Tag Archives: Medicaid

Scooter Trash

February 27, 2013

I love a good satire piece. I love it even more when it effectively illustrates the hypocrisy of the people who complain about “socialized” medicine and those who say Medicare/Medicaid increases the deficit. We get both of these from Kara over at the HumorOutcasts website

The Revolution will not be Motorized

Now that we’re all destined to become fat sacks of trash, it’s especially important that Americans be able to easily access their beloved scooters. But now that Barack Hussein Nobumer has criminalized being old, in the form of raiding The Scooter Store® for massive amounts of Medicare fraud, it’s death panels for us all after all.

It’s not like they didn’t warn us. “They’re just there to shepherd people to the FEMA Death Camps, and to pave the way for the Idealized Workers State/New Caliphate”, they said. “Government out of my Medicare!” they said. “Something about Dr. Mengele,” they mumbled. But we didn’t listen. In fact, we LAUGHED. The Communist in Chief is criminalizing capitalism, and just what we would expect. Note to Obummer/FEMA: target Walmart next!

Approximately 150 federal and state law enforcement agents raided one of the biggest perpetrators of government fraud in America: The Scooter Store®. Yes, that’s right. The Scooter Store®. The Scooter Store® is the target of a massive federal investigation. The nation’s largest provider of single-person electric vehicles and power chairs is railroading doctors into prescribing chairs for its patients, most of whom are on Medicare or Medicaid. That way they can bill the government for their highly dubious “medical device”, while the patient gets a cool new scooter without paying a dime, and The Scooter Store® pockets a tidy profit.

The Scooter Store® tries to wear physicians down with non-stop phone calls and harassing office drop-ins. The Scooter Store® even has a special department devoted to getting scooters for patients who had already been ruled ineligible by Medicare – maybe because their ads guarantee that the chair will be free if they can’t get you qualified. The Scooter Store® is so good at getting Olds and not-so-Olds those scooters that a government audit found that they had over-billed Medicare by over $100 million between 2009-2012. It’s true, what their ads say:

“No other company will work harder to make you mobile.”

The disability fakers are the real criminals if you ask me - The Scooter Store® is just trying to make a buck off a bad situation. Unfortunately, the FBI won’t be going after the lazy able-bodieds who cheat the taxpayers into paying for their scooters (as a penalty, the real-criminal disability fakers should be required to scoot around on Razor scooters). Of course, you can’t judge the nature of someone’s disability by looking at them; people with arthritis and MS have days when they feel fit, and days when they can’t move more than a couple of steps. But, you CAN judge a disability faker a mile away. The Scooter Store® probably took a lesson from FL Gov. Rick Scott on how to bilk Medicare and Medicaid. His medical firm was hit with a $630 Million fraud fine for 13 felonies. Not surprised he managed to segue into politics.

There’s lazy, and then there’s Las Vegas lazy. Forking over about $40 a day and their pride, exhausted by the four miles of gluttony laid out before them, perfectly healthy tourists are cruising down the strip in transportation intended for the infirm. You can actually rent scooters in Las Vegas with extra large drink-holders so you don’t waste all those calories staggering and falling over after you get your drunk.

Next, they’ll be coming to get our guns because they know we can’t get to ‘em first without our scooters. If the gubmint tries to take away the free Medicare scooters, we’ll come speeding into action….at five miles-per-hour.

I’d like to see these guys’ eyeballs explode when they see something REALLY worth getting upset over, like a famine or plague. Then again, it’s hard to imagine anything worse than having your scooter taken away, except maybe the horror of an attractive, intelligent, black Democrat taking the White House.

How are all these people going to get to their Tea Party rallies NOW??

In a related story, “The Price is Right” has been cancelled for lack of advertisers.

Oh, and when the Fiscal Poop Commission comes after our Social Security next year, we’ll probably just sit on our asses watching Dancing with the Slobs. And if our rascals aren’t flying by then I am going to be pissed.

