, would make changes to the Social Security Act that could help make quality long-term health care more available to seniors. The bill would establish criteria for long-term care hospitals (LTCH) and patient criteria for payment to an LTCH.
Though this bill is just one of many health care bills before Congress right now, seeing the effect an inability to afford long-term health care has on our aging population and their families impassioned me to co-sponsor this legislation. As Congress continues to explore the broad reforms needed in the Medicare and Social Security programs, the specific need of long-term health care must not be overlooked. Our nation’s seniors who spent their lives embodying the American work ethic have truly earned it
Wednesday, July 23, 2008
Wednesday, July 16, 2008
Medicare
By ROBERT PEAR
Published: July 16, 2008
WASHINGTON — President Bush on Tuesday vetoed a bill protecting doctors from a Medicare pay cut, but both houses of Congress swiftly overrode the veto with large bipartisan majorities, so the bill is now law.
Brendan Smialowski for The New York Times
Representative John D. Dingell addressed the many Medicare beneficiaries there.
The vote in the House was 383 to 41, with 153 Republicans defying the president. In the Senate, the vote was 70 to 26, with 21 Republicans voting to override.
The bill won more support on Tuesday than when it was first approved. The tally in the House last month was 355 to 59, with 129 Republicans voting for passage. The crucial vote in the Senate was 69 to 30, with 18 Republicans voting yes.
The measure is the fourth bill to be enacted over the president’s veto, and two of those were farm bills.
Mr. Bush has been getting his way on many foreign and national security issues, obtaining money for the Iraq war, persuading Congress to pass new wiretapping legislation and fending off restrictions on harsh interrogation techniques like waterboarding.
But Democrats have gained the upper hand on many domestic issues, passing a water projects bill over the president’s veto and forcing the White House to accept new education benefits for veterans who fought in Iraq and Afghanistan.
After experiencing many setbacks on health legislation in recent years, Democrats rejoiced in a resounding victory on Tuesday.
The vote “renews the light of hope for those who need our help the most, senior citizens who depend on Medicare,” said Senator Harry Reid of Nevada, the majority leader.
The House speaker, Nancy Pelosi of California, said: “Seniors’ organizations and disabilities groups support this legislation. Just about every health-care-providing group in our country supports this legislation, except one, and that is some in the health insurance industry. I guess the president is voting with them and not with America’s seniors.”
The political dynamic was illustrated by Representative Marilyn Musgrave of Colorado, a conservative Republican who boasted that she was voting against the wishes of her party. “I am proud to continue my fight against the White House on behalf of Colorado doctors and seniors,” Mrs. Musgrave said. The votes on Tuesday ended a long string of victories for the health insurance industry.
In his veto message, Mr. Bush said he objected to the bill because it would cut federal payments to Medicare Advantage plans and slow the growth of such plans, offered by insurance companies as an alternative to traditional Medicare.
“I support the primary objective of this legislation, to forestall reductions in physician payments,” Mr. Bush said. “Yet taking choices away from seniors to pay physicians is wrong.”
Many independent studies have found that the private plans, sold by insurers like Humana and UnitedHealth, cost the government more per person than traditional Medicare. But Mr. Bush said that reducing payments to the plans would force them to “reduce benefits to millions of seniors.”
The bill also sets strict standards for the marketing of private plans, to curtail high-pressure sales tactics that have prompted complaints from beneficiaries and state insurance regulators.
The main purpose of the bill is to cancel a 10.6 percent cut in Medicare payments to doctors that took effect on July 1.
Little-noticed provisions of the bill would reduce the beneficiary’s co-payment for mental health services and increase assistance to low-income people on Medicare. In addition, the bill would delay a competitive bidding program for suppliers of medical equipment like oxygen tanks and power wheelchairs.
Competition “should be expanded, not diminished,” Mr. Bush said.
The American Medical Association and AARP, the advocacy group for older Americans, lobbied for the bill, deluging members of Congress with messages warning that doctors would be less likely to take Medicare patients if their fees were cut.
