CHA Blog

• 30Jun

  California’s IHSS Cuts Disproportionately Affect Ethnic Elders

  Long-term care insurance, Low-income help No Comments

  The recently proposed budget cuts, particularly those to the In-Home Supportive Services (IHSS) program, will disproportionately affect immigrants and communities of color. Of those people enrolled in IHSS, over 49% of them speak a language other than English at home.

  California Budget Cuts Target Ethnic Elders:

  Seniors and Individuals with Disabilities May Lose Help Needed to Stay Safely in Their Homes

   

  While everyone in California has heard about the budget crisis that threatens crucial health and social services, less has been heard about the people are who could be harmed.  As a group, immigrants and communities of color would be disproportionately hurt by the proposed cuts.   Data obtained by the National Senior Citizens Law Center show that among recipients of In-Home Supportive Services, one of the biggest targets for Governor Schwarzenegger’s cost-cutting, approximately 49 percent speak a language other than English at home. 

   

  In-Home Supportive Services, or IHSS, is a program that provides assistance to seniors and individuals with disabilities so that they can live safely at home instead of in a nursing home.  Under the most recent budget proposals, an estimated 404,000 people would lose services they need to age at home, such as personal assistance with eating and bathing.  Because ethnic elders are more likely to get long term care at home than in a nursing home, cuts to IHSS have a disproportionate impact on California’s racial and ethnic minority families and communities.  More than sixty percent of IHSS recipients aged 65 and older are from communities of color.  In contrast, the majority of nursing home residents are white. 

   

  There are no good alternatives for ethnic elders hurt by proposed cuts.  Most people prefer to age at home, avoiding the expense and isolation of a nursing home.  Furthermore, research shows that non-whites in nursing homes do not get as good care as white residents.  And there simply aren’t enough beds in the state to house all the IHSS recipients whose services would get cut off.  Instead, a senior who is not able to prepare and eat a healthy diet on her own, or who needs some help getting to and from the bathroom, will instead be left to fend for herself.  The result will be weight loss, broken hips—and worse. 

   

  “These short sighted proposals would cause a health crisis and undermine the stability of thousands of families who currently care for their frail and elderly immigrant parents and grandparents,” says National Senior Citizens Law Center attorney Anna Rich.  “The governor and legislature need to stop trying to squeeze savings out of the most vulnerable members of society.”

   

  IHSS is one of many programs supporting vulnerable seniors that are now on the chopping block due to the state’s budget crisis.  Thousands of older immigrants would be left destitute, unable to pay for housing, food, medicine and other necessities by the proposal to eliminate the CAPI program.  Others will find their already low incomes reduced due to rollbacks to the Supplemental Security Income (SSI) program.  Recent legal immigrants and other poor seniors who don’t get SSI would lose access to healthcare.  Any of these cuts alone would be devastating; all together the results are truly unthinkable. 

   

  For questions, or for additional information about how the proposed cuts to In-Home Supportive Services and other programs will impact particular immigrant groups and communities of color, please contact Anna Rich, arich@nsclc.org, 510-663-1055, ext. 305. 

  IHSS provides assistance to seniors and individuals with disabilities that enables them to live safely in their home instead of a nursing home. Yet with the proposed budget cuts, over 404,000 seniors and people with disabilities will be cut off from these important benefits. Immigrants and people of color are more likely to live at home and use their IHSS benefits  for personal assistance care (such as help with bathing and eating) than live in a nursing home. In contrast, however, the majority of nursing home patients are white. As over 60% of IHSS recipients aged 65 and older are people of color, the state’s proposed cuts will have a greater, more devastating impact on these communities and their families.

  As stated in a recent article from the National Senior Citizens Law Center (NSCLC) on the proposed IHSS cuts, no good alternatives exist for ethnic elders affected by these cuts.  Most people would rather live at home than be isolated and pay the high cost of a nursing home. Also, statistics show that ethnic elders often receive lower quality care in nursing homes than white elders, further contributing to the gap in health disparities and health care equality. In addition, California does not have enough nursing home beds to house all the people who will be cut off from their IHSS benefits if the proposed cuts go through. This means that people who are not able to pay for or find a nursing home for their required assistance with dressing, bathing, preparing food, etc, will be left to fend for themselves. The results can be devastating to ones health, quality of life, or even their ability to live. 