Posted by lbwoodgate in Satire Tags: Federal Bureau of Investigation, Government, leave my medicare alone, Medicaid, Medicare, Rick Scott, Scooter Store, socialized medicine, tea party protesters

12 comments

Understanding Paul Ryan’s Attack on Medicare

April 27, 2011

Paul Ryan’s GOP budget layout to lower the federal deficit has met stern resistance from constituents fearing that Medicare as we know will cease to exist not only for them but for future generations. Ryan claims that “people … don’t understand what we’re doing with Medicare. What I find is there’s a lot of demagoguery and distortion occurring.”

But that’s not completely true. To project as Ryan does that his plan is a practical approach to curing what ails Medicare and Medicaid takes a look at the problem from only one perspective – cutting spending. His plan does nothing to curb rising health care costs in this country and it ignores creating revenues to sustain this health insurance option for people who are on fixed incomes and cannot afford private insurance premiums.

Perhaps the biggest obstacle to reform health care costs and cover low-income people is allowing a system of medical services in this country to fall under the auspices of free-market practices. The free-market system that encourages innovation and competition is a functional economic system that works very well in most areas. But the principles that work well for commercial goods and services do not automatically transfer over to health care.

One of the problems that tends to occur is that market forces make no serious attempt to control how for-profit increases negatively impact low-income people. When private insurers put their profits before service that means some people will not be able to afford their product. There are higher health risks for certain groups like seniors, children and the disabled. Market practices insure that costs to sustain profitability must rise with these groups, the very people who often lack the financial means to meet cost increases.

With Paul Ryan restructuring Medicare and Medicaid with what he terms as a “premium-support payments” program, where states determine who is and who is not eligible, there is nothing incorporated in this plan that accounts for the rise of private health care costs that will exceed the pace of normal inflation rates. According to the impartial Congressional Budget Office’s estimates,

Under [Ryan’s] proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system. For a typical 65-year-old with average health spending enrolled in a plan with benefits similar to those currently provided by Medicare, CBO estimated the beneficiary’s spending on premiums and out-of-pocket expenditures as a share of a benchmark: what total health care spending would be if a private insurer covered the beneficiary. By 2030, the beneficiary’s spend- ing would be 68 percent of that benchmark under the proposal, 25 percent under the extended-baseline scenario, and 30 percent under the alternative fiscal scenario.

Federal payments for Medicaid under [Ryan’s] proposal would be substantially smaller than currently projected amounts. States would have additional flexibility to design and manage their Medicaid programs, and they might achieve greater efficiencies in the delivery of care than under current law. Even with additional flexibility, however, the large projected reduction in payments would probably require states to decrease payments to Medicaid providers, reduce eligibility for Medicaid, provide less extensive coverage to beneficiaries, or pay more themselves than would be the case under current law.

A critical point that we can take from this is how dependent Medicare recipients will be on state authority “to design and manage their Medicaid programs”. In states like Texas where social aid programs are always trimmed to the bone to correct budget shortfalls, this plan is likely to hurt even more people than will occur due to the increased individual spending it is set to impose on them.

What’s obviously missing in Ryan’s plan where he could be accused of demagoguery is the failure to generate revenue to offset costs. The demagoguery that Ryan and the GOP would put into play is that this would raise taxes and hurt more than help those low-income people this plan is designed to benefit. Yet, no taxes need to be created for this and surely most low and middle-income brackets need not be faced with any consequential tax increases.

There are billions in corporate tax loopholes that can be eliminated to go toward health care costs for those least able to afford increases in their premiums. Ryan’s plan does call for tax reform to eliminate most loopholes (he has yet to outline which will and won’t be eliminated) while creating a lower corporate tax rate of 25% from its current 35% level. But this still doesn’t help poor seniors, families with children and the disabled. It also doesn’t guarantee that health insurers will take those lower tax rates and put them back into lower premium costs.

