How Will Healthcare Reform Impact Caregivers?

President Obama recently signed into law a new2014 when the expanded coverage provisions
healthcare reform bill which will make expandcome online.
health insurance coverage for 32 million who doMedicare Advantage Changes. The law changes
not currently have insurance coverage. This lawthe way that Medicare Advantage plans are paid
will be phased into effect over the next decadeby bringing payments closer into line with the
but it offers a lot to help family caregivers both incosts of the regular Medicare program. These
the short term and the long term.payment changes may impact the benefits
The benefits of the law fall into 2 categories -provided under these plans so keep review your
provisions which help the care recipient throughplans coverage carefully at renewal time.
public programs and those that help the caregiver2011 and Beyond
through expanded health insurance coverage andThe bulk of the new benefits and subsidies for
better consumer protections. The biggesthealth insurance will begin in 2014. The lead time is
advantage to care recipients comes throughnecessary to accumulate funds to pay for the
expanded Medicare prescription drug coveragecost of the new coverage.
and additional health insurance options forExpanded Coverage Through Health Exchanges.
pre-Medicare retirees.These state-based marketplaces start operation
Family caregivers will see their biggest benefitsin 2014 and are based on the Massachusetts
come from the fact that they will be able to getHealth Connector system, in which individuals and
health insurance whether or not they aresmall businesses are able to purchase health
employed. The new insurance coverage optionsinsurance. The goal is to provide individuals and
will be a big benefit to caregivers because manysmall businesses with transparency in benefits and
remain tied to jobs in order to receive healthpricing so they can compare health insurance and
insurance. By providing new coverage options andpurchase the coverage that best fits their needs.
subsidies to help pay for them, family caregiversIndividual Mandate. Almost all Americans will be
now have additional options on whether or notrequired to get insurance coverage or face fines-a
they want to continue working or care for theirsystem similar to the one that's already in place in
loved one full time. Below we walk through theMassachusetts. The fines start small at $95 in
key provisions which are likely to impact family2014, but rise rapidly to $695 in 2016. Low-income
caregivers.individuals are exempted from the mandate but
Goes Into Effect Over the Next Yearmost of them will be eligible for coverage through
The expansion of coverage provided by the newMedicaid or other subsidies.
healthcare reform law will not be available untilHealth Insurance Subsidies. In order to help
2014 but there are many portions of the lawfamilies afford the mandatory insurance
which will go into effect during 2010 and 2011.premiums, starting in 2014 subsidies will be
Improvements to Medicare Prescription Drugavailable on a sliding scale, up to a level of
Coverage. The bill provides a $250 "bonus" to all$88,000 per year for a family of four. The
people in a Medicare Prescription drug program inamount of the subsidies will also be on a sliding
2010 that hit the "doughnut hole" which currentlyscale, meaning that people with lower incomes will
begins at $2,830. It also begins closing thereceive larger benefits.
Medicare Prescription Drug "doughnut hole" in 2011Long Term Care. The bill includes the CLASS Act,
and would completely eliminate it by 2020.which provides a public, voluntary long term care
Helping Sandwich Generation Caregivers. The billprogram that working people can purchase. The
helps sandwich generation caregivers, those caringprogram would cover home care, respite care,
for sick parents or relatives and their ownhome modifications, transportation, and assistive
children, by:technologies.
- Eliminating pre-existing conditions for childrenWhat's Next
thereby ensuring sick children can get insuranceWhile health insurance reform has passed and will
coverage.be signed by the President within days, the
- Permitting children up to age 26 to stay on theirSenate still needs to act on a bill to fix some of
parents insurance policies regardless of whetherthe problems in the bill enacted into law. That's
or not they are full-time students. Most insurersexpected to take place this week.
currently cover dependents not in school only upIt is unlikely that work on health reform is done.
to age 19 and those in school up to age 23.The lesson of other social insurance programs is
- Prohibiting lifetime benefits caps on healththat they always remain works-in-progress. Social
insurance. Temporary Early Retiree Program. TheSecurity and Medicare have been modified and
law requires the creation of a temporaryexpanded a great deal since they were first
voluntary reinsurance program for employers toenacted. You can expect similar developments to
help cover early retirees within 90 days ofoccur with healthcare reform as it moves
enactment. This should help pre-Medicare retireesforward.
find affordable coverage. The program ends in