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Article

August 1, 2016

Trending News Today: Baby Boomers to Flood Medicaid Long-Term Care

Author(s):

Lauren Santye, Assistant Editor

Top news of the day from across the health care landscape.

Long-term care poses an issue for Medicaid, which is covering nearly 40% of the nation’s long-term care expenses, reported Kaiser Health News. When Medicaid was implemented, it was never intended to cover long-term care for everyone, but as baby boomers continue to age, federal Medicaid spending on long-term care is widely expected to increase by nearly 50% by 2026. Experts estimate that approximately half of all people turning 65-years-old today will need daily help as they grow older, either at home or in nursing homes. This long-term care will cost an average of approximately $91,000 for men, and double that for women. Since many individuals are unable to afford that cost, they fall back on Medicaid.

The Obama administration stated that qualified Medicare beneficiaries who are also enrolled in Medicaid are being improperly billed for deductibles, copayments, and other costs that are supposed to be exempt, reported The New York Times. This group of improperly billed patients are age 65 and older, are disabled, or have low incomes generally less than $1010 a month for an individual, or $1355 for a married couple. Federal law states these beneficiaries do not have any legal liability to make a payment to a physician or hospital past the amounts paid by Medicare and Medicaid. A study by the Department of Health and Human Services found this form of improper billing seems to be relatively common, since some Medicare providers are unlawfully billing enrollees after receiving payments from Medicare and Medicaid, according to the article.

The US Centers for Disease Control and Prevention (CDC) reported that from February to June 2016, the number of people infected with Zika in Puerto Rico jumped from 14% to 64%. According to The Washington Post, 5582 people, including 672 pregnant women, were diagnosed with Zika as of July 7, 2016, and the rapid increase could lead to hundreds of infants being born with microcephaly or other severe birth defects. However, these numbers are most likely underestimated, because 4 out of 5 people infected with Zika are asymptomatic, and therefore, do not seek out medical care and are not reported to public health officials.

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