The Patient Protection and Affordable Care Act (ACA), enacted by Congress in 2010 and known colloquially as “Obamacare,” has caused an historic amount of controversy over the past two years. It recently survived a Supreme Court challenge, and some of its provisions have begun to take effect. While Americans may disagree vehemently about all or parts of the law, some provisions have begun to benefit Maryland seniors in significant ways. A grant from the federal government, part of the Balancing Incentive Program (BIP), should allow the Medicaid program to cover more patients and provide seniors with more care options. Seniors who may not require full-time care in a nursing home may now be able to obtain home- or community-based care. This could free up space and resources in overburdened and understaffed full-time care facilities.
President Obama signed the ACA into law on March 23, 2010. The hefty bill mainly addresses the rights and duties of health insurance providers and patients. The most controversial provision, the “individual mandate” to purchase health insurance if it is not available through employment or public assistance, survived review by the Supreme Court in a June 28 ruling. The law includes provisions, most of which have not yet taken effect, preventing insurance companies from denying coverage for a “pre-existing condition,” restricting when and how an insurer may cancel coverage, and much more.
Maryland’s governor accepted a $106 million grant from the federal government in March, to be used, in accordance with BIP’s goals, to support community- and home-based care for patients requiring long-term, but not necessarily full-time, care. According to the office of Governor Martin O’Malley, the BIP grant provides more federal matching funds for state money applied to “non-institutional long-term supports and services.” Maryland was the second state, after New Hampshire, to qualify for the program.
According to Reuters columnist Mark Miller, Medicaid is expected to pay for forty-three percent of the cost of all long-term care in the country this year. People needing long-term care but unable to afford it must accept whatever type of treatment is available through Medicaid. Miller cites statistics from the Kaiser Family Foundation suggesting that community-based care might cost as little as ten percent of the average cost of nursing home care.
Hopefully, the benefit to Maryland seniors from this program is better access to appropriate care for those who do not need a full-time facility, and better service and attention for those who do. Understaffing is a common factor in cases of nursing home neglect or abuse, and it can result from having too many residents as well as too few staff. Nursing homes, under their license from the state, owe a duty of care to all their residents, regardless of circumstances, to provide diligent care and a safe environment. Taking steps to ensure that patients get the care they need in the appropriate type of facility, it would seem, would improve conditions for nursing home residents and staff alike.
At Lebowitz and Mzhen, we defend the rights of Maryland seniors who have suffered injury because of nursing home abuse or neglect. To schedule a free and confidential consultation, contact us today online or at (800) 654-1949.
Balancing Incentive Program Application (PDF), Department of Health and Mental Hygiene, State of Maryland, February 10, 2012
More Blog Posts:
U.S. Senators Call for Reauthorization of Older Americans Act, Maryland Nursing Home Lawyer Blog, April 5, 2012
October is Long-term Care Residents’ Rights Month in Maryland and around the Country, Maryland Nursing Home Lawyer Blog, October 19, 2011
Federal Nursing Home Reform Act Compliance, Maryland Nursing Home Lawyer Blog, December 6, 2010