PROVIDENCE, R.I. — Despite President-elect Donald J. Trump’s call to repeal all or part of the Affordable Care Act, known as Obamacare, Rhode Island officials are pushing forward with plans to expand its reach. Governor Gina M. Raimondo and Health and Human Services Secretary Elizabeth Roberts on Monday announced that Rhode Island has received approval for nearly $130 million in federal Medicaid matching funds over the next five years to expand its health care overhaul,
PROVIDENCE, R.I. — As many as 1,000 residents who logged onto the state’s new $364 million benefits computer system from a public computer, such as at a local library, may have had their personal information seen by the next user if they didn’t close the window of their browser – even if the resident logged off. State leaders told the media Wednesday that the disclosure problem with RI Bridges, which is more well known as the Unified Health Infrastructure Project (UHIP), has already
President-elect Donald Trump has already stepped back from his campaign pledge to entirely repeal Obamacare, saying he’ll keep a couple of the law’s popular insurance protections. Soon enough, certain governors in his own party can be expected to argue that it would also be smart to retain the law’s most successful component: the expansion of Medicaid. Trump should take that advice.
Thirty-one states — 11 led by Republicans — have accepted Obamacare funding to extend Medicaid to anyone earning less than 138 percent of the federal poverty line (about $16,400 for an individual). As a result, at least 10 million Americans have insurance who would lose it without the expansion.
Most of these beneficiaries say they’re satisfied with the coverage. And their governors — including Vice President-elect Mike Pence of Indiana — have credited the expansion with encouraging preventive care, cutting emergency-room visits and saving money on health care. What’s more, the Medicaid expansion has succeeded without discouraging employment, as some people worried it might.
Whatever the problems with other parts of Obamacare (chiefly, rising premiums in the state insurance exchanges), Medicaid expansion has worked. Rolling it back now would hurt state budgets, the health-care industry and, most of all, the newly insured.
That isn’t to say Republicans shouldn’t make changes. Many governors already have, with permission from the Obama administration. In Indiana, for example, beneficiaries are required to pay into health savings accounts. The Trump administration will be able to allow other innovations.
Ideally, Trump’s Medicaid officials will resist modifications that make it unduly difficult for qualified people to become insured. Requirements that beneficiaries have jobs, for example, or that they shoulder unaffordable copayments would undermine the purpose of the expansion. More counterproductive still would be for Congress to drastically reduce Medicaid’s funding, as some congressional Republicans have proposed. Far better to let the individual states continue to tailor their operations as need be.
At this point, Medicaid provides insurance to about one in four Americans. With the rest of the Affordable Care Act under threat of drastic change, it’s essential to keep this pillar of health security in place, and even work to persuade the remaining states to accept it.
Major Carrier Withdrawing from Long-Term Care Market
John Hancock Financial, owned by Manulife Financial Corp., a Canadian firm, is pulling out of the long-term care market for insurance this December. John Hancock has been one of the largest long-term care insurance providers in the United States with over 1.2 million outstanding policies. These policies will remain in effect, but no new policies will be sold moving forward. The move comes after years of premium increases for existing long-term care policies, flat consumer demand, and decreasing avenues in which to distribute long-term care insurance. This withdrawal signals what many financial planners, government officials, and financial service firms have known for years—that the United States is nearing a long-term care planning crisis.
Long-term care for seniors is very common, with over 70% of people aged 65 and over needing some long-term care during their lives. And the costs can be staggering, with a semi-private nursing home room costing well above $100,000 annually in some states. Instead of self-funding this cost or buying long-term care insurance, most individuals rely on family caregivers, who often go unpaid, to provide the care. However, this system of relying on family members could also soon be faltering. According to an AARP Study, The Aging of the Baby Boom and the Growing Care Gap, the ratio of potential family caregivers to high-risk people in their 80s will decline from 7-to-1 in 2010 down to 4-to-1 in 2030, and is expected to decline to just 3-to-1 in 2050.
As Hancock withdrawals from the marketplace, Americans are quickly finding themselves with fewer options to fund their long-term care expenses. Limited options coupled with a decrease in available family care givers may force many retirees to rely exclusively on Medicaid as a long-term care funding source. However, Medicaid generally requires that an individual spend down his or her assets before qualifying for government assistance. Additionally, relying on Medicaid means giving up a lot of control over how and where you receive long-term care services.
For years now, state governments and the federal government have been looking at ways to cut back reliance on Medicaid, which could mean increased reliance on state filial laws like the one applied in HCRA v. Pittas.. In this case, a son was required by the court to pay his mother’s $93,000 nursing home bill pursuant to Pennsylvania’s filial responsibility law. Almost half of all U.S. states have a similar law in place, making certain family members potentially liable for another family member’s long-term care expenses. In Pennsylvania, this type of law has even been applied to allow a child to recoup from his siblings the costs the child incurred while taking care of a parent at home. It is possible that states will rely on these filial support laws to ease the burden on Medicaid by requiring family members to chip in for some of the long-term care costs when possible.
Long-term care planning remains crucial, and while John Hancock is withdrawing from the market, other firms like Lincoln Financial, Thrivent Financial, and Genworth are still providing long-term care insurance policies, at least for the time being. However, some of these companies, like Genworth, have seen significant premium increases on existing policies.
Long-term care planning still remains a crucial part of retirement planning and it must be done well in advance of when care is actually needed. If you are thinking about long-term care insurance, in many cases, the best time period to begin planning is in your 50s and early 60s, as it becomes significantly more difficult to qualify for long-term care insurance in your late 60s and 70s. However, other options also exist, like hybrid long-term care and annuity or life insurance products, which have grown in popularity over the last few years. These products can serve multiple functions and can have less restrictive underwriting requirements than long-term care insurance. Ultimately, John Hancock’s withdraw highlights the challenges facing both Americans and companies trying to find the right solution for long-term care funding.
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