The Affordable Care Act: One Year Later

Greetings, folks!

Hope y'all had a Happy Easter or otherwise just a plain peaceful weekend. It's been a little while since we last chatted, mostly since home health care news hasn't been too exciting lately. That's why I figured we would talk about the Affordable Care Act (ACA), now that it's been around for a year. After all, we only recently got the news that college kids can stay on their parents' health insurance until they're 26 now. Now, I'll be primarily looking at Florida for the "Where are we now?" update in this post, since Reliance Home Health Care, LLC is based in Florida, but if you want any more general information, as always, just ask. Anyways, we'll be gathering our intelligence from here. I'm looking at a specific pdf on the site that you need to navigate to, but if you really want to check my facts, I'll tell you how to find it. All right, here we go...

Here are a few things the ACA has done/is doing for us, assuming you're American and have insurance:

• Nearly everyone with Medicare gets free preventative services -- the website lists examples like mammograms and colonoscopies -- and a free annual wellness visit with their doctor. Of the 44 million folks with Medicare, 3.3 million are from Florida.
• If you hit the prescription drug coverage gap, which the White House fondly calls "The Donut Hole", you should've gotten a $250 rebate (tax free!). Also, if it happens again this year, you'll get half off of the brand name prescriptions. So, no need to run to Canada to get your prescriptions filled! They're planning on filling in the donut hole entirely by 2020.
• If you're one of the nearly 300,000 small businesses in Florida, you can get some of the $40 billion in tax credits that'll help you afford insurance premiums and help you get coverage for your employees.
• Basically, governors get a bunch of Federal funds to help their state. Florida's already gotten $110.4 million (as of the time the source was written). Here's the breakdown:
•  $1 million to plan for a Health Insurance Exchange
•  $1 million to crack down on unreasonable insurance premium increases
•  $14.5 million to support capital development in community health centers 
•  $22 million from the Prevention and Public Health Fund
•  $26.2 million in Therapeutic Discovery Project Program Tax Credits and Grants
•  $1.4 million for Medicare improvements for patients and providers
•  $1.7 million for demonstration projects to address health professions workforce needs
•  $515,013 for aging and disability resource centers 
•  $3 million to implement the National Background Check Program for long term care workers
•  $3.4 million for Maternal, Infant and Childhood Home Visiting
•  $35.7 million for the Money Follows the Person demonstration project
• Kids with pre-existing conditions are now covered. By 2014, this should extend to adults as well. If you're a Florida resident and an adult with a pre-existing condition, you're probably eligible for coverage now. Click here to find out more.
• No more lifetime limits. That means insurance companies can't cap your coverage because you have cancer or a chronic illness. Annual limits are also restricted and will be done away with by 2014.
• Insurance companies can no longer drop you when you get sick because of a mistake you made on an application.
• Now, insurance companies have to pay 80% of premiums on health care and quality improvements. This obviously doesn't include marketing, executive salaries or overhead, so this should be a big change for insurance companies. If they don't do this, you get a rebate or lower premiums. So, basically, you win or you...well, win. So long as this is enforced, of course.
• Insurance companies now have to publicly justify "unreasonable" premium increases. No word on where the line is drawn to become "unreasonable," or what would happen if their public justification was "we wanted more money," but I guess we'll just have to cross that bridge when we come to it.
• More jobs.
• Many early retirees can now get insurance from their previous employers.
• Community health centers get more funding.
• For those of you thinking about going into the health care field as doctors, nurses, therapists, or in other careers, there are now even more grants and scholarships, as well as other support, for you to ensure you're able to help folks get better.

So, that's the Affordable Care Act broken down for you. America's health care system may still have a long way to go, but this is a pretty good start. Well, unless you're an insurance company, of course.

Partnership for Patients

Here's the story. Now, here's the explanation.

So, the Obama administration launches this thing called "Partnership for Patients: Better Care, Lower Costs." The plan is to make the safety, quality and affordability of health care better by banding together pretty much any kind of higher-up in the home health care field, including, but not limited to, employers, doctors, and leaders of major hospitals. Apparently, it's supposed to save us (as a country, not each of us, of course) $35 billion, as well as 60,000 lives.

How? Well, glad you asked.

1. Everyone is going to make sure you or your loved one don't get injured or sicker while you're in the hospital. "By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010.  Achieving this goal would mean approximately 1.8 million fewer injuries to patients, with more than 60,000 lives saved over the next three years," the story states.