One thing all sides can agree on is that there are areas where costs can be controlled by insurers and policy holders alike. Preventive practices that reduce health threats should be encouraged to keep costs down. Diet and exercise should be pushed at all levels to reduce the risk of heart disease and diabetes. Michelle Obama’s efforts to reduce childhood obesity is aimed at curbing this serious health threat to future generations yet some on the right berate it to score political points. Sarah Palin’s attack late last year referred to the Let’s Move! program as a “kick” of Michelle Obama’s and falsely claimed the First Lady was attempting to restrict parental “decisions for their own children, for their own families in what [they] should eat.”

One measure that could help reduce overall costs and was implemented in the health care reform bill passed last year – which Ryan and his Party want to repeal – is to streamline the way patient records are handled by promoting the use of electronic medical records (EMR); a system that would efficiently share information and reduce overhead costs. Decreasing unwarranted variation in medical practice and unnecessary care is another way to keep costs down. “Some experts estimate that up to 30% of health care is unnecessary, emphasizing the need to streamline the health system and eliminate this needless spending.”

These and other options are available to help lower health care costs in conjunction with creating revenue in those areas where highly profitable companies and wealthy individuals can contribute. These approaches and cutting Defense spending go missing in Ryan’s plan to reduce the budget deficit. Ryan and the GOP are misleading voters if they continue to insist that others are guilty of “demagoguery and distortion”.

I’m Willing to Take Paul Ryan and the GOP’s “Path to Prosperity” Budget Plan Serious, IF … (woodgatesview.wordpress.com)
CEPR: Cost of Medicare Equivalent Insurance Skyrockets under Ryan Plan (yubanet.com)

Posted by lbwoodgate in Budget Crisis, Health Care Reform, Society and Politics, Texas/Local stories Tags: Congressional Budget Office, defense budget cuts, generating tax revenue, Insurance, Medicaid, Medicare, medicare voucher, Michelle Obama, Paul Ryan, premium-support payments

4 comments

Kill Medicaid and Medicare and You Eliminate Social Security

April 5, 2011

If wealthy financial interests cannot get the revenue that funds Social Security, then no one will.

I’m not the kind that sees conspiracies behind every corner and I’m not much of a patron of those popular conspiracies that appear to have some credibility, like some of those surrounding JFK’s assassination. But if I were to apply myself I could perhaps make a case that Paul Ryan and the GOP are out to eliminate Social Security through a slow process that entails shrinking Medicare and Medicaid to a form that allows more people to die before they reach retirement age.

Mr. Ryan has released the GOP budget plan for 2012 and in it is a proposal that would eliminate $1 trillion from the federal program that enables the poorest and most vulnerable amongst us to purchase health insurance and vital, life-saving prescription drugs for millions. It doesn’t remove the $1 trillion from Medicaid immediately; doing it instead very slowly over a 10 year period. A sort of “death by a thousand cuts” process. It’s conceivable that the GOP hopes that benefits that are not realized by a generation whose age and health make them ineligible to tap into these benefits for years to come will go unnoticed long before they do see the value of such a program for themselves.

As the means to provide health services is reduced through the GOP’s voucher program, illnesses will become more prevalent and cures will be fewer for those who rely on this low cost health insurance, thus increasing the likelihood of death at an earlier age than would have otherwise occurred for senior citizens, poorer children and the disabled. Already the GOP is working the other side of the tracks as they attempt to raise the age on Social Security eligibility to 70.

A 2007 GAO report shows that lower income people who are unable to provide adequate health care insurance die younger than their wealthier counterparts who can.

With this combination of higher eligibility rates for collecting SS benefits and poorer people dying off long before they reach that age due to inadequate health care coverage, the U.S. Treasury will have more money available; money that corporations will lobby for to subsidize their ventures while they re-invest their profits in share holder dividends and upper management bonuses. And any real tax savings here will not significantly impact most middle income wage earners in this country.

A look at the GOP’s budget deficit reduction plan shows their “preferred treatment for Medicaid, outlined in a policy booklet called “A Roadmap for America’s Future,” … convert[s] current federal payments to states into direct assistance in the form of $11,000 per year per recipient, which could be used to purchase private insurance.” (GOP plans $1 trillion Medicaid cut, by Jonathon Allen, Politico, 3/31/11)

There is little in this “Roadmap” about cost of living adjustments (COLA) to deal with inflation and there most certainly are no restraints on the private sector to charge what they will for health care. What $11,000 buys today in terms of treatment and necessary therapies will likely not cover such cost ten years from now and even less on down the road from that. If this practice carries over to Medicare then the elderly along with children and the disabled will have fewer people to collect their Social Security benefits they have earned over time.

