Enthusiasm and Partnerships Overcome the Vastness of Alaska for Healthcare Enrollment (National Minority Health Month)

In recognition of National Minority Health Month, the Diverse Elders Coalition is featuring stories relevant to the health disparities and health issues affecting diverse older adults during April. A new story will be shared every Wednesday with additional posts shared throughout the month. Be sure to visit diverseelders.org regularly during the month of April.

The Alaska Native Tribal Health Consortium (ANTHC) has a bold vision: to ensure that Alaska Native people are the healthiest people in the world. By working to ensure that all Alaska Native and American Indians in Alaska have health insurance, the ANTHC is helping to eliminate long entrenched health disparities. ANTHC was formed almost 20 years ago as a nonprofit health organization that offers quality health care services for all Alaska Natives and American Indians.

Monique Martin - ANTHC Healthcare Navigator

Monique Martin – ANTHC Healthcare Navigator

Recently, the National Indian Council on Aging (NICOA) spoke with Monique Martin, a dedicated healthcare navigator for ANTHC. Growing up in Southeast Alaska gave Monique insight on the best ways to communicate with Alaska Native/American Indian elders across the state. She has traveled the land, teaching about the Affordable Care Act, enrolling and sharing what she knows.

Partnerships were formed with other organizations that had a shared vision to help in tackling the task. The United Way of Anchorage, AARP, Alaska Primary Care Association and the Anchorage Neighborhood Health Center all came together to spread the word about the Affordable Care Act.

Monique said that when they started there was a general lack of information and citizens were seeking a source for reliable, unbiased information. ANTHC has become that source with a content-rich website that has an authentic “Alaska feel”. To make sure the educational materials had that crucial “Alaska feel” they made everything as Alaska Native specific as possible. They took generic PowerPoint slides and took out anything that did not apply to Alaska. They added pictures that reflected the people they were speaking with. They stuck with plain language. For example, instead of the phrase “shared responsibility”; they used the term “tax penalty”. The result was that the message felt like it was coming from your neighbor, someone you know. Personalizing the message makes it more real and more believable. Read More Read More

One Last Push: What you must know before March 31 if you are HIV+

Time is ticking. You and your loved ones only have until March 31st to apply for health insurance. Don’t delay.

Under the Affordable Care Act (or ACA), the Health Insurance Marketplace ensures that no application for health insurance is rejected due to preexisting medical conditions, such as HIV, which disproportionately affects communities of color and older people. Did You Know? Research projects that within the next few years, one in two people with HIV in this country will be age 50 or older. One in Two!

The Diverse Elders Coalition (DEC) knows that understanding the Health Insurance Marketplace can feel a lot like piecing together a puzzle.  With only days left to apply for insurance, it can be especially overwhelming—and there is no time to waste.

This is why we are bringing all the necessary information to you, centralized in one place. If you are (or someone you know is) an older adult, living with HIV/AIDS, needs insurance or just have some last minute questions about the health insurance marketplace, let us help you.

Take a look below and open up the section that is most relevant to you.

I don’t have insurance
If you are an older person living with HIV, The ACA is a big help. Because of the ACA, health insurance is easier to get and can be more affordable.

All private health insurance plans offered in the Marketplace will offer the same set of essential health benefits. These benefits include areas of significant importance to HIV+ people such as prescription drugs, lab services and chronic disease management. Without the ACA, private insurance options have varied widely from limited or no coverage in some states to very expensive comprehensive coverage in other states. For example, prior to this year’s implementation of the Health Insurance Marketplace, New York had no exclusions for pre-existing conditions such as cancer, diabetes, heart disease or being HIV+, however individual HMO coverage with a major insurer cost $1,409 per month in 2013. This price point was extremely unaffordable for many HIV+ older adults. When the ACA was implemented in January 2014, “gold” level coverage from the same insurer cost $688 per month. That’s $721 less a month or $8,652 more a year in an HIV+ older person’s pocket. Based on income levels, there is also the opportunity to qualify for an Advanced Premium Tax Credit to further decrease the cost of health insurance. For HIV+ older people, the Health Insurance Marketplace is yet another major benefit of the Affordable Care Act.

