Improving the Life and Health of Seniors

By Rachael Drew-Kinuthia

At least 10,000 Americans turn sixty-five every day. Getting older is inevitable, so anyone of us should put stock in the issues which affect seniors. There are some recent developments which could improve the lives and health of our seniors. They are just the beginning and we do well to keep in mind, the issues affecting our seniors are decided on a local level too. States decide many things that will affect us in our daily lives. Some of the changes brought about by local government can be incremental and undramatic at first, but they add up to either help or hurt our seniors. After dealing with the Covid pandemic, older Americans have been coping with plenty of healthcare related issues which influence their quality of life and finances. Behind the scenes there are advocacy groups, activists, and senior citizens themselves fighting to make things better.

There are a few ways in which I learned that our seniors’ lives are being affected and what is being done to improve the situation. Recently, a federal appellate court made a ruling regarding Medicare declining to pay for rehabilitation in a nursing home. The Center for Medicare Advocacy confirms traditional Medicare would pay for up to one hundred days of nursing home care, and those who were previously forced to pay out-of-pocket could start to receive refunds. Here was the challenge: Medicare usually required three consecutive days of inpatient hospitalization to be eligible for nursing home coverage. Oftentimes individuals reported their being in a hospital bed—doctors and nurses provided care, but they were not actually admitted. Or they were admitted, and then the hospital changed the status to on observation.

Technically, if the status has been marked on observation the person is still outpatient. This caused many older patients to either pay the tab themselves (the national average nursing home cost is $260 a day) or forgo care and return home immediately upon discharge. Think of the implications for those who had a sudden hospitalization after a serious fall or suffering a stroke. These individuals get discharged, but aren’t ready to return home unassisted yet. They actually need personal assistance and medical care before they can go home safely. I’ve seen this with relatives of mine who, after some rehabilitative care in a nursing facility, were able to either return home living by themselves or with their spouse. Then if we as a family felt it more appropriate, after that temporary nursing home stay, the relative may need to live with one of our family members. But I imagined what would happen if they tried returning home before getting rehabilitated properly.

Unfortunately, there are many who haven’t been able to work through these options and Medicare’s stance on eligibility for payment makes it all the more difficult. Repealing this three-day requirement of inpatient hospitalization would give seniors a fighting chance to get these costs covered. How many of our older citizens have returned home too soon after a medical emergency just to end up back in the hospital? Hundreds of thousands of patients have probably faced this conundrum.

Another circumstance which has affected many seniors is Medicaid setting asset limits when trying to get coverage. Several states have been abolishing these limits. In most states, if you are older than sixty-five, you can’t amass more than $2,000 in assets, or $3,000 for a couple (usually home and car are exempted). “It makes people live in very deep poverty, unable to save for emergencies or even modest expenditures,” said Amber Christ, director of health care policy and advocacy for Justice in Aging. “If you go over the limit by a dollar, you lose eligibility.” Well, there are states doing something about it, thanks to advocacy behind the scenes. To date, thirty-nine states (including DC) have adopted Medicaid expansion.

California is going beyond that by eliminating asset limits for older people as they try to qualify for Medicaid. Gov. Kathy Hochul of New York has incorporated a similar measure in her proposed state budget, eliminating asset limits as of Jan. 1, 2023. Several other states are working on the same. Still, we need more to happen. Older adults are continuing to face serious financial consequences. Biden has already proposed creating a Medicare-like public option plan, which would be available to anyone and automatically cover people with low incomes in states that have not expanded Medicaid. Other legislative actions include reinstating the 100% matching for states that newly adopt the expansion.

Either way it is imperative to rethink the whole benefit design to improve the coverage and reduce health and financial disparities for our seniors. On the White House official website it states, “President Biden will make a renewed commitment to protect and expand Americans’ access to quality, affordable health care. He will build on the Affordable Care Act to meet the health care needs.” This issue is one of the pressing health care needs for all Americans. Let’s keep this in mind when heading out to the polls because we all can work towards improving our lives and the health of seniors. At a time when many were losing their health coverage during this pandemic, these eligibility gaps need to close up. Ideally every American should have coverage, but that’s another article for another day.