1 Changes for Seniors: Collaborating for ChangeKatie Alexander & Shelby Dodson Tennessee Justice Center March 29, 2017
2 Agenda Updates on federal activity Protecting seniors from scamsMedicaid Expansion Advocacy works!
3 American Health Care ActIntroduced mid-March as the replacement plan for the ACA Included: $880 billion in Medicaid cuts Lower tax credits and no cost sharing subsidies Changed age rating from 3:1 to 5:1 Going 63 days without coverage will increase premium by 30%
4 American Health Care ActOn Friday, AHCA was pulled because there weren’t enough votes. Speaker Paul Ryan: “Obamacare is the law of the land… for the forseeable future.”
5 American Health Care Act
6 Elder Justice AmeriCorps25 fellows nationwide, 2 in Tennessee. Abuse Neglect Financial exploitation
7 Financial abuse of older adultsWith big changes comes confusion and opportunity to exploit. Older adults are often targets because of: Isolation Lack of familiarity with the internet/online sources Embarrassment, reluctance to ask for help Grief at loss of spouse, not used to managing finances Cognitive impairment
8 Health Care Scams Older adult hears: Obamacare was repealed. Medicare (or was it Medicaid?) is cut. Scammer says: Medicare has changed. Now you have to pay for your durable medical equipment, prescriptions, etc. Scammer does: Collect insurance and identifying information. Files false claims or collects cash from the older adult directly.
9 Benefits Fraud Older adult hears: food stamps are cut, social security is cut. Scammer says: I am from Social Security. Give me your information, and I will help you keep your benefits. Scammer does: Set up on-line account in the adult’s name and divert the benefits to another account. Note: These can be particularly devastating for adults whose only or primary income comes from the stolen benefits.
10 Immigration Scams Older adult hears: American citizens and legal immigrants are being held at the border and are not able to come home. Scammer says: This is [family member]. I am stuck at the border and can’t get home. I need you to wire money so that I can [get a lawyer, bail out of jail, etc]. Scammer does: Cash out and drop off the map. Note: Immigrant families and communities of color particularly susceptible.
11 Rules of Thumb: If someone is being pushy or says it’s an emergency, red flag. If someone asks you to keep something a secret, red flag. If you get a call from a family member in distress, call and check with someone else immediately. Don’t send money until you’ve confirmed. Don’t wire money to a stranger or put money on a pre-paid card. You cannot win something you didn’t enter. Do not financial information or other personal information.
12 A Note on Tone: Avoid: Focus on: “Bless your heart” attitudeRetaliation or frustration in response to reporting victimization Focus on: Encouraging dialogue. Conversations counter stigma and spread knowledge. You are not alone, and you are not stupid. Coming up with convincing stories is a scammer’s full time job. Team mentality. If older adults look out for one another, the scammers will have a harder time.
13 Resources: Consumer Financial Protection Bureau’s: Money Smart for Older Adults, Resource Guide AARP Foundation ElderWatch Project National Council on Aging, Economic Security Project If you have any abuse, neglect, financial exploitation cases (statewide), let me know. Shelby Dodson: ,
14 See March 8 webinar on our website for more.Continued Threats Threats to the ACA will continue Block grants and per capita caps are still a priority for Congress Medicaid pays for 3 out of 5 nursing facility residents Home and community based services at risk Prescription drug coverage is at risk See March 8 webinar on our website for more.
15 Continued Threats We must continue to fight for access to health care on the federal level. We must work to repair the ACA. We now have opportunities to shift focus back to the state level, too.
16 Closing the Coverage GapACA offered the opportunity for states to expand their Medicaid program to low-income residents, at little to no cost to the state. This would allow 280,000 Tennesseans access to health care coverage.
17 Woman with breast/cervical cancerLow-income, AND… Child Parent Pregnant woman Woman with breast/cervical cancer Some with federally-determined disabilities Income over… $12,000 for 1 $16,000 for 2 $20,000 for 3 $24,000 for 4 NOTE: PAUSE AFTER THIS SLIDE AND MAKE SURE EVERYONE UNDERSTANDS WHAT THE GAP IS. So how is it possible that that many people are living in the coverage gap? The video explains this, but I want to spend some more time on it because there are a lot of misconceptions. TennCare – which is our state’s Medicaid program – is for people who are poor AND are in one of these categories: a child, a parent, a pregnant woman, a woman with BCC, and some people with severe disabilities, including some elderly people who need nursing home care. Those are the only people that TennCare covers. For the Marketplace, the discounts to buy insurance are only available to people who live above the poverty line. This means that they make over $12,000 as an individual, or $24,000 in a household of 4. This leaves a whole lot of people without any access to health insurance. -What about an entrepreneur who just quit her job to start her own business? She used to make $31,000 a year, but once she starts her business, she only makes $10,000 in the first year. She doesn’t fit into any of these categories, so she’s in the gap. -Or, take a woman who had breast cancer – once she stops being in active treatment, she loses her TennCare, and if she makes $9,000/year waiting tables, she is in the gap. -Or, a child who is on TennCare and they turn 19 – they are going to school, their parents don’t have insurance so they can’t stay on their parents’ plan, and they are working part time but are only making $11,000/year. They are in the gap.
18 Closing the Coverage Gap
19 Closing the Coverage GapOur legislature needs to vote YES to: Bringing in over $1 billion per year to our state Covering 280,000 Tennesseans Stabilizing our insurance marketplace and our rural hospitals 4 rural counties have lost their only hospital
20 Closing the Coverage GapGives older Tennesseans a safety net. Strengthens Medicare.
21 Opportunities for AdvocacyFederal level: ACA defense Medicaid defense Improving the ACA State level: Closing the coverage gap
22 Why Advocate? We work one-on-one with people who use health care services. We have a powerful voice. We can make change happen.
23 Case Study: Coverage Gap2016: Pushing for Insure TN 400 people on the hill the first day of session Speaker Harwell got at least 300 calls from her constituents Billboards went up across the state Martha Ingram was quoted in papers asking how the legislators could sleep at night Actions outside her office
24 Case Study: Coverage GapResults Three Star Health Insurance task force formed Tennesseans educated about the issue Steps taken to close the coverage gap
25 Case Study: Coverage GapLessons Know who the decision maker is, and who can get things done Get creative! Make sure they know that their constituents care Make sure they’re hearing it at every turn
26 How do you make change happen?Meet with leg Get peers to take action Write hand written letters and call legislators Inform peers Know the information
27 Advocacy works. Democracy doesn’t end in the voting booth.Our voices matter, our voices are powerful. Our elected officials want to be re-elected.
28 Get Involved Learn more information at Follow us on Facebook Join our advocacy listserv
29 Get Involved Organizations: you will receive a sign-on letter from TJC in the next few weeks. Think through what you can do to advocate for your clients! Educate your listserv? Ask your board members to host a lunch and learn? Host a webinar?
30 Questions?