Learn more on why the ACA is a big help to HIV+ older adults

Apply for health insurance. Download our flyer, Why the ACA Matters to Our Communities, which offers step-by-step instructions for enrolling in the Marketplace (also available in Chinese ∣ Vietnamese ∣ Korean ∣ Spanish)

I have Medicaid
If you are currently covered under Medicaid, there is nothing you need to do. If you are unsure if you are eligible for Medicaid, click this link to see if you qualify.

Medicaid serves as the single largest payer of long-term care in the United States, which is often necessary for older adults and people with disabilities who rely on institutional or in-home health services. Medicaid is also the largest source of funding for medical and health-related services for people with low income in the country, including many older adults with HIV. Additionally, many people with HIV qualify as disabled if their condition has progressed and they have been diagnosed with AIDS.

If you don’t qualify, visit www.healthcare.gov and check your options for buying health insurance.

Need help applying? Download our flyer, Why the ACA Matters to Our Communities, which offers step-by-step instructions for enrolling in the Marketplace (also available in Chinese ∣ Vietnamese ∣ Korean ∣ Spanish)

My job gives me insurance
If you currently have insurance through your employer or that of your spouse or a family member, there is nothing you need to do.

However, if you feel that you can find a cheaper plan through the Health Insurance Marketplace or know that circumstances at work will change, visit www.healthcare.gov and check your options for buying health insurance.

Need help applying? Download our flyer, Why the ACA Matters to Our Communities, which offers step-by-step instructions for enrolling in the Marketplace (also available in Chinese ∣ Vietnamese ∣ Korean ∣ Spanish)

I’m 65 or older and have Medicare
Medicare is critically important to the health and economic well-being of diverse older adults. Among those over age 55, 46 percent of Latinos are covered by Medicare, 43 percent of Asians, and 52 percent of African Americans.

If you are already on Medicare, the Marketplace does not affect you. However, the ACA has provisions that have improved the benefits older people 65+ get through Medicare, including lower-cost prescription drugs and free preventive services.

Unfortunately, you’ll have to wait a while for the next Medicare open enrollment. It will run from October 15-December 7, 2014.

I get support from the Ryan White HIV/AIDS Program
If you don’t currently have insurance (such as through an employer, Medicare or Medicaid), but currently receive support from the Ryan White HIV/AIDS Program and the AIDS Drug Assistance Program (ADAP) for your HIV care and treatment needs, you’ll need to buy health insurance.

It’s important to note that some states have expanded Medicaid, meaning if you weren’t eligible before, you may now be. Click this link to see if you qualify.

If you don’t qualify for Medicaid, visit www.healthcare.gov and check your options for buying health insurance.

Need help applying? Download our flyer, Why the ACA Matters to Our Communities, which offers step-by-step instructions for enrolling in the Marketplace (also available in Chinese ∣ Vietnamese ∣ Korean ∣ Spanish)

I am an immigrant living with HIV
If you are an immigrant living with HIV, how the Marketplace will impact you depends on your immigration status.

For the 10 million non-citizens living in the United States legally, they are expected to gain health insurance through the Health Insurance Marketplace. This means that even for an older person 65+ who has not met the work requirements to qualify for Medicare, they will be able to shop for insurance in the Marketplace.

Unfortunately, the estimated 11 million undocumented immigrants living in the United States are not eligible to buy health insurance in the Marketplace.  For this reason, undocumented immigrants are not subject to the mandate that nearly all residents carry insurance or pay a financial penalty. Those undocumented immigrants who need health care have the option of using the nation’s 8,500 community health centers (they do not ask about immigration status) or visit a hospital’s emergency room.