  These proposals only offer short-term ‘budget relief’ and would most likely cause a health crisis and undermine the stability of thousands of families who currently care for their vulnerable and elderly immigrant parents and grandparents.

  For more information on the proposed cuts, see our recent article:

  • Governor Proposes $9 Billion in New Massive Cuts; Entire Programs Targeted for Elimination

  For updated information on the California budget, see:

  • California Department of Finance
  • California Disability Community Action Network
  • Health Access
  • California Budget Project

  This article was edited in part from NSCLC’s article, California Budget Cuts Target Ethnic Elders.

• 19Jun

  Where Does Health Care Reform Stand In Congress?

  Medicare and other health insurance No Comments

  As the Obama Administration is asking Congress to put together a health care reform package by October 2009 to revamp our $2.5 trillion U.S. health care system, much conversation, debate, and research is taking place in Congress. Reuters recently published a good summary article on what’s happening in health care reform in the Senate, House of Representatives and several special interest groups. 

  Click here to read the article.

• 16Jun

  Final Budget Conference Committee Hearing Today Focusing on Human Services Cuts – IHSS, SSI/SSP, CAPI, MSSP, & More

  Low-income help 1 Comment

  Yesterday June 15th, the Budget Conference Committee of the California Legislature made some severe cuts based on the Governor’s proposals, yet they also largely rejected full-scale eliminations of programs, such as Healthy Families. 

  Today June 16th, the Budget Conference Committee will complete its work focusing on proposed cuts to human services, education, higher education, and general government. 

  Several big issues to be discussed under human services include the Governor’s proposed cuts he made in May to In-Home Supportive Services, Supplemental Security Income/State Supplementary Payment (SSI/SSP), several Department of Aging programs, community care licensing, and the Cash Assistance Program for Immigrants (CAPI). 

  The Budget Conference Committee’s actions, however, are not final. The full Assembly and State Senate must give their final approval to any budget choices that the legislative leaders and the Governor make – which is predicted to happen before the end of this month. 

  Below is a summary of some of the budget decisions made yesterday, Monday June 15th, according to Health Access: 

  • A $1 billion cut in Medi-Cal as part of the Governor’s flexibility and stabilization negotiations with the federal government.
  • A $70 million cut to Healthy Families, which would establish a waiting list for children to receive coverage, unless other sources of funding or donations were made. (For example, last year, the First Five Commission provided $17 million to Healthy Families to prevent a waiting list from being established, but this year’s proposed cuts present a significantly bigger funding gap.)  Without additional assistance, a $70 million cut could mean that no new children can enroll in  the Healthy Families program for an extended time, denying well over 200,000 children coverage.
  • The rejection of the elimination of Medi-Cal coverage for legal immigrants, both legally residing and those with PRUCOL status.
  • A 30% cut to state funding of community clinic programs.
  • A $35.5 million cut for AIDS and HIV programs (as opposed to the proposed $80 million cut), both education and prescription drug service programs.
  • A $26.5 million reduction in Adult Day Health Care Centers, as opposed to a full elimination as the Governor and the Republicans on the committee supported (which would’ve reduced state spending by $170.5 million). The proposed compromise would cap the use of ADHCs to 3 days a week, among other provisions.
  • A smaller cut to small and rural hospitals that what the Governor proposed.
  • A near 50% cut, rather than complete elimination, of the state’s poison control system.

  Below is a summary of some of the specific proposed cuts on the agenda for discussion today, according to CDCAN’s 6/16 Alert:

  • Community Care Licensing – Governor’s proposal to eliminate state funding for this program. (reduction would total over $19 million in state general fund spending)
  • In-Home Supportive Services Share of Cost Buy-out – Governor’s proposal to reduce spending and limit who can participate in the buy-out program (reduction would total over $41 million in state general fund spending)
  • In-Home Supportive Services Domestic & Related Services – Governor’s proposal to limit domestic and related services to only persons with a functional index ranking of 4.0 or higher  (reduction would total over $53 million in state general fund spending)
  • In-Home Supportive Services Cost Containment- Governor’s proposal to make ineligible for any services under IHSS, persons with a functional index score (different from functional index ranking) 2.99 or lower; would provide for some services under IHSS but not domestic and related services for persons with a functional index score between 3.0 and 3.99.  Would make no changes for persons with functional index scores of 4.0 or higher.  “Functional index score” is the average of the activities of daily living that each person on IHSS is assessed by their county social worker.  A person is “ranked” in each of the activities of daily living.  (Reduction would total over $705 million in state general fund spending.)
  • In-Home Supportive Services State Funding for Worker/Provider Wages – Governor proposed reducing the state’s funding (participation) for IHSS worker wages to a maximum of $8 an hour – the state minimum wage, plus 60 cents for health benefits, effective October 1, 2009. (Total reduction would be over $161 million in state general fund money.)  This would impact currently 46 counties who pay higher than the minimum wage.  This proposal would be a further reduction to state funding of IHSS worker wages, which, unless reversed by the Legislature or stopped by legal action, is scheduled to be reduced to $9.50 per hour (plus 60 cents for health benefits) effective July 1, 2009.  That action was previously approved by the Legislature as part of the 2009-2010 State Budget passed in February.  
  • In-Home Supportive Services Integrity Initiative – Governor’s proposal that would result in reduction in IHSS due to increased fraud and abuse efforts. (Reduction would total over $32 million in state general fund spending.)
  • In-Home Supportive Services Public Authority Administration – Governor’s proposal to provide for a $699,000 increase due to caseload and other related adjustments for the 2009-2010 State Budget year.  
  • Multipurpose Senior Services Program (MSSP) – Governor’s proposal to eliminate the program.
  • Linkages Program – Governor’s proposal to eliminate  this program. (Reduction would total over $13 million in state general fund spending.)
  • Senior Community Based Services Programs (Including Alzheimer’s Day Care Resource Center, Brown Bag, Respite Purchase of Services and the Senior Companion Program) – Governor’s proposal to eliminate these programs. (Reduction would total over $4 million in state general fund spending.)
  • Supplemental Security Income/State Supplementary Payment (SSI/SSP) – Governor’s proposal to reduce SSI/SSP grant levels to the lowest amount allowed by the federal government, effective October 1, 2009 (reducing grants for individuals to $830 per month and couples to $1,407 per month).  Grants were already reduced due to suspension of cost of living increases on May 1, 2009 and June 1, 2009. The 2009-2010 State Budget passed in February also included a 2.3% reduction to the SSI/SSP grant level, effective July 1, 2009 (lowering grants to $850 for individuals and $1,489 for couples).  That grant level will be lowered further on October 1, 2009 if this new proposal by the Governor is approved.  (Reduction would total over $264 million in state general fund spending.)
  • Cash Assistance Program for Immigrants (CAPI) – Governor proposed elimination of this state funded program that provides similar SSI/SSP level grants to over 10,000 persons with disabilities, the blind and seniors who are legal immigrants but do not qualify for SSI/SSP due to federal law changes in 1996.  (Reduction would total over $85 million in state general fund money.)
  • California Food Assistance Program (CFAP) – Governor’s proposal to eliminate this program which provides food stamp benefits to legal immigrants not eligible for the federal food stamp program.  (Reduction would total over $33 million in state general fund spending.) 

  For more information on the California state budget, see:  

  • Our article, Governor Proposes $9 Billion in New Massive Cuts; Entire Programs Targeted for Elimination
  • Alert updates from health-access.org and cdcan.us

  Information in this article is edited in part from Health Access’ and CDCAN’s budget update alerts, 6/16/09.

• 10Jun

  Half a Million of California’s Single Elders Struggle to Make Ends Meet

  Low-income help No Comments

  Nearly half a million elders living alone in California cannot make ends meet, lacking sufficient income to pay for a minimum level of housing, food, health care, transportation and other basic expenses, according to a policy brief by the UCLA Center for Health Policy Research and the Insight Center for Community Economic Development. This number jumps to over 1 million when adding in elders living with family members.

  The research for the brief, “Half-Million Older Californians Living Alone Unable to Make Ends Meet,” is based on 2007 data, the last time comprehensive, statewide data was collected. But the numbers of affected seniors are likely to be even higher today as the current recession deepens and as systemic budget cuts in health care and other social service programs are in place for July 1, 2009, with more pending approval of the Legislature. 

  The brief includes county estimates of the percentage of economically vulnerable seniors. Those estimates show that elder economic insecurity is a problem in both more and less affluent counties: The 2 counties with the highest elder economic insecurity are Imperial and San Francisco. 