Four Republican senators switched sides and voted for the bill on Tuesday. The senators — Christopher S. Bond of Missouri, Richard G. Lugar of Indiana, and Thad Cochran and Roger Wicker of Mississippi — had voted against consideration of the bill on three previous occasions.
Representative Lois Capps, Democrat of California, said the veto showed that Mr. Bush “would rather cozy up to his friends in the insurance industry than improve access to health care for seniors and those with disabilities.”
But Representative Jim McCrery, Republican of Louisiana, said the bill “just kicks the can down the road” and does not fix fundamental flaws in the formula for paying doctors. In 18 months, Mr. McCrery said, doctors will face a 20 percent cut in their Medicare payments.
More Articles in Washington »Need to know more? 50% off home delivery of The Times.
Past Coverage
DOCTORS PRESS SENATE TO UNDO MEDICARE CUTS (July 7, 2008)
DEMOCRATS PRESS HOUSE TO PUSH TO EXPAND HEALTH CARE BILL (July 23, 2007)
Bush Threatens Veto of Medicare Drug Bill, but a Senator Is Seeking a Middle Ground (January 12, 2007)
BUSH VOWS VETO OF ANY CUTBACK IN DRUG BENEFIT (February 12, 2005)
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Published: July 16, 2008
WASHINGTON — President Bush on Tuesday vetoed a bill protecting doctors from a Medicare pay cut, but both houses of Congress swiftly overrode the veto with large bipartisan majorities, so the bill is now law.
Brendan Smialowski for The New York Times
Representative John D. Dingell addressed the many Medicare beneficiaries there.
The vote in the House was 383 to 41, with 153 Republicans defying the president. In the Senate, the vote was 70 to 26, with 21 Republicans voting to override.
The bill won more support on Tuesday than when it was first approved. The tally in the House last month was 355 to 59, with 129 Republicans voting for passage. The crucial vote in the Senate was 69 to 30, with 18 Republicans voting yes.
The measure is the fourth bill to be enacted over the president’s veto, and two of those were farm bills.
Mr. Bush has been getting his way on many foreign and national security issues, obtaining money for the Iraq war, persuading Congress to pass new wiretapping legislation and fending off restrictions on harsh interrogation techniques like waterboarding.
But Democrats have gained the upper hand on many domestic issues, passing a water projects bill over the president’s veto and forcing the White House to accept new education benefits for veterans who fought in Iraq and Afghanistan.
After experiencing many setbacks on health legislation in recent years, Democrats rejoiced in a resounding victory on Tuesday.
The vote “renews the light of hope for those who need our help the most, senior citizens who depend on Medicare,” said Senator Harry Reid of Nevada, the majority leader.
The House speaker, Nancy Pelosi of California, said: “Seniors’ organizations and disabilities groups support this legislation. Just about every health-care-providing group in our country supports this legislation, except one, and that is some in the health insurance industry. I guess the president is voting with them and not with America’s seniors.”
The political dynamic was illustrated by Representative Marilyn Musgrave of Colorado, a conservative Republican who boasted that she was voting against the wishes of her party. “I am proud to continue my fight against the White House on behalf of Colorado doctors and seniors,” Mrs. Musgrave said. The votes on Tuesday ended a long string of victories for the health insurance industry.
In his veto message, Mr. Bush said he objected to the bill because it would cut federal payments to Medicare Advantage plans and slow the growth of such plans, offered by insurance companies as an alternative to traditional Medicare.
“I support the primary objective of this legislation, to forestall reductions in physician payments,” Mr. Bush said. “Yet taking choices away from seniors to pay physicians is wrong.”
Many independent studies have found that the private plans, sold by insurers like Humana and UnitedHealth, cost the government more per person than traditional Medicare. But Mr. Bush said that reducing payments to the plans would force them to “reduce benefits to millions of seniors.”
The bill also sets strict standards for the marketing of private plans, to curtail high-pressure sales tactics that have prompted complaints from beneficiaries and state insurance regulators.
The main purpose of the bill is to cancel a 10.6 percent cut in Medicare payments to doctors that took effect on July 1.
Little-noticed provisions of the bill would reduce the beneficiary’s co-payment for mental health services and increase assistance to low-income people on Medicare. In addition, the bill would delay a competitive bidding program for suppliers of medical equipment like oxygen tanks and power wheelchairs.