It’s important to note that Ryan White services and medications are free for those with an income under $44,680, regardless of immigration status.

I need more time. Can I apply for health insurance after March 31?
An important note from the Centers for Medicare and Medicaid (CMS):

The deadline for open enrollment is March 31st.    As the Administration said previously, those consumers who are in line by the March 31st deadline to complete enrollment, we will make sure you get covered.  Just like Election Day, if you are in line when the polls close, you get to vote.  We won’t close the door on those who tried to get covered and were unable to do so through no fault of their own.  So, those who were in line or had technical problems with the website can quickly come back and sign up as soon as possible.

Additionally, CMS also is clarifying that under limited circumstances, people with complex cases may qualify for a special enrollment period.  These include, for example, victims of domestic abuse and consumers who were found ineligible for Medicaid, but whose accounts were not transferred to the Marketplace in a timely way before March 31.  These special cases are for specific situations where a consumer was not able to successfully complete enrollment during the open enrollment period despite their efforts to do so and through no fault of their own.

Read More Read More

Aging in America 2014: Health Reform Advocacy and Engagement in Communities of Color and LGBT Communities

Will you be joining the 3,000 engaged aging professionals and experts March 11-15, 2014 in Sunny San Diego for the ASA Aging in America 2014 conference?

Interested in exploring best practices and learning about successful advocacy and engagement tactics to better engage older adults of color and lesbian, gay, bisexual and transgender (LGBT) elders around the Affordable Care Act and their health?

Yes? Join us Friday March 14, 2014 from 1-2:30pm for a presentation entitled Health Reform Advocacy and Engagement in Communities of Color and LGBT Communities. Leading experts from our nation’s diverse aging organizations will be on hand to share lessons learned, opportunities and challenges within their communities in accessing the benefits of the Affordable Care Act and living full and healthy lives. Speakers include:

  • Introduction from Christine Takada, President & CEO of the National Asian Pacific Center on Aging (NAPCA)
  • Bryan Pacheco, National Coordinator of the Diverse Elders Coalition
  • Randella Bluehouse, Executive Director of the National Indian Council on Aging (NICOA)
  • Robert Espinoza, Senior Director of Public Policy & Communications of Services & Advocacy for GLBT Elders (SAGE)
  • Jason Coates, Policy Associate of the National Hispanic Council on Aging (NHCOA)

As contested and contentious issues go, the American Society on Aging knows there is no hotter topic than the Affordable Care Act. As the ACA approaches its fourth anniversary, it remains a dominant policy and political issue. It is a landmark and transformational law providing first-time access to healthcare for millions, promising reforms in healthcare delivery under Medicare and promoting elder justice in America. At the Diverse Elders Coalition, we know that the ACA has the ability to create a path to better health by offering more affordable health insurance options, improving services and eliminating the usual obstacles. Join us!

AT A GLANCE:

Health Reform Advocacy and Engagement in Communities of Color and LGBT Communities
Friday, March 14, 2014: 01:00 PM – 02:30 PM
Room: Cortez Hill B (3rd floor, Seaport Tower)
Event Format: 90-minute Workshop
Event Category: Policy & Advocacy — Healthcare Reform
Book Code: FR345

Aging Out: Exploring Ageism and Heterosexism Among African American Lesbians and Gay Males (Black History Month)

In honor of Black History Month, the Diverse Elders Coalition is featuring stories relevant to black aging during February. A new story will be shared every Wednesday, with additional posts shared throughout the month. Be sure to visit diverseelders.org regularly during the month of February.

People are complex, and African-American older LGBT adults are no exception. They live at the intersection of multiple identities experienced over the life span, in a culture steeped in racism, sexism, ageism, heterosexism and homophobia. African-American lesbian and gay males experience at a minimum two hostile environments: being lesbian or gay in a heterosexist society; being a person of color in a racist culture; being female in a sexist culture; and being old in a youth-worshipping culture.