  The findings in the policy brief are based on the Elder Economic Security Standard Index (Elder Index) for California, a tool that measures the actual cost of basic necessities for older adults in each of California’s 58 counties. The Elder Index is viewed by many as a more accurate measure of economic security than federal poverty level (FPL) guidelines, a standardized national estimate that does not take into account the cost of living in high-cost states such as California. 

  Among the findings in the brief:

  Most older renters can’t make ends meet

  Older renters were more than twice as likely to be economically insecure as those who owned their homes and had paid off their mortgages (70.4 percent of older single renters were insecure, compared with 34.4 percent of homeowners without mortgages). 

  Latino elders at risk 

  About 3/4 of Latino elders who lived alone, and almost half of those who lived with only a spouse, could not cover their basic costs of living. 

  Women at risk

  Older women accounted for 72% of all older Californians who lived alone. Those women were more likely than older men to be unable to cover their basic needs (53.5% of women, compared with 44% of men). 

  The very old at risk

  A majority of all single elders aged 75 or older were economically insecure, regardless of ethnicity. More than 90% of female single renters aged 75 and older who were Latino or Asian had incomes below the Elder Index, as did 2/3 of all white single renters and 85% of all African American single renters aged 75 and older. 

  FPL indicates only half of what is needed

  In 2007, the nationwide federal poverty level (FPL), used to determine eligibility for public assistance, was $10,210 for a single adult living alone. According to Elder Index calculations, however, the average minimum income needed by a single older Californian who rented was $21,011.

  With so many elders already at risk and unable to make ends meet, the current budget cuts will only exacerbate this situation.

  Read our recent article on California’s state budget for more info and how the cuts will affect our state’s elders and people with disabilities.

• 04Jun

  CHA Testifies on Long-Term Care Insurance Consumer Protections at Senate Hearing

  Long-term care insurance No Comments

  On June 3, 2009, Bonnie Burns, Training and Policy Specialist, testified on the need for greater consumer protections, standardization of policies and regulation of long-term care (LTC) insurance products and marketing practices. Her written testimony also includes a detailed discussion on Partnership policies and the unique situation and precautions needed in regulating and marketing a state-endorsed product.  Client case studies and highlights on rate increases from 2 major players in the LTC insurance industry, Conseco and Penn Treaty Network America, are discussed as well. 

  Senator Herb Kohl (D-WI) chaired this hearing entitled “Boon or Bane: Examining the Value of Long-Term Care Insurance.” Policymakers are investigating the role LTC insurance could play in financing our country’s growing LTC needs, as the strain of the recession affects both consumer and government budgets, and the gap between the long-term care services people require and the public and private programs to cover those services is growing wider. About 6 million people currently have LTC insurance. 

  The 4 other people who testified in this hearing were: Diane Rowland, Executive Vice President, Henry J. Kaiser Family Foundation; Sean Dilweg, Insurance Commissioner, Wisconsin Department of Insurance; Carol Cutter, Chief Deputy Commissioner, Indiana Department of Insurance; and Thomas Stinson, President, Genworth Long-Term Care.

  • Read Burns’ testimony, Gambling on Consumer Ignorance: Comprehensive Consumer Protections and Regulatory Scrutiny Are Required To Protect Purchasers of Long-Term Care Insurance Products. 
  • View the archived webcast of the hearing and other presenters testimonies posted on the Senate Special Committee on Aging’s website.

  For more information on long-term care (LTC) and LTC insurance, see the LTC section of our website.

• 27May

  Governor Proposes New Massive Cuts ~ $9 Billion ~ Entire Programs Targeted for Elimination

  Low-income help No Comments

  California’s budget situation is growing worse with the budget deficit now projected at over $24 billion. Yesterday, on May 26th, Governor Schwarzenegger proposed over $5.5 billion in new massive, permanent spending cuts – all in addition to the cuts he proposed on May 14th. He will also propose over $3 billion additional cuts on Friday, May 29th. No action on the Governor’s proposals are expected until at least mid June.

  Legislative analysts have said that even if California adopted all of the Governor’s proposed cuts, the budget deficit for the 2010-2011 State Budget year would still be over $15 billion.

  Included in yesterday’s proposed reductions is the proposed elimination of the state’s welfare to work program, CalWORKS, that serves over 500,000 people, including many with special needs, and critical senior programs. The Governor also proposed elimination of several essential community-based senior programs under the Department of Aging including the Multipurpose Senior Services Program (MSSP). 

