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Affordable Care Act (ACA) Facts: Fact # 3

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Affordable Care Act (ACA) Facts: Follow this Series

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 more specifically, Medicare. We decided to do a series of blog posts about the facts; this is part of our ongoing posts, so please see Fact # 1 in a post dated, Feb 8, 2011 and Fact # 2 in the post dated 2/24/11.

Fact: The law will make it easier to receive and pay for long-term care at home.

As we covered in our Medicare Myths post, Medicare does not cover long term care costs. Long term care in a facility or at home is often an out of pocket expense. The Affordable Care Act has some provisions (Section 2401-2403) that allow States to apply for Federal Funding to provide in home services. Some of these programs already exist in NJ and are open to those who have or are eligible for Medicaid. Starting in 2011, the Law allows States to apply for additional funding for these Medicaid programs, often referred to as, Waiver programs.

You may have heard about the new national long-term care insurance program called CLASS (Community Living Assistance Services and Supports). According to the ACA this will become available in 2013. Full and part-time workers with salaries of at least $1,200 per year will be eligible to participate in CLASS and may choose to have the premiums deducted from their paychecks. Non-working retirees are not eligible for the program. After you have participated in CLASS for at least five years and you can no longer perform basic activities (such as eating, dressing, or bathing, or if you have Alzheimer’s disease or other forms of dementia), you are eligible to receive a daily cash benefit. This cash benefit is expected to average $50 per day and can be used to pay for anything that will help you stay at home. Examples of things it will pay for include, home care services and equipment.

Beginning in 2014 the ACA specifies that more regulations be put in place to protect spouses of those who are receiving home care services. Sometimes referred to as, “Spousal Impoverishment” rules, some states, including NJ already have these in place for those who have a spouse living in a nursing home who needs to apply for Medicaid. What the regulations do is protect the money that the other spouse needs to remain living in the community, the ACA states that this should be extended to spouses that have an ill husband or wife at home who is in need of Medicaid services.

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

For more information:

A brochure from Medicare:

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

Webpage from the National Association of States United for Aging and Disabilities (NASUAD):

http://www.nasuad.org/affordable_care_act/nasuad_materials.html

Answers from the National Association of Area Agencies on Aging (n4a):

http://www.n4a.org/advocacy/health-care-reform/

Straight Talk for Seniors from the National Council on Aging:

http://www.ncoa.org/public-policy/health-care-reform/straight-talk/

Details about the law at Heathcare.gov

http://www.healthcare.gov/law/about/index.html

More about NJFA’s 12th Annual Conference!

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Offering welcoming remarks at the New Jersey Foundation for Aging’s conference this year was Patricia Polansky, Assistant Commissioner from the Dept. of Health and Senior Services.  We were pleased to have Pat join us and kick off the day! Her remarks began with comments about the budget and fiscal concerns for the State. However, the Assistant Commissioner transitioned to big changes coming to NJ as a result of Healthcare reform. Ms. Polansky advised that as a result of President Obama signing into law the healthcare reform bill, also known as the Affordable Care Act, “$60 million in grants are being made available for states to help individuals and their caregivers better understand and navigate their health and long-term care options”.  Adding, “the purpose of this grant program authorized by the Affordable Care Act is to create streamlined, coordinated statewide systems of information, counseling and access that will help people find consumer-friendly answers they seek to meet their health and long-term care needs”.

The Assistant Commissioner went on the describe what NJ is already doing, “New Jersey has achieved excellent results in building on existing programs and implementing new approaches for supporting home and community based services”. Pat was referring to the Independence, Dignity and Choice in Long-Term Care Act, stating that, “the state’s long-term care funding structure is being adjusted to provide more options for older adults through budgetary rebalancing”. She followed up this statement by pointing out that there is a growing population of older and disabled persons who desire to stay at home with care rather than going into a nursing home, she stated that policy changes have been made to support that.

Pat added, “The State’s effort to expand home and community based services options for individuals who qualify for Medicaid Institutional Care, started with consolidating 3 Medicaid Waiver Programs into a single line item now know as Global Options for Long-Term Care. Pat added, “we have seen an increase of 1,840 or 23% more participants served; yet well within the SFY 2010 budget”.  She informed the crowd that GO serves 10,000 aging and disabled clients, but that is was actually a cost savings.  She pointed out to the audience, “The average Medicaid rate for a NJ nursing home is $63,541 per year, whereas the annual cost is $17,112 for the Medicaid Waiver, Global Options. Clearly this demonstrates a more cost-effective approach”.

