AARP Continues to Push for ObamaCare Medicaid Expansion

State leaders tout benefits of ACA despite public disapproval


by Dan Way

Source: Carolina Journal Online

State AARP officials Friday rolled out their 2014 legislative priorities, and among them were safeguarding Medicare from cost-cutting, expanding Medicaid, and helping more seniors not yet eligible for Medicare to enroll in the federal health exchange. At the Raleigh event, AARP leaders also acknowledged “legislators of the year,” and discussed issues those at or nearing retirement face with retirement savings and independent living.

“The Affordable Care Act remains the best way to cover the uninsured, and to address health care disparities,” said James Wall of Oxford, state AARP president.

“I don’t know why the Affordable Care Act would be, say, preferable to a tax credit” for early retirees or those approaching retirement to get private coverage on their own, countered Devon Herrick, senior fellow and health economist at the Dallas, Texas-based National Center for Policy Analysis.

Buying a health insurance policy from a government exchange “may be a benefit to people who want to retire early and have highly subsidized coverage without having to work to get it,” Herrick said.

However, he said, “I have been somewhat surprised by the fact that a lot of people who thought they were going to get pretty generous subsidies are finding that they’re actually paying a lot more than they realize.”

Polls have shown the Affordable Care Act is unpopular with North Carolina residents and with voters nationwide. U.S. Sen. Kay Hagan has tumbled in polls leading up to her re-election bid, presumably because of her continued support for the law.

Even so, Wall hailed what he called “the benefits and protections of ACA,” commonly referred to as Obamacare. He claimed it expands coverage, protects consumers from canceled policies, and eliminates annual and lifetime caps on what insurers will pay for health care.

However, millions have lost plans under Obamacare, including 183,821 canceled policies affecting 473,724 North Carolinians.

The Wall Street Journal has reported that only 11 percent of those who enrolled in a plan on the health exchange previously lacked insurance. Obamacare is shifting people from private insurance to government-subsidized and mandated plans, a phenomenon known as crowd-out.

Wall said 15 percent of North Carolinians age 50 to 64 were uninsured in 2011, and more than 100,000 people in that age group would qualify for coverage if the state would expand its Medicaid program using the federal subsidies provided by the Affordable Care Act.

“We continue to urge the state to expand this program,” he said.

Gov. Pat McCrory and legislative leaders have ruled out any expansion of Medicaid rolls at this point. In a press conference last week, McCrory said the system is still rife with problems that must be corrected before expansion could be considered.

Herrick said it would be interesting to know how many of the 100,000 Medicaid-eligible would qualify for the exchange coverage “because Medicaid is not a very generous health plan by any means.” Putting more people on Medicaid makes it more likely physicians would not take their cases because government reimbursement is less than costs, he said.

Robert Palombo of Southern Shores, an AARP Executive Council member, said the organization is fighting to stop cuts in Medicare and Social Security, and “defending those programs in Washington to ensure workers and retirees get the benefits they’ve been promised.”

“Medicare provides guaranteed health care coverage, but out-of-pocket expenses are high. On average, North Carolinians spent 14 percent of their annual income, or $5,200 year, on out-of-pocket health care expenses,” Wall said.

Medicare injected $12.5 billion for health care services into the North Carolina economy in 2011; Social Security paid $23.5 billion to North Carolina seniors 65 and older, he said.

“It doesn’t make sense if you’re really advocating for care for seniors that you would support a law that essentially funded itself into perpetuity by cutting Medicare fees for the very doctors and hospitals that treat your constituents” and might reduce or refuse service, Herrick said.

“You would think that doing any kind of tinkering with Medicare would be that third rail that nobody would dare touch, but yet the Affordable Care Act, half of the funding was to come from cutting Medicare fees, physician fees,” Herrick said.

He suggested AARP supports reducing subsidies to Medicare Advantage because AARP “makes more money off of Medi-Gap policies than it does off memberships by far. So you’re cutting out the competition,” he said.

Doug Dickerson, AARP state director, said adults age 50 and older in North Carolina are cutting back, saving more, paying down debt, and postponing retirement. Yet nearly half of workers age 50 and older have less than $25,000 in savings and investments.

With personal savings rates at historic lows, and health costs continuing to rise, “Unemployment for the 50-64 age group remains very high, and underemployment an even bigger problem,” Dickerson said.

According to a 2013 AARP retirement confidence survey, only 56 percent of respondents said they are confident that they’ll be able to live comfortably throughout their retirement years.

“Half or more older workers and retirees are not confident Social Security and Medicare will continue to provide the benefits of at least equal to what retirees receive today, and more than half of older adults are not confident that they’ll be able to pay for long-term care that they need in their retirement,” Dickerson said.

Cheryl Schramm of Wilmington, an AARP Executive Council member, said the organization offers in-home services.

“Unfortunately, the state is losing ground in providing these important services. The waiting lines are getting longer” for home-delivered meals and home services, and both the costs and population needing the services “is vastly increasing,” Schramm said.

Family caregivers provide 80 percent of the state’s in-home care, “and they are the backbone of the long-term care system,” she said. Many are part of the “sandwich generation,” caring for both children and senior parents, “so it is critical that they receive the kind of support they need to keep … their older parents at home.”

The organization, which has 1.1 million members in North Carolina, named state Rep. Nelson Dollar, R-Wake, and former Sen. Ellie Kinnaird, an Orange County Democrat, as their North Carolina Legislators of the Year.

Dickerson said Dollar’s and Kinnaird’s ongoing support for aging issues included protecting funding in the 2013 budget for a home and community care block grant, a primary funding source for home-delivered meals and in-home aid services.

Dollar was “instrumental in ensuring Medicaid services for older and disabled adults such as physical therapy, dental care and prescription drugs issues were maintained,” Dickerson said.

Kinnaird said she hopes the General Assembly will pass legislation barring landlords from refusing to rent to low-income tenants who have approval under federal Section 8 housing rules.