What do depression, diabetes, dyslexia, prosthetics, hearing loss, obesity and heart disease all have in common? All are considered disabilities or associated with increased risk of disability. About a quarter of American adults have some type of disability, according to the U.S. Centers for Disease Control and Prevention, including two in five adults over age 65.
The Trump administration in January gave a long-expected approval for states to proceed with work requirements for their Medicaid beneficiaries, via this guidance; Kentucky was the first to get its waiver approved and other states have waiver requests at various stages in the process.
That includes Arkansas, Arizona, Indiana, Kansas, Maine, New Hampshire, Utah, Wisconsin. Also, North Carolina could add work requirements for its potential Medicaid expansion population if the state’s Democratic governor ever gets expansion through the GOP-dominated legislature. Continue reading
Covering LGBT aging can be an exercise in frustration for journalists. Though more older adults are living openly as LGBT these days, health data on this segment of the population often is missing from government reports and statistics, according to Matthew Bajko, assistant editor at the Bay Area Reporter.
When it comes to summarizing the NPR news investigation “Home or Nursing Home,” you really can’t do much better than its tagline: “America’s empty promise to give the elderly and disabled a choice.”
The package is anchored by Joseph Shapiro’s wonderfully written profile of the family of a young woman who lives at home, despite the need for 24-hour intensive care. She’s 20, and Illinois Medicaid will stop covering her care as soon as she hits 21. Why?
It’s expensive to care for Olivia at home: nurses cost about $220,000 a year. Still, that’s less than half the cost of what the state counts as the alternative — having her live in a hospital. The Welters figure they’ve saved the state millions of dollars by keeping her at home.
But when she turns 21, the state changes how it measures cost. For an adult, the state says the alternative is no longer a hospital — it’s a less expensive nursing home.
At 21, Olivia and thousands like her around the country enter an uncomfortable gray area rife with lawsuits, acts of government and supreme court decisions. In fact, families like hers have lately been suing states – and winning. Shapiro explains how.
In 1999, the U.S. Supreme Court ruled, in Olmstead v. L.C., that under the ADA, people with disabilities often have the right to live in the community rather than in institutions. Since then, other federal laws and policies have said that states have an obligation to provide more home-based care. The new health reform law is filled with incentives for the states to spend more.
But federal law is contradictory. An older federal law, the 1965 law that created Medicaid and Medicare, says states have an obligation to provide nursing home care. Home care programs are still optional.
Nearly 2 million disabled Americans “fall into a twilight with the first monthly Social Security disability payment, for they then must wait two years to become eligible for Medicare,” according to The Oregonian‘s Anne Saker.
With at least 15,000 in that position in Oregon, Saker tells the story of Sue Sherman, diagnosed last year with pancreatic cancer, who discovered she must wait two years for Medicare to cover her. “Only 20 percent of pancreatic cancer patients live more than a year past diagnosis,” Saker reports.
Saker outlines the history of the waiting period, statistics about how many people in that situation go without insurance and the machinations in Washington, D.C., over the waiting period, but weaves it all into Sherman’s story, keeping a human face on the issue.
She looks at how Sherman’s illness and lack of coverage affects her family and includes an observation by Sherman’s daughter that the costs of her care will be passed on to everyone else.
As Trudy Lieberman says in her blog at CJR.org, “Her plight illustrates the traps that snare the disabled in every state.” Lieberman explains how people get caught in this waiting period and will be stuck with another waiting period with today’s launch of high-risk insurance pools.
With 2 million people affected, this is a story that should be told in every state. Lieberman wrote in 2008 about putting a human face on the proposed health reform plans. Reporters would be smart to heed that advice as they report on how the new law will be enacted.