Moreover, research shows that living with racism on a daily basis influences the health and well-being of African Americans, leading to major gaps in health and financial equality, higher levels of infirmity and chronic illness, even earlier death than other populations. African-American elders are likely to experience poverty at more than two times the rate of all other older Americans.

This article comes from research cited in Lift Every Voice: Treading our Path, (NGLTF Task Force, 2012) that tells the stories of lives lived and the very real problems of lesbian, gay, bisexual and transgender African Americans coming-of-age and how those experiences shaped their lives as they grew older. People remember being conflicted in telling family members their sexual orientation and sexual identity, fearing rejection and abandonment. A 66-year-old African-American lesbian woman described it this way:

  • “I knew I was different as a child. … But I guess I was in my early teens [before I knew the words], because you don’t know what the word is. When I was coming up, the word was bull dagger. It was so negative, so you still don’t know. You are a kid; you don’t know, there were no words for it, I hate that word. It’s just I’ve gotten older, I just, ugh. … That’s so derogatory. It’s negative.”

Many older African-American lesbian women and gay men have experienced a sense of grief and loss from being alienated within one’s own race and ethnicity because of perceived sexual identity and orientation. Often the disaffection happens early and scars last for life. Many elders speak of living in hostile environments within the African-American community. As this 63-year-old African-American man explains:

  • “I know I have an androgynous look, it was even more so when I was younger. So therefore, there was some discrimination against me by assumption rather than fact because they would look at me and because I am androgynous looking they would assume. … One of my issues being African American and looking like this was really when I came out in college in the late ’60s at the height of the Black Power Movement and I was distinctly told by a couple of Black organizations at the time, ‘we don’t want your kind here.’ ”

Read More Read More

Creative Approach Leads to Success in Enrolling American Indians and Alaska Natives in the New Mexico Health Insurance Marketplace

Recently, the National Indian Council on Aging (NICOA) spoke with Roxane Spruce Bly, a member of the Pueblo of Laguna, who has been leading the ACA outreach and enrollment effort for American Indian/Alaska Natives (AI/AN) in New Mexico. Ms. Spruce Bly brings invaluable experience in the field of health policy research, analysis, and development. She is the Director of Healthcare Education and Outreach for Native American Professional Parent Resources (NAPPR), Inc. NAPPR is one of two navigator entities in New Mexico.

Roxane Spruce Bly

Roxane Spruce Bly

She reflects that the Affordable Care Act (ACA) got off to a rocky start but her team turned that barrier into an opportunity to focus on outreach and education. The older Indians they target are those in the 55–64 age group, too young to receive Medicare and yet perhaps ready to plan for their retirement or address a long standing health issue. Ms. Spruce Bly is excited to get the message out about health insurance in New Mexico. Her theory of change is that once people increase their knowledge they will in turn change their behavior. Her initial approach resulted in 441 inquiry calls which led to 269 appointments, culminating in 244 individuals signing up for coverage.

Ms. Spruce Bly shared two remarkable success stories. One self-employed older couple too young for Medicare signed up and found a plan for 32 cents a month, with no cost sharing, no co-insurance, and no co-pay. They were also able to assist an older man who was paying over $400 a month for Medicare part A; once he signed up he was able to get the same coverage for $6.00 a month. Read More Read More

ACA: Vital to Diverse Older Adults – Don’t Be Left Out

With the start of the New Year, people across the country started coverage on insurance plans selected through the Health Insurance Marketplace. For racially and ethnically diverse and LGBT older adults, the Affordable Care Act (ACA) and the Marketplace pose both the opportunity for better health and the challenge of possibly being left behind by a new program. The Diverse Elders Coalition (DEC) is now working to improve the health of the populations that it serves and to empower them to fully participate in the ACA.