Competition “should be expanded, not diminished,” Mr. Bush said.
The American Medical Association and AARP, the advocacy group for older Americans, lobbied for the bill, deluging members of Congress with messages warning that doctors would be less likely to take Medicare patients if their fees were cut.
Four Republican senators switched sides and voted for the bill on Tuesday. The senators — Christopher S. Bond of Missouri, Richard G. Lugar of Indiana, and Thad Cochran and Roger Wicker of Mississippi — had voted against consideration of the bill on three previous occasions.
Representative Lois Capps, Democrat of California, said the veto showed that Mr. Bush “would rather cozy up to his friends in the insurance industry than improve access to health care for seniors and those with disabilities.”
But Representative Jim McCrery, Republican of Louisiana, said the bill “just kicks the can down the road” and does not fix fundamental flaws in the formula for paying doctors. In 18 months, Mr. McCrery said, doctors will face a 20 percent cut in their Medicare payments.
More Articles in Washington »Need to know more? 50% off home delivery of The Times.
Past Coverage
DOCTORS PRESS SENATE TO UNDO MEDICARE CUTS (July 7, 2008)
DEMOCRATS PRESS HOUSE TO PUSH TO EXPAND HEALTH CARE BILL (July 23, 2007)
Bush Threatens Veto of Medicare Drug Bill, but a Senator Is Seeking a Middle Ground (January 12, 2007)
BUSH VOWS VETO OF ANY CUTBACK IN DRUG BENEFIT (February 12, 2005)
Related Searches
Vetoes (US) Add Alert
Medicare Add Alert
Senate Add Alert
House of Representatives Add Alert
More Articles in Washington »Advertise on NYTimes.comMOST POPULAR
E-Mailed Blogged Searched Well: Drugs to Build Bones May Weaken Them
Everybody’s Business: Lessons in Love, by Way of Economics
Want Obama in a Punch Line? First, Find a Joke
Scientist at Work | Edward O. Wilson: Taking a Cue From Ants on Evolution of Humans
Findings: A New Frontier for Title IX: Science
Calm Down or Else
In Paris, Burgers Turn Chic
Country, the City Version: Farms in the Sky Gain New Interest
Op-Ed Contributor: My Plan for Iraq
Going Down the Road: Places Captured in Time, but Not Frozen There
Go to Complete List » Want Obama in a Punch Line? First, Find a Joke
A New Frontier for Title IX: Science
Taliban Breached Base in Clash
At the Uneasy Intersection of Bloggers and the Law
Post and Daily News Explore Print Pact
Planned Guns N' Roses Deal Underscores Power of Video Games to Sell Songs
Buy.com Deal With EBay Angers Sellers
Court Backs Bush on Military Detentions
Abortion Proposal Sets Condition on Aid
From the Inside, Jerry Yang Looks Out for Yahoo
Go to Complete List » \"share with\" video
obama
july 13, 2008
affiliate video
ben stein
new yorker
china
news, stocks, funds, companies
american financial group growth
maureen dowd
Go to Complete List »
nytimes.com/travel
Lisbon comes alive
Also in Travel:
36 hours in Dublin
Spying on Bucharest's cool underground
Sicily, through the eyes of the leopard
Advertisements
Need to know more?
Get 50% off home delivery of The Times.
All the news that's fit to debate.
Ads by Google what's this?
Arby's Franchises
Want Something Different, Something Better? Apply Now to Own An Arby's!
www.Arbys.com
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Blazing a Trail from a Reservation to Ownership
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At Oceana, the Voyage Continues
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Tuesday, July 15, 2008
Long term health care at home
A Balancing Act: State Long-Term Care Reform, is the first to examine Medicaid spending on long-term care for older people and adults with physical disabilities, separate from other LTC users such as people with mental retardation/developmental disabilities (MR/DD).
Nationally, 75 percent of Medicaid LTC spending for older people and adults with physical disabilities pays for institutional care in nursing homes. In contrast, states have done a much better job balancing Medicaid LTC for people with MR/DD, spending just 39 percent on institutional care. The majority of funds now supports people in home and community-based settings.
