The American healthcare system has been through its share of changes over the past decade. Another round of changes has recently rolled through that may impact you, particularly if you are a senior. Changes to both Medicare and Medicaid will be felt by seniors across the country in the coming years, with some states implementing controversial changes to their Medicaid programs that bear watching by residents of all states as these changes could cause a chain reaction across the country. The following is a summary of some of the changes to Medicare and Medicaid and how those changes might impact you.
Higher Insurance Premiums for Older Americans
The recent tax bill killed the ACA individual mandate, a change that experts say will have an impact on millions of Americans in the coming years. According to a study by AARP, individuals in the 50 to 64-year-old age group can expect to incur an average jump of $1,500 in health insurance premiums starting next year (2019).
Loss of Retroactive Medicaid
Although people think of Medicaid as a federal program, it is really more of a collaboration between the federal and state governments. Medicaid is primarily funded by the federal government; however, individual states can supplement that funding. In addition, individual states administer their own Medicaid program with oversight by the federal government.
For those not familiar with the details of the Medicaid program, one of the benefits that have saved millions of people from crippling medical debt, and often bankruptcy, is retroactive coverage. When you apply for Medicaid, your coverage begins three months prior to your application date if you are approved. Two states have sought, and received, permission to do away with retroactive benefits.
In Iowa, the Trump administration approved the state’s request to end retroactive coverage for new Medicaid recipients. According to Kaiser Family Foundation (KFF), the waiver will affect “low-income parents, children over one year old, ACA expansion adults, seniors, and people with disabilities.”
Indiana is implementing similar changes to its Medicaid program. After the Trump administration’s approval of a state waiver request, many new Medicaid enrollees will not get retroactive benefits. The list includes low-income parents, people moving off welfare, and 19- and 20-year-olds new to the program, Kaiser Family Foundation reported.
Medicare Limits Physical Therapy
Caps for Medicare Part B patients undergoing physical therapy did not get extended into 2018. That means seniors who suffered a stroke and need crucial therapy have limits on how much rehab they can receive. Advocates are lobbying Congress to act; however, Congress recessed for the holidays without acting, leaving Medicare recipients in need of therapy out of luck if they have reached their limit.
Medicaid Work Requirements
At the end of 2017, seven states had requests for some type of work requirement pending with the Trump administration. Arkansas, Indiana, Kentucky, and New Hampshire will tie it to the ACA Medicaid expansion. Maine, Utah, and Wisconsin seek work requirements for most adults applying for benefits.
Decrease in Nursing Home Penalties for Violations
Whether you currently have a loved one in a nursing home, or could be facing the need for nursing home care yourself in the near future, this change is likely to be worrisome. As part of President Trump’s promise to cut regulations, the administration has been limiting oversight and decreasing penalties for nursing homes that abuse or neglect Medicare patients. Just when it seems that nursing home abuse has reached epidemic proportions (40 percent of the nation’s 6,500 nursing homes received fines for a serious violation since 2013, according to CNN), the administration has enacted guidelines that discourage regulators from fining nursing homes even when a patient dies. CNN provided an illustration of the new guidelines in action with a recent news story involving a nursing home that was fined $282,000 following neglect that led to the death of a patient. (A judge called the penalty “modest.”) Under the new guidelines, the home would pay about $21,000 in fines following a death.
Drug Testing for Medicaid Applicants
Wisconsin Governor Scott Walker has requested approval to require drug testing for Medicaid applicants, though he plans to move forward with or without federal approval. Gov. Walker asserts that the state has the authority to implement the change without federal approval while some federal authorities don’t agree, claiming to do so without federal approval would be a violation of the law.
Medicare Budget Cuts
Some experts tell us that the new tax law will tack on $1.4 trillion to the federal deficit – and Medicare may pay the price. An automatic $25 billion cut to Medicare triggers in 2018 unless Congress does something about it.
Medicaid Asset Tests
Medicaid has long imposed a “countable resources” limit on applicants; however, the State of Maine is now seeking authority to take that rule one step farther by asking for savings account information and property values. These waiver requests came from a state where voters approved a referendum on Medicaid expansion in 2017.
Contact a North Dakota Medicaid Planning Lawyer
If you have questions about Medicaid or Medicare planning, contact an experienced North Dakota Medicaid planning lawyer at German Law by calling 701-738-0060 to schedule an appointment.