Watching our legislators doing their thing in the nation's capital, one can be forgiven for thinking Vlad the Impaler could learn a thing or two from these folks. But last Friday, in a rare Washington Kumbaya moment, peace broke out and the Bipartisan Budget Act zipped into law with the speed of an Olympic skater, Rand Paul notwithstanding.
The newly minted budget act has pork for everyone, but the pork I like is one little section that won't get much press coverage, because it benefits poor people who are aging and sick: America's Dual Eligibles. Duals are those among us who, by virtue of their age, health status and poverty are eligible for both Medicare and Medicaid benefits. The new budget act permanently re-authorizes Special Needs Plans aimed at caring for Duals.
Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) [Pub. L. 108-173), Congress created a new type of Medicare Advantage coordinated care plan focused on individuals with special needs. “Special needs individuals” were identified by Congress as: 1) institutionalized beneficiaries; 2) dually eligible; and/or 3) beneficiaries with severe or disabling chronic conditions. The MMA allowed for the creation of “Special Needs Plans” for these populations. For example, to accommodate the new legislation, my state, Massachusetts, created the Senior Care Option health plan, which “covers all of the services normally paid for through Medicare and MassHealth (Medicaid).”
Medicare, because of the aging of the Baby Boomers, and Medicaid, because of increasing poverty and state expansion through the Affordable Care Act, have grown significantly since 2010, making Special Needs Plans more and more important. Trouble was, Congress had to re-authorize the plans every few years. That concern is now in the past. The Bipartisan Budget Act, with its permanent re-authorization of Special Needs plans makes sure the safety net created by the plans is solid, secure and long-lasting.
The new budget act also re-authorizes the Children's Health Insurance Plan (CHIP) for another ten years, something that has long had bipartisan support.
Finally, this Congress has done something that will benefit our most vulnerable citizens. Let's hope it's not a one-off.
ABOUT THE AUTHOR
Tom Lynch is the founder of Lynch, Ryan & Associates, Inc., the nation's first workers' compensation employer consulting firm, which, In 1991, he sold to Travelers Insurance Company where it became an independent subsidiary. In 2003, he founded the award-winning Workers Comp Insider, the first insurance blog in the world. Lynch is also the Chair of Biomere, a Massachusetts biotechnology company, and the Vice Chair of Commonwealth Care Alliance (CCA), a Massachusetts HMO serving dual eligible beneficiaries, which has the highest Medicare Star Rating and the highest Patient Satisfaction Rating for its class in the nation. To visit his blog, click here.
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