But surely the Republican Tea Party is not that cold and calculating. Not everyone on the Right can be as conniving as Grover Norquist whose Americans for Tax Reform group, since 1989, has aligned itself with conservatives and business interests to shrink the government through tax and spending cuts to a size that “can be drowned in a bath tub”; tax cuts that benefit the wealthiest 2% more than anyone else. However, that may not be as far-fetched as it seems.

Too many Americans have been convinced by GOP rhetoric that the budget is a spending issue, not a tax issue. But anyone can clearly see a correlation between tax cuts, especially for the wealthiest amongst us and a short-changing of vital social services. The specified taxes that come out of paychecks while paying for Medicare/Medicaid and Social Security are small in comparison if the majority of Americans were left to fend for themselves.

“Medicare, by means of cost controls and the distribution of risk, is the best deal going in health care by a third. To scrap Medicare would mean loss of that price leverage and higher prices for seniors that will likely end up being passed on to the sandwich generation” says Huffington Post commentator, Stephen Herrington.

“Vouchers for private insurance in lieu of Medicare … would instantly increase the federal deficit component for assistance to seniors by 30%, the cost advantage of Medicare over private plans. Anything less than full value would simply disproportionally shift the burden from government to a public already groaning under the weight of servicing medical profits. There are no net savings to the public here. (emphasis mine) Servicing private profit is no less onerous than taxes.”

So is this a conceivable conspiracy by the GOP to kill benefits for low and middle-income families? We don’t see any efforts to reduce the deficit with cuts in a bloated Defense budget. Even Scrooge reluctantly agreed to support the “Treadmill and the Poor Laws” that created a meager safety net for the poorest of the poor rather than allow for-profit efforts to take charge of this. And so what if more people die sooner than they would without this aid that they have all contributed to throughout their working lives? Decreasing this “surplus population” will only leave more in the Treasury for the wealthy patrons of Republicans to feed off of for years to come.

RESOURCES:

GAO Report: ‘Poverty in America: Consequences for Individuals and the Economy’ January 24, 2007.

GOP Budget Proposal for 2012 to Gut Medicaid

Posted by lbwoodgate in Economy, Health Care Reform, Poverty/Homelessness, seniors/aging Tags: federal spending cuts, GOP deficit reduction plan, Grover Norquist, health care block grants, Insurance, Medicaid, Medicare, Paul Ryan, private vs. public health care coverage, Republican, Social Security, United States

6 comments

Could Elder Financial Abuse Become the Crime of the 21st Century?

February 11, 2011

a repost from my AC Yahoo site

It seems reasonable to assume that as people age their trust factor diminishes over time as life experiences teach them that much of what we presumed about people and our way of life are not all that we thought and hoped they were. Too many times we have read about or been victim to scoundrels whose self-interests have cost us our treasure, our good health and valuable time. From the incompetent person who handles our payroll at work to the individual who makes a career of deception with the sole purpose of stealing from others, little room is left in our lives to allow trust to take up much space.

Becoming skeptical is a healthy response when dealing with certain unknowns. Not everyone is out to rip us off and we could miss some great experiences and financial opportunities if we shut out trust completely. But if we allow ourselves to go pass the stage of “trust but verify” we are on a downward spiral that isolates us from friends and relatives that we will come to need as we grow old.

Time unfortunately doesn’t teach all elderly people at this critical time in their lives how to measure and restrain their trust for some. Now more than ever they are dependent on others as their bodies deteriorate physically and mentally to the point where they can no longer take care of routine necessities themselves. Hands and legs no longer function at the level they did when you could do a day’s work in the field or at the office. Cognitive skills have also been lost to some degree where making rationale decisions prove more difficult than it ever was.

