Health Care Reform Leaves Out Seniors

The current debate over health care reform in Washington, D.C. has left many seniors scratching their heads---because the major worry of older people is not even being discussed. As of 2010, an estimated 40 million Americans will be over the age of 65—and that number will double to 80 million by the year 2040. By 2020 one in six Americans will be age 65 and older. The fastest growing segment of the aging population is individuals over the age of 85---often the most vulnerable older adults needing long-term care services and supports, and whose numbers will reach 7.3 million by 2020, and 15.4 million by 2040. Health care solutions in 2010 are totally out of touch with the graying of our population by 2040. An engineer might say we are designing for the wrong event. Whether or not there is an employer mandate to provide health care, for example, it is of little consequence to millions of seniors who are living in retirement, and have no employer. Just over a month ago, legislation was introduced in Congress that would reform the way long term care is provided to individuals with disabling conditions. For many seniors, the financial burden of long term care is more frightening---because Medicare covers very little long term care---and many seniors are not poor enough to get onto MassHealth. For seniors, health care reform is not the burning issue---it’s long term care reform. During this debate, Medicare has been called “socialized medicine,” so the obvious move to expand Medicare to younger populations is off the table.

The long term care legislation introduced is called Project 2020 (S. 1257/H.R. 2852), and its purpose is to improve the way consumers in all points of life (age, disability, income) access information on long-term care; to provide cost-effective health promotion and chronic disease management programs in every community to keep older adults healthier and thus save Medicare dollars, and to preventing people from spending their life’s savings to qualify for Medicaid nursing home eligibility by offering those most at-risk of nursing home care a range of home and community-based services to keep them off Medicaid in their own homes for as long as possible. This nursing home diversion program is estimated to create net savings of $27 million in Massachusetts from 2010 to 2014 by keeping people out of institutions.

Project 2020 provides the first coordinated national long-term care strategy that will generate savings in Medicaid and Medicare at the federal and state levels. At the same time, Project 2020 will enable older adults to get the support they need to successfully age where they want to—in their own homes and communities.

Project 2020 is estimated to reach over 41 million Americans and will reduce federal Medicaid and Medicare costs by approximately $2.8 billion over the first five years, resulting in a net savings to the federal government of nearly $250 million. The program would also generate significant savings for state governments.

This legislation builds on the existing network of community-based long-term care agencies. In Massachusetts, community based care has helped to drive down the number of Medicaid nursing home days by roughly 20% since 2000.
Project 2020 provides the nation’s rapidly increasing aging population, as well as persons with disabilities, with enhanced home and community-based support services while at the same time saving Medicaid and Medicare dollars.

The limited context of the health care debate is leaving many seniors cold. It’s time for Congress to remember long term care. One way to do that is to include Project 2020 in whatever health care reform bill has legs.

Until this happens, 40 million Americans are being left out of the debate.

(Courtesy of Mass Home Care)