The Impact of the ACA on Long-Term Care
With the implementation of the Patient Protection and Affordable Care Act (PPACA) that has taken place in recent years there has been many questions about the effectiveness of this measure for Americas aging population. The passing of this law has drastically changed this countries health care system; especially Medicare. During the course of this paper we will explore both positive and negative implications due to the passing of the ACA on some of Americas most vulnerable citizens; the elderly, and how this impact could potentially effect Long-Term Care.
The History, Perks and the Pits of the ACA
Most legislative health care reforms come with their fair share of those that support their initiatives and those that feel it will be the beginning to the end of life as we know it. The Patient Protection and Affordable Care Act established in 2010 is no exception. The purpose of the ACA includes a lengthy list of health related provisions that started being implemented in 2010 and will continue to be rolled out until 2022 approx. ( Health Insurance Glossary, 2015) Some of the major initiatives intend to increase health care coverage for millions of uninsured Americans, increase efficiency, lower heath care costs and eliminates the practice of denying coverage to individuals due to pre-existing conditions. If your an individual that has been affected by any of these particular provisions you will likely be in favor of the ACA. If you find yourself on the opposite side of the fence and do not support the ACA it is likely do to the increased anxiety of potential higher taxes. Or you could be one of those people that feel like your civil rights have been violated by the government by requiring you to obtain affordable health insurance.
Either way, there are many real positive and potentially negative aspects that the ACA has on long-term care for our elderly. This is a particularly concerning subject as we only anticipate that our aging population will increase in numbers as the baby boomers meet that golden age marker; and with our senior population living longer due to advances in medical technology increasing our life expectancy.
Advantages of the ACA on Long-Term Care
The White House Press released in June of 2010 stipulates the the inaction of the ACA will provide seniors and their families with greater savings and increased quality health care. It also insures that patients and doctors have more control over their own health care, not insurance companies. (White House Press, 2010)
As the health care industry is moving towards preventative care measures as a means of creating cost savings to the masses, one of the advantages this shift gives to our elderly is the implementation of free preventative care services like colorectal cancer screenings, mammograms and free annual wellness visits. (White House Press, 2010) The methodology behind preventative care and cost savings lies in the thought that preventative measures should keep chronic and costly health illness' at bay. The cost of the screenings and initial treatments that will hopefully ward off more serious conditions will cost far less then treating the more serious illness' and chronic conditions that could have been prevented. (Sirpal, 2014)
The ACA also provides patient-centered care through community health teams that work together to establish a more personal and thorough doctor-patient relationship. (White house Press, 2010) Other efforts outlined in the ACA that helps support the aging population and keep costs minimal is providing community support and coordinating care for the elderly that have had recent hospital stays. In doing so helps keep seniors from unnecessary and costly return trips to the hospital.
Through provisions outlined in the ACA there will also be cost savings associated with the implementation of the ACA for the elderly population. With most older Americans that live on a very fixed income this news couldn't be more welcomed.
It is anticipated that over the next 20 years Medicare spending will grow at a slower rate then in the previous years extending the life of the Medicare trust fund by 12 years and offer cost savings to people utilizing Medicare. The savings amount to approx. $400 annually in reduced insurance premiums and co-insurance. An additional one-time tax free $250 rebate check for seniors that meet the prescription drug qualifications that are not on Medicare is also a cost savings option. (White House Press, 2010)
All of these paired ACA provisions are thought to bring down heath care spending; in-turn saving American tax payers a great deal of money. The preventative care measures will likely have the greatest impact on the elderly. By utilizing patient-centered care, patients and doctors can better manage the onset of more debilitating age related illness. It will keep individuals out of costly long-term care facilities and enjoying their existing quality of life.
The disadvantages of the ACA on Long-Term Care.
The ACA has been on the fore-front of many heated debates. As with any government implemented health care reforms there are the perks and the pits. With the anticipated rising numbers of the elderly population due to baby boomers and advanced medical services increasing the average life expectancy, there is concern over whether there will be enough providers and facilities to accommodate this growing population.
There is also growing concern about the planned $716 billion in Medicare payment reductions and how those cuts are disbursed. (Senger, 2013) These cuts are across-the-board and not aimed specifically at waste, fraud and abuse. These cuts are anticipated to effect Medicare providers including hospitals, nursing homes, home health care agencies and hospice agencies. (Senger,2013) With major cuts to these Long-Term Care facilities it is likely the aged population will have less access to much needed care with 15 percent of hospitals, skilled nursing facilities and home health agencies becoming unprofitable by 2019; these numbers are only anticipated to increase as time presses on. (Senger, 2013)
In addition to less access to care for the elderly they could be looking at fewer plan choices, less access to physicians, higher part D premiums and higher taxes. All these attributed to provisions outlined in the ACA such as reducing payments to Medicare Advantage by an estimated $156 billion. Cuts in Medicare through the Independent Payment Advisory Board (IPAB) that will likely choose to cut physician reimbursement rates. As mentioned as a perk above in 2020, the initiative that is providing the elderly with a $250 savings in prescription drug coverage will be phased out which will lead to and increase in cost for Part D beneficiaries. (Senger, 2013)
Most of these negative aspects of the ACA are speculative in-so-far, but are still worth exploring as some, if seen to proliferation, will have a large impact on Long-Term Care, and the elderly.
It is guaranteed that with any change people become increasingly nervous and anxiety ridden. It's difficult to anticipte the future on the Affordable Care Act on all people of our population especially the elderly. I can say with all certanty that this revololutinary reform was not created in a vaccuum and did have the best interest of the American poplualtion in mind. It's fact that unfortunatly the Medicare system is in jepordy of going bankrupt before it's time. Necessary provision were needed to be made to ensure some longevity in heath care for our incresing elderly population. Hopefully though preventitive care measures it will provide enough cost saving to ensure Medicare for our elderly until other reforms are thought of or revisions to our current ACA are made.
The White House Press. (2010). The Affordable Care Act: strengthening medicare, combating misinformation and protecting America's seniors. Retrieved from http://search.proquest.com.csuglobal.idm.oclc.org/docview/365909216. Greenwood Village, CO. Colorado State University-Global Campus.
Sirpal, S. (2014). The affordable care act and incentivized health wellness programs-A tale of federalism and shifting administrative burden. The Journal of Health & Human Service Administration. Retrieved from http://search.proquest.com/docview1644727727. Greenwood Village, CO. Colorado State University-Global Campus
Senger, A. (2013) Obamacare's impact on seniors: An update. Heritage. Issue 4019. Greenwood Village, CO. Colorado State University-Global Campus [online library]