Trust is often the only thing most retired individuals have when it comes to financial choices. Few actually do the serious leg work to research investments and unique “business offers” that promise increased fortunes. During economic hard times the retirement savings of many elderly are depleted by downward trends in a volatile market. But many of their funds are actually robbed from them through “scams” by the people they trust, and that includes family and close friends.

As we age many elderly people become “susceptible to people looking to defraud or deceive them.” It is estimated that seniors are ripped off each year to the tune of $2.6 billion and that’s with only 1 in 5 cases being reported. In a report issued by MetLife Mature Market Institute (MMI) last year entitled, Broken Trust: Elders, Family and Finances, we find older citizens are often taken advantage most often by family members and caregivers.

Of all the abuses the elderly are subject to (neglect, physical, emotional, sexual), more than 1 in 10 is a victim of financial abuse (12.3%). It is a crime however that affects all Americans of upwards to $10 billion a year in the form of health care, social services, investigative and legal costs, and lost income and assets; a crime that goes largely unreported and is under-prosecuted.

Elder financial abuse could become the crime of the 21st Century, thinks journalist J.F. Wasik, as more and more baby boomers retire and look for way ways to spend their retirement savings while also looking for new ways to add to it. Here are some areas where seniors are financially abused and steps that can be taken to reduce the risk:

IDENTITY THEFT - In one year alone (2001-02) 3 times as many people older than 60 were victims of identity theft.

- Never give a stranger your personal information like social security number and bank account number, over the phone or in person unless you can confirm who they are and how they are serving you.

- Make sure any website you purchase goods off of with a credit card is a secure website. The best way to determine this is to check the URL address at the top of your browser. If it is a secure website it will begin with the letters HTTPS. The “S”, for SECURE, following HTTP means you can trust it for financial transactions.

- Shred all documents that have your personal information on them like monthly statements from banks and other creditors. Criminals who have been surveying you will go through your trash.

- If you or a trusted relative suspect financial abuse it should be reported to appropriate agencies such as Adult Protective Services, a law enforcement agency, or compliance department of a suspected financial institution.

FRIENDS AND FAMILY – Not all friends and family are dependable and honest. It is incumbent for seniors to establish early which friends and family are most likely to defend their best interests before their condition deteriorates to a point where they have to rely on another’s assistance in most if not all matters. Make a list of each so that in the event one moves away or passes away, you will have the next best person for the job lined up.

For what it’s worth, in the MetLife study, “Broken Trust: Elders, Family and Finances”, findings suggested that grand-daughters that you have a good relationship with would be the least likely relative to take advantage of you and your finances, while conversely, females in general from ages 20-59 are more likely than males in this age category to exploit your assets. (p.13) Friends and non-relative care takers would fall into this category.

Clues that should keep certain friends and family members off this list will consist of the following:

1. How often do they do things for you without expecting rewards?

2. Do they discuss too frequently what your financial status is and what arrangements you have made for these assets when you’re deceased?

3. What is their financial status like? Could they benefit from your demise or absconding some of your funds on “lucrative opportunities” they claim they’ve come across and present to you?

4. What’s your relationship been with them over your life? Have they all of a sudden gained new interests in you as you’ve become dependent on others? Do they or have they had problems with alcohol and drug abuse? Widows and widowers are subject to “new loves” in their life who take advantage of a person’s loneliness.

5. Do they seem concerned about how your estate will be handled when you’re gone, asserting some sense of “entitlement” while frequently pointing out what little other friends and relatives have done for you?

6. Do children prey on motherhood instincts to provide for them in “their hour of need”.

Though some or all of these indicators could truly be virtuous ones, they must be weighed in terms of your historical relationship with them. People’s vices in the past do not always get better, especially when it is aimed at someone who is less capable of fending for themselves as the elderly are.

MEDICARE/MEDICAID FRAUD – Billions are stolen each year from the Medicare and Medicaid Funds by the acts of unethical doctors, care facilities and medical suppliers who over-charge these federal funds for services and equipment never used by the Medicare/Medicaid recipient.