  The Governor also proposed the elimination of the Healthy Families program, which provides with matching State Children’s Health Insurance Program (SCHIP) federal funds, health insurance for over 900,000 children from low income families

  Also proposed are even deeper cuts to Medi-Cal to slow the growing use of services, eliminate certain Medi-Cal state funded only programs, and cut state funds for the Community Care Licensing program. See below for details.

  The non-partisan Legislative Analyst Office (LAO), who works directly for the Legislature and provides analysis, recommendations and review of budget issues, estimates that if California’s budget shortfall and cash flow crisis is not resolved soon, the State may not be able to pay its bills after July 1st.  

  Below is a summary of several of the Governor’s additional cuts proposed on May 26th. This summary is edited from the California Disability Community Action Netork’s (CDCAN) latest alert.

  Summary of Governor’s Proposed Cuts as of 5/26/09 

  Multipurpose Senior Services Program (MSSP) – ELIMINATE

  Proposed elimination of the Multipurpose Senior Services Program and senior Community-Based Services programs.  Funding for Adult Day Health Care would continue in support of the California Department of Aging’s responsibility for Medi-Cal certification of providers.

  • 2009-2010 State Budget Year:  $24.2 million cut (state general funds)
  • 2010-2011 State Budget Year: $35.3 million cut (state general funds)

  Mental Health Managed Care Services and Early Periodic Screening, Diagnosis and Treatment Services (EPSDT) – REDUCE FUNDING

  Proposes to reduce funding for these services but would retain funding for Mental Health Managed Care services for acute inpatient services and prescription drugs for Medi-Cal enrollees only.  EPSDT reduction would result from eliminating State general fund money for county programs identified as new programs in 2007-2008 and 2008-2009.

  • 2009-2010 State Budget Year:  $92 million cut  (state general funds)
  • 2010-2011 State Budget Year:  $92 million cut (state general funds)

  Medi-Cal – ADDITIONAL $250 MILLION CUT

  The Governor has proposed an additional cut of $250 million to the Medi-Cal program, adding to the already $750 million of cuts proposed in the May 14th budget. This means a total of $1 billion in unspecified cuts to Medi-Cal, through a negotiation with the federal government to cut eligibility. If approved, these cuts could deny coverage to nearly 1 million California children, parents, seniors and people with disabilities. 

  Medi-Cal – ELIMINATE Certain State Only Programs

  Proposes to eliminate certain “state-only” programs that don’t get federal funds, thus denying coverage to specific populations for breast and cervical cancer treatment, postpartum care, dialysis, and non-digestive nutrition. 

  • 2009-2010 State Budget year:  $34.4 million cut (state general funds)
  • 2010-2011 State Budget year:  $57.8 million cut (state general funds)

  Medi-Cal – SUSPEND Skilled Nursing Facility Costs of Living Increase 

  Proposes to suspend an estimated 5% cost of living increase effective August 1, 2009 for skilled nursing facilities.

  • 2009-2010 State Budget year: $67.1 million cut (state general funds)
  • 2010-2011 State Budget year: $109.8 million cut (state general funds)

  Community Care Licensing – ELIMINATE STATE FUNDING

  Proposes to eliminate state funding for the Community Care Licensing program. According to the Governor, the reduction would be off-set by a fee increase to maintain “critical health and safety standards.”

  • 2009-2010 State Budget Year:  $19.5 million cut (state general funds)
  • 2010-2011 State Budget Year:  $39 million cut (state general funds)

  AIDS Drug Assistance Program – REDUCE FUNDING

  Proposes to reduce funding for the AIDS Drug Assistance Program (ADAP) and for other Office of AIDS programs.  Specific proposals include: expanding client cost-sharing and limiting the formulary in the AIDS Drug Assistance Program; reducing and eliminating other HIV/AIDS programs such as HIV Counseling and Testing, Epidemiologic Studies/Surveillance, Therapeutic Monitoring Program, and Home and Community-Based Care.

  • 2009-2010 State Budget Year:  $55.5 million cut (state general funds)
  • 2010-2011 State Budget Year:  $58.9 million cut (state general funds)

  CALWORKS Program – ELIMINATE

  Proposes to eliminate California’s “welfare to work” program formally called the California Work Opportunity and Responsibility to Kids program, that includes thousands of children and parents with special needs.  Program serves over 500,000 people.

