Health Care Law Addresses Many Needs of Aging Women

Article excerpt

Byline: Nancie Peacocke Fadeley For the Register-Guard

Annually, the Older Women's League issues a Mother's Day report about issues of particular concern to women as they age. The Affordable Care Act is the subject of this year's report. It's an informative resource for those wondering what's really in the legislation commonly called Obamacare.

OWL still favors a single-payer system for health care, but finds much to like in the Affordable Care Act.

Because of the Affordable Care Act, Medicare coverage for wellness and preventive care for midlife and older women will be vastly better. Studies show that too often, co-payments have kept many Medicare beneficiaries, especially women beneficiaries, from taking advantage of preventive services like mammograms, physical exams and flu and pneumonia vaccinations, services that prevent or delay serious illnesses and complications. The Affordable Care Act bans cost sharing for services like those, services that could be major factors in ultimately controlling costs.

And OWL is pleased that the act also takes aim at hospital-acquired conditions, complications resulting from care within a hospital. The Centers for Disease Control and Prevention estimates that almost 100,000 Americans die each year from hospital-acquired conditions, and millions more suffer. There is an incentive in the Affordable Care Act to address this alarming problem: In 2015, the act will begin reducing payments to hospitals with much higher-than-average rates of hospital-acquired conditions.

A related issue is the high rate of hospital readmissions. According to OWL's research, almost one in five Medicare beneficiaries are readmitted within 30 days of discharge from a hospital. The Medicare Payment Advisory Commission estimates that Medicare spends $12 billion annually on potentially preventable readmissions. In an effort to reduce them, the Affordable Care Act will make hospital readmission rates publicly available by posting them on the website of the Centers for Medicare and Medicaid.

By requiring federal and state governments to implement a system for collecting and reporting information, the act also includes consumer protection provisions that will aid in choosing a nursing home. That information will deal with issues like staffing, including staff turnover rates. And the Centers for Medicare and Medicaid Services will collect and publish on its website information about the ownership, substantive complaints, criminal violations, and civil monetary penalties of nursing home facilities.

Since our state was the leader in promoting alternatives to nursing homes, Oregonians will be particularly interested to learn that the Affordable Care Act includes the Community Living Assistance Services and Supports (CLASS) Act, a brainchild of the late Sen. Edward Kennedy, D-Mass.

The purpose of CLASS is to offer opportunities for persons to avoid institutionalization in nursing homes and stay in their own homes and communities.

Beginning in 2013, working adults can choose to pay premiums into a new, voluntary long-term care insurance program. Beginning in 2018, enrollees in CLASS who have functional limitations of two or three activities of daily living expected to last 90 days or more will receive an average cash benefit of $50 per day to help pay for the services and supports participants need to maintain independence at home.

Those services and supports may include home modifications, assistance technologies, and home care aides. CLASS beneficiaries can use this financial assistance to hire informal caregivers, including family and friends. That's a recognition of the reality that it is family and friends - primarily female family and friends - who provide 85 percent of the care giving needed at home. …