A recent article by Kaiser Health News identifies some of the opportunities and challenges California’s Hispanic population face. The article highlights the tremendous help the Health Insurance Marketplace has been to Maria Garcia, who worked with a community health center to enroll herself and her husband in an insurance policy costing $36 per month after subsidies. The article also describes the need for culturally and linguistically appropriate enrollment assistance. Many Hispanic older adults enrolling in the Marketplace like to enroll with the help of a person that they trust. Health Care Navigators can also help diverse older adults overcome barriers such as lower levels of internet connected home computers and fear of putting personal information online.
 

NHCOA Health Care Navigator

NHCOA Health Care Navigator

Read More Read More

The Road Less Traveled: Medicare and the Medicare Savings Programs as a Potential Solution for the Underinsured Immigrant

Every year, the National Asian Pacific Center on Aging (NAPCA) receives over 9,500 phone calls through a national, toll-free, Asian language Helpline from limited and non-English speaking seniors needing help understanding benefit programs for which many are eligible but unable to access.

Mrs. Pang and Mrs. Taduran (not their real names) represent thousands of immigrant seniors in the United States, who are legal permanent residents but have little or no work history in this country and go without adequate healthcare because they cannot access affordable insurance. Many are eligible for Medicare or Medicare Savings Programs but are unaware of their eligibility.

Mrs. Pang, a Chinese grandmother living in Seattle, was worried that Medicaid would not cover her health care costs while visiting her grandchildren in Los Angeles. She was right to be worried because as a Washington State resident, her Medicaid was issued by Washington State and so she had no Medicaid coverage outside of the state.

Mrs. Taduran emigrated from the Philippines with her daughter and her family so she could care for her grandchildren while her daughter and son-in- law worked. Mrs. Taduran had no health insurance because her household income was too high to qualify for Medicaid yet far too low to afford private health insurance premiums. A few years later she began to have blurred vision but didn’t tell anyone since she knew her family couldn’t afford a doctor. Read More Read More

Webinar Recording: Why the Affordable Care Act Matters to Diverse Older People

The health coverage expansions under the Affordable Care Act (ACA) will affect you, your loved ones and your communities. The Diverse Elders Coalition represents millions of diverse older people age 50+ who are among those affected: they include the Health Insurance Marketplace, the Medicaid expansion, new benefits for elders 65+ on Medicare, and a range of protections that make health care more accessible for lesbian, gay, bisexual and transgender (LGBT) older people and older people of color. The number of uninsured older adults age 50-64 continues to rise—from 3.7 million in 2000 to 8.9 million in 2010. In addition, people of color make up more than half of uninsured people in the U.S.— and research shows that people of color, across the age span, face significant disparities in physical and mental health. Additionally, many people of color delay care because of potential medical costs and out of fear of discrimination or cultural incompetence from medical providers. This webinar highlights both national and state-specific examples on what is being done to ensure that older people know about the changes that are taking place under the ACA and how it affects them.

Speakers: Yanira Cruz, President and CEO, National Hispanic Council on Aging; Michael Adams, Executive Director, Services and Advocacy for GLBT Elders (SAGE). Special thanks to our co-sponsors, The John A. Hartford Foundation and The California Wellness Foundation.

Original Webinar date: Wednesday, November 6, 2013.

Watch it at http://www.screencast.com/t/yzeTQbgEze2.

Our Issues Entwine: LGBTQ Aging and Economic Justice

MY IMMIGRANT MOTHER sits silently in a room the size of a small kitchen. Earlier this year, she survived multiple failures of the heart, kidneys, and limbs over the course of six weeks. She is seventy-three, uses a wheelchair, and for the first time in her life is surrounded by white people who do not speak Spanish, in the only nearby nursing home my parents can afford. In turn, my father drives through the days confronted by three omnipresent realities: hour-long daily visits with my mother, a night shift to keep him mentally and financially afloat, and a mailbox flooded with health care bills, insurance disputes and the complexity of navigating Medicare, Medicaid, and private insurers. When I speak of health reform, queer rights, or racial and economic justice, he gazes at me solemnly. He survived a lifetime of racial discrimination, fought in two wars and lived through the ensuing decades with a cacophony in his psyche. At seventy-eight, nearly blind and deaf, he will hear nothing of systems and reform. More often than not, these days we sit in silence.