  • 2009-2010 State Budget Year:  $1.31 billion cut (state general funds)
  • 2010-2011 State Budget Year:  $1.77 billion cut (state general funds) 

  Healthy Families Program - ELIMINATE

  Proposes to eliminate funding for this program and assumes that the program phases out “as quickly as possible” after providing notice to those persons in the program.  Program serves over 900,000 children.

  • 2009-2010 State Budget Year:  $247.8 million cut (state general funds)
  • 2010-2011 State Budget Year:  $322.4 million cut (state general funds)

  Community Clinic Programs — ELIMINATE FUNDING

  Proposes to eliminate state funding for Indian Health, Seasonal and Agricultural and Migratory Workers, Rural Health Services Development, and Expanded Access to Primary Care (EAPC).

  • 2009-2010 State Budget Year:  $34.2 million cut (state general funds)
  • 2010-2011 State Budget Year:  $34.2 million cut (state general funds)

  Submit Your Comments!

  For the first time, the Budget Conference Committee is receiving public comments on these proposals. If you’re not able to come to a hearing in person, submit your written comments to: 

  Assemblymember Noreen Evans, Chair

  Assembly Budget Committee – Budget Conference Committee

  State Capitol

  Sacramento, CA 95814

  Be sure to include your complete name and address.  Also send a copy to the vice chair of the Budget Conference Committee, Senator Denise Ducheny (she is also the chair of the Senate Budget and Fiscal Review Committee).

  Sen, Denise Ducheny, Chair

  Senate Budget and Fiscal Review Committee

  State Capitol

  Sacramento, CA 95814

• 20May

  What’s Happening to Our Nation’s Health Care Reform? Resources to Learn and Share Ideas

  Resources No Comments

  Earlier this year President Obama declared his resolution to enact comprehensive health care reform by the end of 2009. (Read a live blog from the event here) The Administration is conducting forums, igniting conversations, ideas and solutions with health care leaders, professionals, employers, academic researchers, and rural and urban communities across the country. Each community, geographic region, ethnicity, gender, age group have their own experiences, challenges, opinions and ideas on how to reform our health care into a system that works for all. Part of the conversation is highlighting what doesn’t work. For example, the typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone (see The Costs of Inaction at HealthReform.gov). Also, in the U.S. Health and Human Services Department’s 2008 National Healthcare Quality and Disparities Reports, a few highlights on what’s not working include:

  • 40% of recommended care is not received by patients.
  • Only 40% of diabetic patients received 3 recommended diabetic preventive exams in the past year, and this rate has not improved over time.
  • Disparities in health care persist. Minority patients receive disproportionately poor care compared to Caucasian patients. At least 60%of quality measures have not improved for minorities compared to Caucasians in the past 6 years. (See our recent article on health care disparities in Medicare beneficiaries’ end-of-life-care.)
  • 1 in 7 hospitalized Medicare patients experience one or more adverse event.
  • Only half of obese adults and children are given advice to exercise more and eat a healthy diet.
  • 7 out of 10 adults with mood, anxiety, or impulse disorders received inadequate treatment or no treatment at all.
  • Patient safety measures have worsened by nearly 1% each year for the past 6 years.

  In taking a good look at what is currently happening – what is working and what isn’t – we have a foundation to reshape our current system. 

  To facilitate this reform, the Obama Administration has a website, HealthReform.gov. Here you can find a wealth of information, perspectives and reports on what’s happening in health care nationally and locally. 

  In addition, KQED’s Healthy Dialogues program recently launched a blog, Healthy Ideas: Californians Weigh In on Health Care Reform, where a group of thought-leaders, health care professionals and reform advocates share their ideas on how best to reshape our health care, from a California perspective. Our state has over 6.6 million uninsured people and over 4.4 million people on Medicare; both of these groups are larger in Californina than in any other state in the nation. California’s input in shaping our health care reform is unique and essential for Washington to hear. 

  New articles are posted each week and are open for public comments. You can visit the blog and add your thoughts, ideas and contributions to reshaping the health of our nation. Healthy Ideas is an 8-week project ending July1, 2009.  Article topics include:

  • covering the uninsured; 
  • eliminating health disparities; 
  • improving quality access; and 
  • slowing costs. 

  Our country’s health care reform is projected to lower costs and ban insurance companies from denying coverage based on pre-existing conditions.  Much is on the table for discussion, and the goal is to offer all Americans access to affordable quality health care .