"We recognize the success state Medicaid programs are having providing home and community based services to people with mental retardation/developmental disabilities," said AARP Pennsylvania State Director Dick Chevrefils. "It proves that balancing long-term care is doable and should be used as a model to help states provide home and community based services for older adults."
As part of its Commonwealth Long-Term Living Project, Pennsylvania set a goal of 50 percent home-based care to 50 percent institutional care for all long-term care populations by FY 2011-12. Unfortunately, the recently passed 2008-09 state budget included no new spending to reduce existing HCBS waiting lists for Pennsylvania's lottery-funded OPTIONS program.
The report examines Medicaid LTC funding because it is the primary payer for LTC in the country. "This underscores the need for better government and private sector financing options for long-term care. Americans have few options to plan and pay for their long-term care. Balancing Medicaid LTC options will require a commitment from our state officials and cooperation from federal authorities. HCBS can be both cost-effective and responsive to the preferences of older people and adults with disabilities," said Chevrefils.
The new report includes state rankings and can be found at: http://www.aarp.org/research/longtermcare/programfunding/2008_10_ltc.html.
Nationally, 75 percent of Medicaid LTC spending for older people and adults with physical disabilities pays for institutional care in nursing homes. In contrast, states have done a much better job balancing Medicaid LTC for people with MR/DD, spending just 39 percent on institutional care. The majority of funds now supports people in home and community-based settings.
"We recognize the success state Medicaid programs are having providing home and community based services to people with mental retardation/developmental disabilities," said AARP Pennsylvania State Director Dick Chevrefils. "It proves that balancing long-term care is doable and should be used as a model to help states provide home and community based services for older adults."
As part of its Commonwealth Long-Term Living Project, Pennsylvania set a goal of 50 percent home-based care to 50 percent institutional care for all long-term care populations by FY 2011-12. Unfortunately, the recently passed 2008-09 state budget included no new spending to reduce existing HCBS waiting lists for Pennsylvania's lottery-funded OPTIONS program.
The report examines Medicaid LTC funding because it is the primary payer for LTC in the country. "This underscores the need for better government and private sector financing options for long-term care. Americans have few options to plan and pay for their long-term care. Balancing Medicaid LTC options will require a commitment from our state officials and cooperation from federal authorities. HCBS can be both cost-effective and responsive to the preferences of older people and adults with disabilities," said Chevrefils.
The new report includes state rankings and can be found at: http://www.aarp.org/research/longtermcare/programfunding/2008_10_ltc.html.
Monday, July 7, 2008
Massachusetts FY '09 State Budget Update
Massachusetts FY '09 State Budget Update
Dear Howard,
Last Thursday, before departing to observe the July 4th holiday, Massachusetts legislators approved next year's state budget.
The Commonwealth is facing fiscal challenges. However, the Massachusetts Legislature chose to fund critical programs and services for our residents.
Prescription Drug Costs
-New program and funding for evidence based outreach and education program.
Prescription Advantage
- Full funding.
- Maintained structural integrity and hold enrollees harmless by keeping cost sharing at 2007 levels and prohibiting increases without legislative approval.
- Ongoing open enrollment.
Long Term Care Continuum
- Adequate funding for a long term care continuum, that includes high quality, affordable skilled nursing facilities, assisted living facilities, senior housing, and home and community based services, to meet the needs of our aging population.
- Adequate funding to provide home and community based care that enables older and disabled persons to remain healthy and independent.
- Adequate funding of skilled nursing facilities -- which often care for the most frail and vulnerable individuals; including the nursing home criteria known as "Score 3".
- New funding to rebalance the system to allow for more home and community based care.
- Increased funding for the Councils on Aging and Senior Centers.
Health Care Reform
- Adequate funding to implement the new health care reform law so that consumers will have access to affordable insurance products with meaningful benefits.
- Outreach grants to educate residents and assist in enrolling them in health care insurance coverage.
Money Management Program
- Maintained funding to operate the program statewide.
Please make 2 important calls today!
