“Federal Court Blocks Medicare Agent Pay Cap Regulations,” by Allison Bell, ThinkAdvisor “A federal judge in Texas has blocked the Centers for Medicare and Medicaid Services from enforcing its new pay rules for Medicare agents. If the stay survives court challenges, it will apply to all Medicare agents throughout the U.S.” LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform: HHS and CMS want to micromanage everything. Consumers’ preferences are lost for lack of free-market  signals to enable them. I wonder if this latest development comes from the Texas court’s taking heart from the Supreme Court’s reversing Chevron
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  “Medicaid Efforts to Address Racial Health Disparities,” by Akash Pillai, Elizabeth Hinton, Robin Rudowitz, and Samantha Artiga, KFF “Racial and ethnic disparities in health remain persistent in the United States, driven by inequities in access to and utilization of health care and social and economic factors that drive health, often referred to as social determinants of health (SDOH), that are rooted in historic and ongoing racism and discrimination. As a major source of health coverage for people of color, Medicaid programs are an important potential mechanism to address racial health disparities. Recent coverage gains across racial and ethnic groups between 2019-2022 were largely driven by increases in Medicaid enrollment as
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  “Medicaid’s $100+ Billion Leak,” by Stephen A. Moses, Paragon Health Institute “Medicaid long-term care (LTC) has a problem: The wealthy access funds intended for the most vulnerable. Half or more of Medicaid’s $217 billion annual LTC budget goes to beneficiaries who could otherwise afford to pay privately. This diverts scarce program resources from the neediest recipients while causing caregiver shortages and worsening access and quality problems for people on the program. LTC has been in the news recently because of President Biden’s nursing home staffing mandates (as explored in a previous Prognosis by Jackson Hammond). Unfortunately, misguided government programs, specifically the current
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“Older adults’ home equity tops $13 trillion in first quarter,” by Kathleen Steele Gaivin, McKnights Senior Living “Homeowners aged 62 or more years saw their housing equity grow by $328.5 billion in the first quarter, according to data released Friday by the National Reverse Mortgage Lenders Association. The increase brings older adults’ housing equity to a record $13.19 trillion, according to NRMLA. Housingwire reported that the increase marks ‘a recovery after decreases observed over the past year.’” LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform: Good news indeed because home equity is America’s true LTC safety net when Medicaid, Medicare and
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“Medicaid’s 80/20 Rule: New Restrictions on Funding for Home and Community Based Services,” JD Supra “Without an increase in rates, the 80/20 rule may have a significant negative effect on the financial feasibility of operating HCBS. Even without the additional restrictions of the 80/20 rule, the low Medicaid reimbursement rates for these services already make it challenging for many operators to make a profit. Requiring operators to spend 80% of these low rates on compensation may make it more likely that operators will choose not to participate in Medicaid, which will likely further reduce access to home-based service in rural
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“BREAKING: Supreme Court’s Chevron ruling could defang CMS,” by Kimberly Marselas, McKnights LTC News The Supreme Court this morning threw out a long-standing doctrine that has given regulatory agencies, including the Centers for Medicare & Medicaid Services, broad discretion to set rules for the entities they cover. Abandonment of the so-called Chevron doctrine will likely have implications for nearly every US industry and could even affect the outcome of a lawsuit challenging CMS’ authority to issue a nursing home staffing mandate.” LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform: The reign of authoritarian “progressives” at CMS may
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“Battle Flares Over Long-Term Care Insurance Rate Hike Rules,” by Allison Bell, ThinkAdvisor “Some regulators want special rules for the oldest insureds and phase-ins of big increases. Trade groups said regulators should stick with rules meant to keep insurers in business. Genworth said some moves to soften rate increase blows may create confusion or lead to bigger total increases. … ‘Deviating from actuarial principles may lead to inadequate premiums, jeopardizing insurer stability and consumer protection,’ according to a letter to the LTC Actuarial Working Group signed by Jan Graeber of the American Council of Life Insurers and Ray Nelson of
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“Medicaid Long-Term Care: Future And Current Retirees Need To Prepare,” by Ilana Gertsen and Rachel Mahoney, The Street “Experts agree enrolling in Medicaid can be a long process, so don’t wait until it’s absolutely necessary to begin the process. It’s not uncommon for people to wait so long to apply that it will, sadly, make their life much more difficult. … While the Medicaid long-term care program is designed to help people who might be struggling to pay for those vital services, if someone is planning to enroll in Medicaid for long-term care then meeting with an elder law attorney
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“Keep an eye on Washington state initiative, long-term care insurance expert cautions,” by Kathleen Steele Gaivin, McKnights Senior Living “As the one-year anniversary of the effective date of the country’s first publicly operated, tax-based long-term care insurance program approaches July 1, voters in Washington state ‘are being given the choice to make the program optional, and early polling shows that’s very likely to happen,’ Jesse Slome, director of the American Association for Long-Term Care Insurance, said Wednesday.” LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform: It looks like WA Cares will follow the Pepper Commission, CLASS, and a series
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“How much long-term-care insurance do I need?,” Dow Jones “The way to get a more accurate figure is to look closely at the sick person’s family history and current medical circumstances, and also their financial situation. This is not something you can do in a back-of-the-envelope way or even with a spreadsheet. Waterlily said it is able to help by crunching through decades of case studies to more accurately pinpoint the length of care needed, and also the range above and below that number to create a cushion. The service mostly is available through advisers, insurance companies and care facilities
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