Affordable Care Act

Since the advent of ACA, our home care agency seems to be seeing more clients sooner in the healthcare process. These patients are sicker with acute medical conditions.

There ADL needs are far greater with less clients needing companionship, light housekeeping and transportation and more clients needing transfers, hoyer lifts and personal care.

Unfortunately, one of the first things carved out of the ACA benefits for consumers was a long term care insurance.

The Sentinel in PA reported “A significant component of Obamacare was the Community Living Assistance Services and Supports Act (Class Act). This would have made long-term care insurance available, similarly to the way that health insurance is now offered by Obamacare, except that the long term care insurance would have been optimal. …. suffice to say that a bipartisan conclusion that the CLASS Act was not economically viable led to it to being removed legislatively from Obamacare.

Now, the federal government has no answer for the funding to pay for the long term care needs of an American citizen after Medicare stops paying at the maximum of 100 days of service, other than the means-tested Medicaid program and a limited pension for war-time veterans.”

Potential long-term care needs should ideally be evaluated around age 50, a time when it is likely that retirement resources can be reasonably estimated. Peter Katt, Katt and Co.

Since the largest cost associated with long-term care is custodial nursing home care, this is the cost that should be planned for.  According to Katt, “Obtain the cost of living in a nursing home in the area where you are most likely to retire. Typically, nursing home costs will range from $3,000 to $9,000 per month depending on the area and quality of the facility.”

With more of my clients at home sooner they will have to pay for more care out of pocket as Medicare and traditional insurance do not cover LTC needs.

According to the US Department of Health and Human Services, :

• Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services and supports in their remaining years.
• Women need care longer (3.7 years) than men (2.2 years)
• One-third of today’s 65 year-olds may never need long-term care support, but 20 percent will need it for longer than 5 years.