This silence haunts me as an advocate who works at the intersection of aging and lesbian, gay, bisexual, transgender, and queer (LGBTQ) rights. The aging and LGBTQ advocacy fields often propose policy solutions that are too narrow to address the complexity of how all marginalized people — including heterosexual people of color such as my parents, members of the LGBTQ community, and more — experience the process of aging. We need social transformations that address the intersecting forms of oppression that older people face — and that can make sense of the chaos and silence that shroud my parents. This has become especially clear to me through my work as the director of a national policy program devoted to improving the health and well-being of LGBTQ older people.

A closer look at the lives of aging LGBTQ people reveals how deeply identity politics and class politics are entangled. Here, an older protester rallies for marriage equality in Pasadena, California.

A closer look at the lives of aging LGBTQ people reveals how deeply identity politics and class politics are entangled. Here, an older protester rallies for marriage equality in Pasadena, California.

For the full essay, which originally appeared in Tikkun Magazine click here

Reminder: One Month Left in Medicare Open Enrollment

340

Medicare Open Enrollment is the time of year when beneficiaries can change their Medicare health plan and prescription drug coverage for the following year. Each year Medicare Open Enrollment runs from October 15-December 7. The National Hispanic Council on Aging (NHCOA) encourages you to consider reviewing your Medicare drug or health care plan, and/or assist your loved ones in reviewing theirs. You can use the materials provided in NHCOA’s Medicare Open Enrollment toolkit to assist you in reviewing your options in order to find the coverage that best meets your needs. However, if you and your loved ones are satisfied with your current health plan, no action or change is required.

Medicare is health insurance for people 65 years or older. The U.S. Federal government provides this health care service from revenue collected through payroll taxes. If you’ve paid into Social Security and Medicare for 10 years as an employee, you are most likely eligible for Medicare benefits.

Following the three C’s is a good criterion to keep in mind when reviewing your current plan and making the decision whether or not to make changes. Read More Read More

WEBINAR: Why Obamacare/the Affordable Care Act Matters to Older People of Color and LGBT Older People

When: Wednesday, November 6, 2013 2-3pm EST
Register Now: http://bit.ly/1c0l5zd
Speakers: Dr. Yanira Cruz, President and CEO, National Hispanic Council on Aging (NHCOA)
Michael Adams, Executive Director, Services and Advocacy for GLBT Elders (SAGE)
Who can attend? Advocates. Policy makers. Older Adults. Funders. Anyone interested in learning more about Obamacare and how it affects diverse older people. *There will also be additional information for funders on how they can support both national and state-specific work.

First 30 Minutes: Conversation with Dr. Cruz and Michael Adams about why Obamacare/the Affordable Care Act Matters to diverse older people. Learn about the opportunities, challenges and lessons learned.
Second Half of the Conversation: Dr. Cruz and Michael Adams will take your questions.

WEBINAR DESCRIPTION
The health coverage expansions under the Affordable Care Act (ACA) will affect you, your loved ones and your communities. The Diverse Elders Coalition represents millions of diverse older people age 50+ who are among those affected by these expansions. They include the Health Insurance Marketplace, the Medicaid expansion, new benefits for elders 65+ on Medicare, and a range of protections that make health care more accessible for lesbian, gay, bisexual and transgender (LGBT) older people and older people of color. The number of uninsured older adults age 50-64 continues to rise—from 3.7 million in 2000 to 8.9 million in 2010. In addition, people of color make up more than half of the uninsured people in the U.S.— and research shows that people of color, across the age span, face significant disparities in physical and mental health. Additionally, many people of color delay care because of potential medical costs and out of fear of discrimination or cultural incompetence from medical providers. These issues are especially true for LGBT people of color who face challenges on multiple aspects of their identities. The ACA has the ability to create a path to better health by offering more affordable health insurance options, improving services and eliminating the usual obstacles. This webinar will highlight both national and state-specific examples of what is being done to ensure that older people know about the changes that are taking place under the ACA and how it affects them.

