logoThe National Association of Area Agencies on Aging (n4a) has published a policy brief on the impact that repealing the Affordable Care Act would have on older adults, their caregivers, and the aging services network in the United States. The brief identifies key issues and questions that aging services stakeholders and advocates should be asking their elected officials as ACA replacement proposals are discussed and introduced.

Efforts in Congress are already underway to repeal the ACA, President Obama’s landmark healthcare legislation. There have been more than 60 legislative attempts to repeal the ACA since it was signed into law in 2010. While previous efforts at repealing this law have been unsuccessful, the new Republican administration and Congressional majority now hold the power to substantially alter or altogether rescind this legislation.

n4a’s brief highlights the many provisions under the ACA that affect older adults and that have been targeted as components of the law to be eliminated, including: “dismantling the federal insurance exchange Marketplace; repealing Medicaid expansion in states; rolling back or eliminating efforts to spur delivery systems innovation and reform through the Center for Medicare and Medicaid Innovation (CMMI); dropping longstanding efforts to rebalance long-term services and supports (LTSS) from institutions to more cost-effective home and community-based services (HCBS); and defunding disease prevention and health promotion programs though the Prevention and Public Health Fund (PPHF).”

The report emphasizes that a repeal of the ACA would jeopardize health insurance coverage for millions of older adults. Low-income adults who gained access to Medicaid through the ACA would lose their Medicaid coverage if the federal match for state Medicaid programs was eliminated. Pre-Medicare adults ages 54-65 will be at risk of losing their health insurance through the dismantling of the federal insurance exchange Marketplace. If uninsured, these individuals aged 54-65 increase the likelihood that that they will be sicker and ultimately more costly patients once they reach Medicare eligibility.

Repealing the ACA would also have economic effects on vulnerable older adults and their caregivers. The ACA introduced efforts to close the Medicare prescription drug coverage gap for up to nine million Medicare beneficiaries, as well including protections so that spousal caregivers would not have to exhaust their personal assets in order to secure Medicaid LTSS for their partner. The elimination of these changes will have the most adverse impact on older adults who are already economically vulnerable.

The n4a brief concludes by emphasizing the importance of considering the needs of older adults and their caregivers in any legislation that replaces or alters the Affordable Care Act. n4a vows to work “to ensure that any major changes to our nation’s health care and LTSS systems take into consideration the impact on older adults, people with disabilities and caregivers.”

To read the full policy brief, click here.

To learn about n4a, click here.