  For more information on our nation’s health care reform, visit:

  • HealthReform.gov — See what other Americans are saying about health care reform, read research findings, and find the latest news on reform from the Administration.
  • White House Agenda on Health Care — Describes the Administration’s goals for health care reform.
• 13May

  No Social Security Cost of Living Increase Expected in 2010

  Medicare basics 2 Comments

  For the first time in more than three decades, Social Security beneficiaries will not get any increase in their benefits next year, according to forecasts from the Obama Administration and Congressional Budget Office. This will affect over 49 million Americans receiving Social Security benefits nationwide, 4.5 million of whom live in California. 

  Social Security typically increases benefits annually to keep up with rising prices of consumer goods. This year, in 2009, the increase was 5.8%, and beneficiaries have received an automatic increase every year since 1975. The current economic recession, however, coupled with other factors such as decline in energy prices, has resulted in low inflation, which likely will result in the lack of a cost-of-living increase for at least the next two years, possibly three. The Obama Administration and CBO estimate a modest 0.8-1.4% increase for 2013.

  Federal law mandates that most Social Security beneficiaries cannot have their Medicare Part B premiums increase by more than the dollar amount of the cost-of-living increase in their Social Security checks. Since there will be no COLA increase, about 75% of Medicare beneficiaries’ Part B premiums will remain the same ($96.40) for 2010. 

  However, about 25% of Medicare beneficiaries are not protected by this law and could see their premiums increase. CBO estimates the basic premium will rise to $119 next year, $123 in 2011 and $128 in 2012 for those not protected by the law. Beneficiaries who aren’t protected by this law include:

  • New enrollees in Part B (because they did not have the premium withheld from their Social Security benefit in the prior year),
  • Higher-income enrollees who are subject to an income-related premium (see our chart on Part B Premiums for more info), and
  • Individuals who do not have the Part B premium withheld from their Social Security checks, nearly all of whom have their premiums paid by Medicaid (Medi-Cal in California).

  In addition, millions of beneficiaries also may experience higher premiums for drug coverage under Medicare Part D because there are no laws that prevent such an increase. If such an increase in Part D premiums does occur, beneficiaries will see their Social Security checks reduced for the first time.

  For more information, see the following articles from the Congressional Budget Office (CBO):

  • Why CBO Projects No Social Security COLA for 2010 to 2012 Under Current Law
  • Effect of a Zero Social Security COLA on Part B Premiums in Medicare
• 05May

  Translated Medicare Fact Sheets Available in Vietnamese

  Resources No Comments

  Four of our Medicare fact sheets are now also available in Vietnamese:

  1. Original Medicare: An Overview (PDF)
  2. 2009 Premiums, Co-insurance & Deductibles (Original Fee-for-Service Medicare) (PDF)
  3. Medicare Part D: An Overview (PDF)
  4. Extra Help for Part D Costs (PDF)

  Several other fact sheets are also available in Chinese, Spanish, Russian and Korean. See our fact sheet page to download.

• 27Apr

  More Beneficiaries in MA plans Will Qualify for Free Pharmacy Consultation Services in 2010

  Medicare Advantage, Prescription drugs 1 Comment

  Currently, Medicare Advantage (MA) beneficiaries with at least $4,000 worth of annual drug costs are eligible for pharmacy consultations at no cost. These consultations are provided to ensure: 1) people understand how to use their medication, and 2) the medication prescribed will not produce adverse side-effects with other medications the person may be taking.

  In 2010, new guidelines from the Center for Medicare and Medicaid Services (CMS) will broaden the pharmacy consultation benefit to more MA beneficiaries. Health plans will be prohibited from restricting access to the benefit to members with a high number of chronic health conditions and medications, and the annual drug cost limit will be reduced from $4,000 to $3,000. Also, under the revised guidelines, MA plans will be required to review their member rolls on a quarterly basis to identify eligible members for the program. 

  Pharmacists will be paid $50 by the health plans to review a beneficiary’s medications and make recommendations to their physician. Pharmacists will receive additional payments if they recommend a less-costly, therapeutic equivalent to the patient. This may be an important step, both in reducing health care costs and in improving people’s overall health as less medications reduce side effects and harmful interactions between medications.

  For information on Medicare’s Part D drug coverage, see:

  • Prescription Drugs – Medicare Part D

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