Image via Wikipedia

$60 billion alone gets stolen from Medicare says Florida Congresswoman Ileana Ros-Lehtinen who along with fellow congressperson is co-sponsoring the Medicare Fraud Enforcement and Prevention Act (H.R. 5044). Medicare and Medicaid fraud hit you with any out-of-pocket expenses and will ultimately affect what seniors receive in benefits as efforts are made to offset these costs in the form of reduced payments to doctors, providers and suppliers.

- If you suspect fraud from a doctor, care giver or supplier after reviewing your monthly Medicare Summary Notice (MSN) contact those that appear to have over-charged for services rendered to get a clarification. If they are unresponsive call the number on your MSN to report your suspicions.

- Have information available before you call such as the provider’s name and any identifying number, the item or service you are questioning, the date of the incident and the amount approved and paid by Medicare.

- For other pertinent information in handling such claims you can go to Medicare.gov website at www.medicare.gov/fraudabuse/howtoreport.asp or call 1-800-HHS-TIPS (1-800-447-8477).

BUSINESS RIP-OFFS – Aggregate dollar amounts lost through commercial elder abuse are the highest of all forms of elder financial abuse.

- Never succumb to business deals or monetary charity requests over the phone. Call your local Better Business Bureau (BBB) or State Attorney General’s office to validate that any business you are considering investing in or paying for services is registered and licensed to the extent such businesses can be. Always ask home repair vendors for three references.

- Common kinds of commercial theft, fraud, and embezzlement include life and health insurance scams, predatory lending practices from credit card debt, home loans and “once in a life time” schemes. Avoid unknown “professionals” who claim to they can enhance your wealth through annuities, stocks and bonds or set you up with an “unbelievable” property purchase.

- High-pressure telephone solicitations, especially for charities, magazine book publishers’ solicitations and Internet scams dealing with social networks, medications and make-up and age reduction remedies should be avoided. To be sure, employ the impulsive-buying deterrent of waiting 24 hours and adhere to the wisdom that if it’s too good to be true, it probably isn’t.

CARRY VERY LITTLE CASH - Use bank debit and credit cards on all your purchases that will allow it. What income you do receive in the form of Social Security benefits, IRA payouts, or periodical payments from

investments like stock dividends can be direct-deposited into your account. The added benefit of statements that can be accessed on-line with a security password helps you and your legal proxy keep track of all expenditures and income and out of sight from those who would take advantage of you.

PRECAUTION AND PREVENTION ARE KEY: A REPRISE

Key points to consider when trying to protect yourself from fraud is to establish early who you can trust while you are still mentally able to. If your finances allow, find a licensed attorney who can assist you with a trust and create a budget that can be monitored by an independent 3rd party.

- Never give out private information, like SS number, bank account numbers, license number or credit card information that can make you a victim of identity theft.

- If you do make loans to friends or family or make investments with unfamiliar risks, do so in partial amounts.

- Never lend out better than 10% of your total assets over a short period (1-3 months) and never turn over all your assets to anyone while you are still alive if economic conditions allow.

- You should have a will in place to reward those who you feel truly had your best interests and well-being in mind while you were alive.

For more information about fraud and financial elder abuse, visit AARP’s Fraud Fighters website.

RESOURCES:

Broken Trust: Elders, Family and Finances

National Center on Elder Abuse

Mysa.com: Experts warn seniors about scams (mysanantonio.com)
Friends, family increasingly rip off elderly (dispatch.com)
Secrets Aging Parents Keep and How to Help Them (aolhealth.com)

Posted by lbwoodgate in seniors/aging Tags: Abuse, Adult Protective Services, Crime, elder financial abuse, Identity theft, Ileana Ros-Lehtinen, Medicaid, MetLife, protecting the elderly, vulnerable seniors

12 comments

Benefits for Early Retirees in the Affordable Care Act

February 3, 2011

Early retirement, considered to be between the ages of 55 and 64, has its own set of issues to deal with regarding health insurance coverage. New measures enacted through the Affordable Care Act (ACA) and signed into law last year will eliminate a lot of these concerns and ease people into retirement with secure options, at least until the law sunsets on January 1st, 2014. On May 5, 2010, HHS released an Interim Final Rule referred to as the Early Retiree Reinsurance Program (ERRP) that will directly address retiree issues related to health care coverage.