The conference attendees were glad to have heard these valuable updates from the Assistant Commissioner. Many people came up to us during the day to say how wonderful it was to have the Assistant Commissioner share these details with the group.

We hope you have also found this synopsis of the remarks offered by the Assistant Commissioner helpful and informative, please stay tuned for more details and excerpts from the conference.

NJ’s Budget Impact on Seniors

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May 26, 2010

New Jersey’s budget is in the midst of a heated debate. Governor Chris Christie has proposed the new budget and made many cuts. There have been many groups affected by the cuts that have reacted with press releases, meetings and rallies. NJFA and its partners have done much research and speaking out about the impact on our most vulnerable populations, including seniors.

Some of the proposed cuts included PAAD, NJ’s prescription drug assistance program, seniors would have been forced to pay a $310 deductible and face a co pay increase for brand name drugs from $7 to $15. Thanks to the efforts of many groups, the message of the impact of these cuts got to the legislators and they were successful in getting Gov. Christie to remove those cuts from the budget and keep the PAAD program the way it had been.

While that victory feels pretty good there are still many issues regarding the budget and seniors. The Senior Freeze program, a property tax reimbursement program, will not be given out in 2011, that is approximately $1,000 that many low to middle income seniors rely on to help make ends meet. Another item in the proposed budget that will affect the low income senior in NJ is the addition of a $5 co pay for medical day care services with a monthly cap of $25 and the elimination of medication administration as a criteria for medical day care attendance. Many caregivers rely on medical day care as part of a senior or disabled persons care plan, this will be a hardship for those who need it most.

A decrease in the provider reimbursement rate for the PCA program, a home care program that services 29,000 disabled persons and seniors, has been a hot topic in regard to Gov. Christie’s budget. The cut, which decreases the rate by approximately $2, has been the subject of budget hearing testimony due to the fact that this will cause many providers to withdraw from this vital service, leaving many clients in need without services.

With the Elder Index NJFA highlighted an issue regarding some of our most vulnerable seniors and that is the NJ SSI State Supplement which is just $31 a month and has been since 1986, a payment that is meant to help disabled persons make ends meet on a fixed income and just doesn’t cut it at that level. Recently a budget item has come to our attention that is equally troubling, the spousal supplement for caregivers of disabled persons is due to be eliminated in the proposed budget. Again, many of the cuts in this budget are affecting seniors, the disabled and their caregivers, many of whom are already living on the edge.

NJFA and many of our partner organizations have put out press releases, op eds and fact sheets, sending them to newspapers, legislators and community groups, hoping to get the word out about the proposed budget cuts and their impact on seniors. NJFA encourages everyone to contact their representatives in the legislature to make their voice heard.

You can find contact information for your local representatives at www.njleg.org

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What the budget cuts mean for NJ Seniors

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We are sure you’ve heard all about the proposed budget cuts from Gov. Christie for Fiscal Year 2011. What you may be wondering is how does this affect me? You may ask what it all means to you, your children, your parents, or your community?

NJFA has been looking at the proposed budget and doing some research with some of our stakeholders. What we’ve found is that there will be some significant impact for NJ’s seniors. Especially for those most vulnerable, who may already be living on the edge.

Some of you know that in 2009 we advocated, along with many others, for the change in the eligibility level for the NJ Senior Property Tax Freeze program, making the requirement for time you’ve lived in your home to 1 year instead of 3 years. It was disappointing to learn that among the cuts was a freeze on Senior Freeze (also known as Property Tax Reimbursement Program). In the proposed budget those eligible would not receive a property tax reimbursement in 2011. The average reimbursement payment for this program is $1042. So, NJ’s seniors can add that to their cost of living for 2011.

Another cut that is going to add to a NJ senior’s expenses is the increase in co-payments for PAAD. Those who participate in this program do so to save money on medications, because they have limited income. The proposed increase in co-payments for brand name drugs will go from $7 to $15, When you factor in the deductible of $310 a year this will mean another $430 a year added to their cost of living.

Cost of living for a single elder renter in NJ according the NJ Elder Index =$25,941.

Add on the $1042 they won’t receive from the Senior Freeze program  =$26,983

Add on the $430 due to increased PAAD co-pays/deductible  = $27,413

Will there be some safety net or increase to another program such as senior housing to help offset this increase to the NJ senior’s cost of living?