2. They will reduce the amount of hospital readmissions by 20% by lessening the number of preventable complications that come up during the transfer from hospital to home.

The source goes on to list a few scary facts that show us how important this plan really is:

• A study published in April, 2011 in the journal Health Affairs found that on average, 1 in 3 patients admitted into a hospital suffer a medical error or adverse event – nearly 10 times greater than previously believed.
• On any given day, about 1 in every 20 patients is affected by an infection related to hospital care.
• On average, 1 in 7 Medicare beneficiaries is harmed in the course of care, costing the government an estimated $4.4 billion every year.
• Nearly 1 in 5 Medicare patients discharged from the hospital is readmitted within 30 days – that’s approximately 2.6 million seniors at a cost of over $26 billion every year.

So, basically, everyone's trying to stop you or the ones you love from becoming one of the above statistics. I'd say that's a pretty good thing, wouldn't you?

How's it all gonna work? Who's paying for it? Well, using up to $1 billion from the Affordable Care Act, the CMS (Centers for Medicare & Medicaid Services) will dedicate money to researching and testing accident prevention in hospitals, but also for awarding community-based organizations who help in the transition from hospital to home. So yes, while this does use a good billion dollars to get going, it should save us about 35 times that amount in the long run, along with saving lives. Who can put a price on that?

The White House's Framework for a Better Tomorrow: Explained

So, here's what we have today: http://www.whitehouse.gov/the-press-office/2011/04/13/fact-sheet-presidents-framework-shared-prosperity-and-shared-fiscal-resp . Now, if the link button were working properly or I knew HTML, that link would say:

FACT SHEET: The President's Framework for Shared Prosperity and Shared Fiscal Responsibility

Well, you get the idea.

Now, this basically boils down to a way for the country to slim down its deficit by about $4 trillion "in 12 years or less." (Note: Funny thing is, if we keep on going the way we have been since September of '07, we'll rack up $4 trillion in debt in about 3 years, according to the U.S. National Debt Clock -- http://www.brillig.com/debt_clock/.)

Anyways, once you sift through all the other stuff that doesn't talk about health care, here's what you end up with: 

1. The President refuses to let seniors and "the vulnerable" carry the weight of any huge health care change. If you fall into this category, then, instead of making you pay for increasingly more expensive health care,  the President plans to save the country money by increasing the quality of health care, which should lower the cost of Medicare by $50 billion in the next decade. Also, Medicaid will become "more flexible, efficient and accountable," allowing a savings of at least $100 billion. And here's one to rejoice about: the President plans to "reduce Medicare's excessive spending on prescription drugs and lower drug premiums for beneficiaries without shifting costs to seniors or privatizing Medicare. Also, they plan to bend the cost curve, which should save about a trillion over the next decade, but this shouldn't effect you as much as it will the deficit.

2. Social Security gets brought up shortly after that, but the only plan is to talk about it, through bipartisan efforts, more "sooner than later." But he does say that the program should be strengthened without being privatized, protecting beneficiaries and improving retirement security, and "not slashing benefits for future generations." 

3. The President also makes it known that this plan is different from "the House Republican plan that would increase seniors’ health costs by $6,400 annually starting in 2022, raise health insurance premiums for middle-class Americans and small businesses, cut Federal Medicaid spending by one-third by the end of the decade, and increase the number of uninsured by 50 million." 

....And then there's a whole lot more technical jargon with numbers and letters that stand for agencies and talk about how it effects the deficit, but nothing on how it effects you, which basically boils down to the stuff above (i.e. no privatization of Medicare or Medicaid, lowering Medicare costs without making you pay for it, and being different from the House Republican plan that, quite frankly, sounds a bit scary if you're a senior, on Medicaid, own or work for a small business, or are part of the middle class).

Well, that's everything pertinent to you and health care! If you have any questions on this post or something I didn't talk about in the framework, ask! For now, this is Matt -- signing off.

Introduction

Hey there, everyone!

This is Matt at Reliance Home Health Care, LLC, the best darn little home health care agency in South Florida. "But I don't live in South Florida," you might be saying to yourself. Well, don't go navigating away from the blog just yet, you Magellans of cyberspace! This blog will tell you all about national health care news, as well as more specific news about Florida health care.

If you'd like to learn a little more about us, visit us at: http://reliancehomehealthcare.com/aboutus.html .

And hey, if you ever have any questions, feel free to comment on the post. I'll be here!

Take care, and talk to you soon!