Ending Cost-Sharing Reduction Payments Will Hurt Older Adults

Federal subsidies, known as cost-sharing reductions (CSRs), have been critical to ensuring that over 2 million lower-income adults ages 50 to 64 who purchase coverage through health insurance Marketplaces can afford health care.[1] Despite the subsidies’ crucial role, the Administration announced yesterday that it will terminate payments for CSRs. The announcement—which comes less than 3 weeks before millions of Americans who buy insurance on the individual market start shopping for 2018 health coverage— is bad news for older adults and people …

Graham-Cassidy Would Weaken Protections for Older Adults and People with Preexisting Conditions

A late-breaking attempt to repeal and replace the Affordable Care Act (ACA) threatens to weaken critical federal consumer protections and raise costs for older Americans ages 50-64 who purchase health insurance coverage in the individual market. Tucked into the sweeping legislation known as the Graham-Cassidy bill are provisions allowing states to receive waivers from crucial consumer protections. Such waivers could allow insurance companies to increase costs for older consumers based on their health, preexisting conditions, and age–potentially putting health coverage …

More Price Transparency Needed for Implantable Devices

Implantable devices, such as hip replacements and heart valves, are a central part of medical treatment today. Americans receive about 370,000 cardiac pacemakers and about 1 million total hip and knee replacements per year. Despite how common the use of implantable devices is, little information is publicly available on the prices paid for these devices in the United States. Limited information about prices and performance of many implantable devices has raised concerns that providers, consumers and insurers may be paying …

The Financial Costs of Family Caregiving: A Stark Reality

Families and close friends are the most important source of support to older people and adults with a chronic, disabling or serious health condition. They already take personal responsibility for providing increasingly complex care to the tune of $470 billion (as of 2013). That figure, representing family caregivers’ unpaid contribution in dollars, roughly equals the combined sales of the four largest U.S. tech companies (Apple, IBM, Hewlett Packard and Microsoft, $469 billion) in 2013. The out-of-pocket hit Caregiving families feel …

Notice to Medicare observation patients misses the mark

If you’re one of the roughly 2 million Medicare beneficiaries placed under observation each year, there’s (potentially) good news for you: You may be less vulnerable to sticker shock when you get your medical bill. But Medicare hasn’t gotten the details right just yet. In less than two months, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act will require hospitals nationwide to notify Medicare observation patients that they are not formally admitted as inpatients and why. …

It’s a Shame: Low-Income Medicare Beneficiaries Continue to Be Plagued With Balance Billing

Federal law prohibits traditional Medicare and Medicare Advantage providers and suppliers from billing people who are qualified Medicare beneficiaries (QMBs) for Medicare deductibles, coinsurance and copayments — a practice known as balance billing. Qualified Medicare beneficiaries (QMBs) are people with Medicare who have incomes at or below 100 percent of the federal poverty level — or a higher level set by their state — and very few resources. In spite of the prohibition, many QMBs are receiving and, out of …