people. Many uninsured adults are employed by small businesses that find healthcare too costly. Healthcare reform, specifically the “exchange”, would allow for those individuals to obtain affordable healthcare coverage.  EANJ also reports that healthcare premiums in New Jersey rose almost 5 times faster than wages in the past decade. If healthcare reform is able to create some rules and standards regarding the cost of coverage and companies abilities to deny coverage, perhaps this disparity would not be so great.

Lastly, Representative Rush Holt has done much to educate his constituents about healthcare reform; his website contains many links with information about the bills. Some of the statements regarding how New Jersey could benefit from the passing of healthcare reform are: improving employer based coverage, credits to help pay for coverage for households that are uninsured, allowing small businesses to obtain affordable health care coverage and providing tax credits to help reduce health insurance costs, improving Medicare, including closing the prescription drug donut hole and reducing the cost of uncompensated care for hospitals and health care providers by $38 million.

Want more information? Have something to add or a question to ask? Please contact your Senator!

Frank Lautenberg

Robert Menendez

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