Early retirement is often forced upon this aging population due to illnesses that stem from chronic diseases. Prior to the enactment of ERRP most early retirees could only look towards COBRA (Consolidated Omnibus Budget Reconciliation Act) for reasonably priced, post-employment health care coverage. If you are dismissed from your job for other than gross misconduct, or if your work hours are reduced to the point that you are no longer eligible for coverage, COBRA health benefit provisions are available to you.

COBRA is the government-funded health insurance for people who are laid off, allowing them to access health insurance for themselves and their dependents when they have lost their company-provided insurance, at affordable rates, for at least 18 months. Apart from this, your only option becomes to find health insurance on your own in the private market; an option that has been fraught with headaches for early retirees – until recent health care reform was passed.

This age group is more likely than others to have some pre-existing health condition that, prior to the passage of the ACA, would most likely remove them from coverage consideration by the private sector. The new requirements for private insurers no longer permits this type of discrimination nor will they be allowed to increase premiums for any policy holder they have if they become sick under the coverage they initially signed up for.

Another problem that has plagued early retirees is their loss of health care coverage as a result of vanishing retirement packages that companies have traditionally offered their employees. Large firms (200+ employees) saw a drop of 12% from 1991 to 2001 and smaller companies (3-199) saw a drop of 6% according to a study done with the data from the Kaiser/HRET survey of human resource and benefits managers in public and private-sector organizations. New proposals under the health care reform bill allow federal assistance to relieve this loss of coverage resulting from diminishing employer-funded retirement programs.

With the new ERRP guidelines, those retirees 55 or older, along with eligible spouses, surviving spouses, and dependents of such retirees and who are not eligible for Medicaid, may me eligible for this coverage if one or more of their employers have opted to participate in this program. A current list of these participating employers, which is up-dated monthly, can be found at the healthcare.gov website here. The program is aimed at providing health care coverage for those with chronic and high-cost conditions, health issues that would likely not be covered in basic plans. Regardless if your were employed by a private employer, state or local government, educational institutions, unions or non-profits, ERRP will cover you if your employer has applied for this assistance.

It should be clear that this is coverage that retirees themselves cannot apply for. It has to a part of an employer-based program that the retirees works through, with all claims being processed through the Health and Human Services Department.

Image via Wikipedia

To be eligible the claim must not be less than $15,000 nor greater than $90,000. These amounts also reflect any out-of-pocket expenses by the retiree or his family. The plan pays 80% of these costs so if the retiree can afford it, a good supplemental plan to allay the remaining 20% should be considered

Once the provisions of ERRP have expired on 1/1/2014 further relief will come in the form of an “exchange pool” that will be implemented under federal guidelines. Though they have been available to retirees 6 months after the original health care reform bill passed in March, 2010 they become open to all who voluntarily seek them after January 1, 2014. This exchange pool is a collection of private sector companies that will compete to offer a variety of plans with premium rates and deductibles that suit the individual consumer.

Further assistance is available for those whose resources are scarce paying for long-term health care through federally funded Consumer Assistance Programs(CAPs). Only 40 states have applied for this assistance however so check this site here to see if your state is a participating member.

Finally, along with the general population, early retirees will not only benefit from those parts of the bill that address their needs but will also share reduced costs that come from the bill’s efforts to streamline paperwork, utilizing easy-to-read forms and processing it all in rapidly available, computerized medical records for doctors and nurses. Stuck in limbo for too long, early retirees can now find some relief through these new measures. With incomes insufficient to buy practical and cost-effective policies, most retirees will no longer have to face purchasing low-cost policies that have limited coverage and high deductibles or being forced to go without altogether.