1. Contact Representative Christopher Fallon and Senator Richard Tisei at (617) 722-2800 and thank them for continuing to support important programs and services that help our residents remain healthy, independent and economically secure.
2. Contact Governor Patrick at (617) 725-4000 and urge him to approve the budget as submitted.
Thank you again for your continued advocacy on these very important matters.
Dear Howard,
Last Thursday, before departing to observe the July 4th holiday, Massachusetts legislators approved next year's state budget.
The Commonwealth is facing fiscal challenges. However, the Massachusetts Legislature chose to fund critical programs and services for our residents.
Prescription Drug Costs
-New program and funding for evidence based outreach and education program.
Prescription Advantage
- Full funding.
- Maintained structural integrity and hold enrollees harmless by keeping cost sharing at 2007 levels and prohibiting increases without legislative approval.
- Ongoing open enrollment.
Long Term Care Continuum
- Adequate funding for a long term care continuum, that includes high quality, affordable skilled nursing facilities, assisted living facilities, senior housing, and home and community based services, to meet the needs of our aging population.
- Adequate funding to provide home and community based care that enables older and disabled persons to remain healthy and independent.
- Adequate funding of skilled nursing facilities -- which often care for the most frail and vulnerable individuals; including the nursing home criteria known as "Score 3".
- New funding to rebalance the system to allow for more home and community based care.
- Increased funding for the Councils on Aging and Senior Centers.
Health Care Reform
- Adequate funding to implement the new health care reform law so that consumers will have access to affordable insurance products with meaningful benefits.
- Outreach grants to educate residents and assist in enrolling them in health care insurance coverage.
Money Management Program
- Maintained funding to operate the program statewide.
Please make 2 important calls today!
1. Contact Representative Christopher Fallon and Senator Richard Tisei at (617) 722-2800 and thank them for continuing to support important programs and services that help our residents remain healthy, independent and economically secure.
2. Contact Governor Patrick at (617) 725-4000 and urge him to approve the budget as submitted.
Thank you again for your continued advocacy on these very important matters.
Wednesday, July 2, 2008
CARING FOR AN AGING AMERICA
Caring for an aging america act
1. Sen. Boxer Introduces Health and Long-Term Care Workforce Bill
Sen. Barbara Boxer (D-CA) introduced S. 2708, the Caring for an Aging America Act, on March 5. The bill would address the emerging gap between the increasing number of older Americans and the serious lack of providers trained in caring for their medical, health, and social support needs. NCOA supports the proposal.
The bill would provide $130 million over five years to recruit and retain trained healthcare professionals and direct-care workers by providing them with loan forgiveness and career advancement opportunities. Specifically, the legislation would:
• Establish a Geriatric and Gerontology Loan Repayment Program for health professionals who complete specialty training in geriatrics or gerontology and agree to provide full-time clinical practice and service to older adults for a minimum of two years.
• Expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings.
• Offer specialty training in long-term care services through the existing Career Ladders Grants Program.
• Create a Health and Long-Term Care Workforce Advisory Panel for an Aging America to identify incentives for recruitment and retention of new populations of clinicians and providers to serve vulnerable older adults
1. Sen. Boxer Introduces Health and Long-Term Care Workforce Bill
Sen. Barbara Boxer (D-CA) introduced S. 2708, the Caring for an Aging America Act, on March 5. The bill would address the emerging gap between the increasing number of older Americans and the serious lack of providers trained in caring for their medical, health, and social support needs. NCOA supports the proposal.
The bill would provide $130 million over five years to recruit and retain trained healthcare professionals and direct-care workers by providing them with loan forgiveness and career advancement opportunities. Specifically, the legislation would:
• Establish a Geriatric and Gerontology Loan Repayment Program for health professionals who complete specialty training in geriatrics or gerontology and agree to provide full-time clinical practice and service to older adults for a minimum of two years.
• Expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings.
• Offer specialty training in long-term care services through the existing Career Ladders Grants Program.
• Create a Health and Long-Term Care Workforce Advisory Panel for an Aging America to identify incentives for recruitment and retention of new populations of clinicians and providers to serve vulnerable older adults
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