The Affordable Care Act attempts to put in place several new laws (leaving it to the States to implement Medicaid expansion) that that would positively impact ailing seniors’ and the disable’s ability to stay in their own home with both community medical support and financial funding.
This is the third part of three blogs (Saturday, yesterday and today) on an important topic. I hope you find it helpful.
There are several provisions under the ACA that concern nursing homes. For example, the ACA requires the Center for Medicare and Medicaid Services to provide a comprehensive website where consumers may find information regarding local nursing homes, including inspection and complaint reports. The law has makes it easier to file complaints about the quality of care while prohibiting retaliation for filing a complaint.
Further, the law requires any nursing home that decides to close its doors to provide notice, in advance and that all residents have been successfully relocated prior to actual closure.  Finally, the ACA provides all states with the option to enroll in federal grants to pay for criminal background checks for nursing home.
The ACA aims to strengthen the emphasis on home and community-based care by giving states several options to expand such programs for Medicaid enrollees. There are three voluntary provisions for the expansion of home and community-based services (HCBS) under Medicaid. First, a state may choose to offer a 'community first' option to provide long term care services. Second, a state may amend its state plan to provide an optional HCBS benefit. And, finally, states may rebalance spending on long term services to increase the proportion that is community-based. The first and third provisions offer states enhanced federal matching rates as an incentive. Although the new provisions are valuable, the law does not set minimum standards for access to HCBS, and the new financial incentives are limited especially for the many states facing serious budget problems. 
The benefits received under the ACA must be funded and seniors will bear part of the burden of funding the law. As mentioned, there will be some cuts to the Medicare Advantage Plans in the form of $145 billion over a ten (10) year period. Those seniors enrolled in such plans will no doubt undergo adjustments as the changes are implemented. In addition, the ACA will be funded with a surcharge tax of 3.8% to unearned or investment income of singles with an annual income over $200,000 and couples with an annual income over $250,000 with seniors who fall subjected to the tax. Another impact on seniors is the increase in the floor for medical expense deductions from 7.5% to 10% of Adjusted Gross Income. Finally, working seniors may be subject to the additional 0.9% Medicare payroll tax on high income earners (defined as taxpayers with over $200,000 in earned income, $250,000 for families). This additional tax applies to the excess over the stated limits.
Clearly there are many changes made by the Affordable Care Act that will affect seniors and their loved ones. It is important to have a general understanding of what seniors are facing in terms of their health care coverage. With seniors facing so many changes during a susceptible time in their lives, it is crucial that they be directed to resources that can assist them to make educated decisions about their health, their finances and their care options. Our firm is dedicated to helping seniors and their loved ones work through these issues and implement sound legal planning to address them. If we can help in any way, please don’t hesitate to contact our office or visit our website, specifically, elder law planning in Virginia, for additional information. Be sure you also sign up for our complimentary e-newsletter so that you may be informed of all the latest issues that could affect you, your loved ones and your estate planning.