In general, June 28, 2012, was a good day for older Americans. Because of the Supreme Court ruling on the Affordable Care Act (ACA), improvements in the Medicare program remain in place and nearly half of the 8.6 million Americans ages 50 to 64 who currently lack health insurance will gain access to care through subsidized coverage in the insurance exchanges. Unfortunately, the court's decision on Medicaid expansion threatens the future care of 3.3 million low-income people ages 50 to 64.
The Big Positives
Because the court upheld the ACA, lowincome older adults across the country will maintain access to preventive health services such as annual wellness visits that the law established under Medicare. Also, because of health reform, Medicare will continue to fully cover preventive screening procedures for older women such as mammograms, pap smears and bone mass measurements. And, coverage for diabetes, HIV and obesity screenings will be available for everyone with Medicare.
The law's phasing out of the so-called donut hole has already saved 5 million elders and people with disabilities $3.2 billion. And, the preservation of the ban on using pre-existing conditions to deny health coverage will help many younger elders enter Medicare in a far healthier state because they will have had access to healthcare. In addition, adult children ages 26 or younger can remain on their parents' health insurance plan, relieving another burden on older adults.
For elders with limited English proficiency, the court's decision retains new important requirements that help ensure services are delivered in a culturally and linguistically appropriate manner. Also, low-income older adults in need of longterm services and supports will find that they have more opportunities to avoid nursing home care and receive care at home and in the community.
Limited Medicaid Expansion
But the day was not all that bright for many younger, uninsured elders. The court introduced a limit to the law's expansion of the Medicaid program for those who live at or above the poverty level. …