Above all, major changes to Medicare, which are set to be implemented in the near future, will likely have the most far-reaching impact on seniors across the nation. The most immediate of these changes being the cuts to Medicare-funded home health services that the Centers for Medicare and Medicaid Services (CMS) included in a final ruling released on Nov. 2.
Under the recently passed healthcare reform legislation, spending on home healthcare services, which help with everything from managing diabetes to providing physical therapy following an accident, will be reduced by nearly $40 billion. At the same time, CMS’ recently released rule cuts billions more, while also adding unfunded mandates on services that will make business literally impossible for many home healthcare providers. Many seniors, particularly in less populated areas, will likely find the services altogether unavailable. The decisions to cut home healthcare are based on questionable assumptions (among other things, the government assumes that American seniors won’t get sicker as they age) and they will likely result in some seniors ending up in the hospital or long-term care centers rather than remaining at home in their communities. Since these services cost so much more than home-based healthcare — a typical four-day hospital stay runs $20,000 — they likely won’t save taxpayer money.
A Battleground poll released in October by Democratic pollster Stan Greenberg found that 74 percent of seniors oppose the CMS cuts – not surprising given the recent midterm election results.
Additionally, seniors living on their own will have less money to spend as a result of the lack of a cost of living adjustment for Social Security. While official statistics show little inflation, many of the things most relevant to older Americans — food, fuel, and rent — have gone up in price. Gasoline prices, for example, have risen almost fifty cents since January and, in many regions, this winter’s heating bills could be 10 percent more than last winter's. Without at least a modest cost of living adjustment, many seniors used to independence will find it harder to make ends meet and may have to consider options — moving in with family members or transitioning to long-term care facilities — that they would rather avoid.
Finally, two other changes threaten the open choice system available to today’s older Americans. First, significant cutbacks in the Medicare Advantage program (which allows seniors to combine parts A, B and D through a Medicare approved private plan) may well eliminate this option which currently serves over 10 million seniors. Second, within the government designed program that remains, a super-powerful new “Independent Payment Advisory Board” will have the power to set rates for services so low that doctors and hospitals will refuse to perform them.
Shouldn’t a panel whose decisions stand to significantly alter the quality of healthcare for the aging at least be comprised of elected officials? And shouldn’t there be a better mechanism for overriding their decisions than a supermajority vote in Congress? Clearly, America’s seniors think so given the message they sent to Congress on Election Day.
Many policies have recently been implemented that will lead to the erosion of health security and severely impact the platform of quality healthcare for many seniors. These policies, especially taking away much needed home health services, are just the opposite of where we as nation should be heading.
Thair Phillips is president and CEO of RetireSafe.