Long term care insurance Obamacare Doesn’t Include

Washington DC; August 12, 2013 – Long term care insurance is not included under provisions passed by Congress as part of the Affordable Care Act also known as Obamacare.

“We are getting an increasing number of calls from consumers wanting to know how to apply for long term care insurance once insurers must accept pre-existing health conditions,” explains Jesse Slome, executive director of the long term care insurance industry trade group.  “Unfortunately I have to tell them long term care insurance is not included under Obamacare and is only available to those who can meet health requirements.”

Consumers are expected to start investigating insurance plans available under Obamacare next month and open enrollment starts October 1st.

“The Department of Health and Human Services abandoned any plans to implement the provision calling for a voluntary long term care insurance program which would have allowed those with existing health insurance to apply,” Slome notes.  “They found the monthly premiums they’d have to charge would have been far too expensive for people to afford so they walked away and allowed Congress to repeal the CLASS Act.”

“There are about a dozen insurance companies currently offering private long term care insurance,” says Slome.  About eight million Americans have some form of protection against the significant risk of needing long term care.  “If you have some existing health conditions, we can advise whether pursuing a long term care insurance policy will even be possible.”

The American Association for Long-Term Care Insurance advocates for the importance of long term care planning and supports insurance professionals who market the complete range of planning products.

Consumers interested in learning more about long term care insurance protection can read four consumer guides providing helpful information on planning and reducing long term care insurance costs.  They can be accessed on the Association’s website at www.aaltci.org/guides and no information is required to access these guides.  To connect with a designated long term care insurance professional, a member of the Association, for information and no-obligation cost comparisons call the organization’s at 818-597-3227.

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“The holidays are an ideal time to take an aging parental reality check,” suggests Jesse Slome, director of the American Association for Long Term Care Insurance.  “Those who can’t regularly look in on aging family members should use seasonal visits to help aging parents maintain their independence as long as possible.”

Holiday visits are an excellent opportunity to assess the health of a loved one, to address home safety issues and to discuss important planning issues.  “Difficult discussions are best started in a face-to-face setting because they are seldom one-shot conversations,” Slome acknowledges.

Some tips when visiting older loved ones:

Check the home environment.  Look for unopened mail, especially unpaid bills.   Address safety issues such as loose rugs or wires that could result in falls.

Has the parent lost weight.  Is there outdated and spoiled food in the refrigerator or pantry?

Write down important information including the license plate of the parent’s car.  That way, if it is gone, you’ll have information accessible to share with the police.

Prepare a list of medications and the physician contact information.  Record important local resources such as plumbers or electricians should repair issues arise.

Ask if the parent has prepared advanced health directives and know where they keep copies.  If they own long term care insurance protection write down the policy number and claim department contact information.   ”The number of people calling with questions about policy benefits increases by roughly 15 percent immediately following the holidays,” explains Bill Jones, President of MedAmerica a family of leading long term care insurance carriers.   ”Many older Americans eventually need some hands-on assistance and the holidays are often the time of year when families recognize that eventuality has arrived.”

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Attained Age Before Close of Taxable Year   

40 or less – $   350

More than 40 but not more than 50 – $   660

More than 50 but not more than 60 – $1,310

More than 60 but not more than 70 – $3,500

More than 70 – $4,370

The per-diem limitation under 7702B(d)(4) is $310.

For more information click here to access the page on our website.

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That’s the analysis reported by Devon Herrick, a senior fellow with the National Center for Policy Analysis.

The Patient Protection and Affordable Care Act (PPACA) is expected to add up to 16 million more Medicaid enrollees and will significantly expand eligibility for families with incomes up to 133 percent of the federal poverty level. The PPACA requires states to streamline their enrollment process – making it easier for eligible populations to enroll and retain Medicaid coverage.

Initially, the federal government will pay 100 percent of the cost of the newly eligible, newly enrolled populations and 95 percent of costs through 2019. However, there are hidden costs that will strain state budgets.

According to various estimates, there are 10 million to 13 million uninsured people who are already eligible for Medicaid – but not enrolled. When the individual mandate to obtain health coverage takes effect in 2014, many of the uninsured are likely to be swept up in outreach efforts, Herrick reports.

Although the cost of enrolling newly eligible individuals will be paid by the federal government, the cost of covering those previously eligible for Medicaid must be paid for under the current federal matching formula. Many states will find the cost of their Medicaid programs higher as a result. 

For example, a decade after the PPACA’s implementation, Texas Medicaid rolls are predicted by the Texas Department of Health and Human Services to rise by 2.4 million people.  Of these, only 1.5 million enrollees will be newly eligible. About 824,000 individuals will be those previously eligible but not enrolled. The federal government will contribute a much smaller share of the cost of these previously eligible enrollees compared to newly eligible enrollees.

On the average, reimbursements for Medicaid providers are only about 59 percent of what a private insurer would pay for the same service, but it varies from state-to-state.   The reports notes that New York pays primary care physicians only about 29 percent of what private insurers pay for primary care.

Many of the newly insured under Medicaid will likely be those who previously had private coverage. Research dating back to the 1990s consistently confirms that when Medicaid eligibility is expanded, 50 percent to 75 percent of the newly enrolled are those who have dropped private coverage. In addition, a 2007 analysis by MIT economist Jonathan Gruber, found, on average, about 60 percent of newly enrolled children in State Children’s Health Insurance Program were previously covered privately. Thus, it is reasonable to conclude that much of the increase in Medicaid rolls will be individuals who were previously privately insured, meaning the number of uninsured will not fall as expected.

“Everyone wants something for nothing forgetting that someone ultimately has to pay the cost,” explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance.  “In two decades we will have two classes of citizens.  Those with the means to pay will have choice and con

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