Preventive care measures are also a part of the new health care reform. Though this 55-64 age group is most likely to have undergone some health treatments for illnesses or physical damage earlier in life, many are relatively healthy and fit currently, needing only encouragement to practice preventative health measures to maintain these conditions. The new reform will cover some of those costs associated with preventive services. Health maintenance is an assurance that more serious and costly potential health care issues will be kept in check as we age.

One of the hallmark’s of the Affordable Care Act is the Community Living Assistance Services and Supports (CLASS) Act, the pet project of the late Senator Edward Kennedy. Early retirement due to ill-health often carries over to expensive long-term health care that has limited coverage under Medicaid, Medicare and standard private health care insurance policies. McKnight’s Long-Term Care News, a business news magazine serving the institutional long-term care field, reported that the CLASS Act offers some relief by creating a voluntary long-term care insurance program that will help defray some of the costs of those who currently use this limited coverage under Medicaid.

Image via Wikipedia

The current costs of private sector long-term health care coverage are out of reach for the average American. The costs increase dramatically if you have to be put in a nursing home facility.

In a 2010 issue of AARP magazine (March /April), an article by Mary A. Fischer pointed out that long-term health care requiring a stay in nursing homes averaged “2.5 years and costs about $175,000. In 2008, the most recent year for which numbers are available, 9 million older people required long-term care. That number is expected to reach 12 million by 2020 as the boomer population ages. Currently, only about 8 million Americans have private long-term-care insurance, leaving the government to underwrite care at an enormous cost to taxpayers.”

Stay in touch with what’s new in health care reform and available to you through programs that have arisen through ARA legislation by visiting the healthcare.gov website routinely. Get involved too by making your state and federal legislators know how you feel about their efforts to strengthen or weaken these provisions. Right now the GOP in both houses of Congress are trying to eliminate all of the benefits that retirees, seniors and young at-risk adults currently have under this bill without any plans to offer a suitable alternative.

RESOURCES:

Bricker and Eckler Legal website

healthcare.gov

Posted by lbwoodgate in Health Care Reform Tags: Affordable Care Act, COBRA, Early Retiree Reinsurance Program, Health care, health care reform, Insurance, long-term health issues, Medicaid, United States Department of Health and Human Services

4 comments

Tag Archives: Medicaid

Scooter Trash

“No other company will work harder to make you mobile.”

Next, they’ll be coming to get our guns because they know we can’t get to ‘em first without our scooters. If the gubmint tries to take away the free Medicare scooters, we’ll come speeding into action….at five miles-per-hour.

How are all these people going to get to their Tea Party rallies NOW??

In a related story, “The Price is Right” has been cancelled for lack of advertisers.

Oh, and when the Fiscal Poop Commission comes after our Social Security next year, we’ll probably just sit on our asses watching Dancing with the Slobs. And if our rascals aren’t flying by then I am going to be pissed.

Understanding Paul Ryan’s Attack on Medicare

Could Elder Financial Abuse Become the Crime of the 21st Century?

Benefits for Early Retirees in the Affordable Care Act

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Tag Archives: Medicaid

Scooter Trash

“No other company will work harder to make you mobile.”

Next, they’ll be coming to get our guns because they know we can’t get to ‘em first without our scooters. If the gubmint tries to take away the free Medicare scooters, we’ll come speeding into action….at five miles-per-hour.

How are all these people going to get to their Tea Party rallies NOW??

In a related story, “The Price is Right” has been cancelled for lack of advertisers.

Oh, and when the Fiscal Poop Commission comes after our Social Security next year, we’ll probably just sit on our asses watching Dancing with the Slobs. And if our rascals aren’t flying by then I am going to be pissed.

Understanding Paul Ryan’s Attack on Medicare

Kill Medicaid and Medicare and You Eliminate Social Security

Could Elder Financial Abuse Become the Crime of the 21st Century?

Related Articles

Benefits for Early Retirees in the Affordable Care Act

Search Blog Content

America Honors Leaders, Not Politicians

Bet on solar power

What I have written recently

Blogroll

Archives

Follow “Woodgate's View”