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On March 21st, the House passed the health care reform bill that is historical. I would like to share with you what this really means to seniors – the real scoop.

During early March, I was fortunate enough to attend the National Council on Aging (NCOA) and American Society on Aging (ASA) Conference: Aging in America, in Chicago. Attending were over 3,000 professionals, providers, and policy administrators from across the country. I counted only about 4 from Nevada, which is another discussion.

The conference had many presenters on health policy and the health care reform legislation that was coming to a head. What an exciting time to be with the leaders in the field of aging. In this article, I would like to share with you what that leadership presented to the participants about health care reform, not really knowing what was to occur in the house a week later.

The health care reform debate has been going on for over a year, with a lot of confusing information. The lines in the sand have been drawn, by party lines. Unfortunately, the facts get distorted based on political perceptions and beliefs and not actual facts. We believe sound bites and do not seek the facts. Our media and its advertising process have a lot to do with this exposure. So given all this twisting and turning, what is the impact that health reform will actually have on you and Nevada seniors?

According to literature and presentations by NCOA public policy leadership, the 5 following facts are contained in the legislation and are the real scoop.

Fact #1: “The plan will provide health coverage for millions of uninsured Americans – plus extra protections for most people who currently have insurance.”

The plan provides insurance coverage for 32 million uninsured Americans. It will guarantee that insurance companies cannot deny coverage due to pre-existing conditions or drop them because they become sick or exhaust their coverage.

Fact #2: “The plan will not cut any benefits provided under traditional Medicare – and it will even improve some benefits.”

Help with prescription drug coverage: If you fell into the prescription coverage gap or “doughnut-hole”, the plan will eventually close that period where you had to pay 100% of the coverage. It also provides an easier appeal process if coverage was denied.

Chronic care coverage: If you have a chronic condition (e.g., heart disease, high blood pressure, arthritis, diabetes) like 80% of seniors, then you will receive better care through health care teams that provide patient centered care, keeping you out of hospitals and emergency rooms. It will enhance coordination and integration of care by teaching you how to care for yourself at home through evidence-based community programs that enhance independence.

Better preventive care: You will receive a new, free annual wellness visit and no out of pocket costs for preventive benefits under Medicare (e.g., cancer and diabetes screenings).

Fact #3: “The plan will help you find and afford long term services and supports at home.”

Many of us are forced to spend down our life savings and go into nursing homes at a cost of $60,000 – $80,000 a year because we cannot find or afford care in the home. The plan creates a new national insurance program called CLASS to help pay for care at home. Through voluntary payroll deductions, when we need care at home, the insurance will provide a cash benefit to you so you could pay for whatever non-medical service you need – home modifications, transportation, or paying a family member to provide personal care.

Fact #4: “The plan will improve care for older Americans in other ways.”

Help prevent and combat elder abuse, neglect, and exploitation.

Improve the training of the workforce that cares for seniors and increase numbers of primary care physicians (currently, only about 1% of MD’s, nurses, social workers, etc. are trained in geriatrics).

Improve nursing home quality.

Reduce health insurance premiums for Americans aged 55-65.

Fact #5: “The plan will reduce Medicare spending growth and it is fully paid for.”

The Medicare program will be strengthened according to an article entitled “How Health Reform Legislation Will Affect Medicare Beneficiaries”, from the Commonwealth Fund. “Despite criticism that health reform legislation will result in cuts to Medicare, the bills passed by the House of Representatives and the Senate, as well as President Obama’s proposal, contain provisions that would strengthen the program by reducing costs for prescription drugs, expanding coverage for preventive care, providing more help for low-income beneficiaries, and supporting accessible, coordinated, and comprehensive care that effectively responds to patients’ needs. The legislation also would help to extend the program’s fiscal solvency—for nine years, under the Senate bill. This issue brief examines the provisions in the pending legislation and how each one would work to improve benefits, extend the fiscal solvency of the Medicare Hospital Insurance Trust Fund, reduce pressure on the federal budget, and contribute to moving the health care system toward better access to care, improved quality, and greater efficiency.” (Guterman, Davis, Stremikis, March, 2010).

Even though health expenses are predicted to grow over the next 10 years, the health care plan will reduce that increase by $138,000 billion, according to the independent, nonpartisan Congressional Budget Office. Hence, it will be fully paid for, extend the solvency of the Medicare program, and even reduce the deficit.

The plan will slow the rate of payment increase to providers, which many providers have already agreed. Doctors will not be affected.

Reduce the payments to Medicare Advantage insurance plans which have about 25% of the senior population. Currently, Medicare pays over $1,000 more per person than traditional Medicare. The plan will level the playing field, which means that by cutting the reimbursement to these programs, the insurance plans may drop out or cut some of the extra benefits such as eyeglasses or hearing aids or increase premiums.

Reduce fraud and waste to make Medicare more efficient.

Ask high income Medicare beneficiaries to pay higher premiums. The plan will affect individuals with annual incomes of $85,000 and above and couples with incomes above $170,000.

Create a new Payment Advisory Panel to recommend ways to reduce costs in the future.

In summary, I am simply presenting to you 5 facts that the current legislation reforming health care in this country will have on you and the rest of the seniors in Nevada. Given the real scoop, this legislation will certainly “add life to years” for many us. I support it and you should as well.

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