This webinar is in collaboration with Grantmakers in Aging (GIA) as part of their “Conversation with GIA” series.

Special thanks to our co-sponsors, The John A. Hartford Foundation and The California Wellness Foundation.

Southeast Asian American Elders and the Affordable Care Act

Historically Southeast Asian Americans have faced significant barriers to accessing affordable health insurance and culturally and linguistically appropriate health care. These barriers have contributed to health disparities:

• Southeast Asian American communities experience high uninsurance rates; 26.7% of Hmong Americans live in poverty and 18.3% of Vietnamese Americans lack health coverage.

• Cervical cancer incidence rates are among the highest in the U.S. for Laotian, Vietnamese and Cambodian American women. Factors for this disparity have been attributed to low Pap smear rates, lack of preventive care prior to immigration and a lack of sensitivity by providers.

• Asian American adults aged 65 years and older were 30% less likely to have ever received the pneumonia shot compared to white adults of the same age group.

• One of the greatest health disparities between Southeast Asians and the general population is liver cancer, 80 percent of which is caused by chronic hepatitis B virus infection. Liver cancer rates for Vietnamese men are 13 times higher than rates for White men.

The Affordable Care Act (ACA) has provided many benefits to the Southeast Asian American (SEAA) community, and in particular, its elder population. The positive impacts have continued with the start of Open Enrollment in the Health Insurance Marketplace. The ACA’s benefits include: Read More Read More

Attention Diverse Elders: Medicare’s Open Enrollment Period Starts Today!

Medicare’s Open Enrollment period is October 15 – December 7. This is when ALL people with Medicare can change their Medicare health plan and prescription drug coverage for 2014. You can find information on 2014 plans by visiting the Medicare Plan Finder. People with Medicare can call 1-800-MEDICARE or visit www.medicare.gov to learn all about Medicare. If a person is satisfied that their current plan will meet their needs for next year, they don’t need to do anything.

The Diverse Elders Coalition (DEC) knows well that large numbers of older people of color and LGBT elders nationwide face financial difficulties, making Medicare critically important to their health and economic well-being. Did you know? 46% of Latinos, 43% of Asians, 52% of African Americans over the age of 55 and 92% of American Indians and Alaska Natives are covered by Medicare (based on different studies); and according to a national health study of LGBT older people, almost all (97%) had some form of healthcare insurance coverage, primarily through Medicare. Without Medicare, many older people of color and LGBT elders would be required to pay for health expenses on their own, accrue enormous debts, and likely not receive the health care they need. The Affordable Care Act has further strengthened this vital program.

HOW DOES THE AFFORDABLE CARE ACT AFFECT MEDICARE?

Your Medicare coverage is protected. Medicare isn’t part of the Health Insurance Marketplace established by ACA, so you don’t have to replace your Medicare coverage with Marketplace coverage. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now. You don’t need to do anything with the Marketplace during Open Enrollment. Read More Read More

Open Letter to Health Reform Advocates: Pay Attention to Discrimination

The harms inflicted by discrimination reveal themselves in our bodies as we age — as people of color, as poor and low-income people, and as lesbian, gay, bisexual and transgender (LGBT) people. The symptoms manifest as higher rates of high blood pressure, cholesterol, diabetes, heart disease, HIV/AIDS, depression, social isolation and more. In medical charts throughout the country, our bodies record what it means to survive a life shaped by perpetual poverty, higher concentrations in low-wage jobs with no health insurance, thin retirement options and inadequate protections in the workplace. They depict our fractured relationships to health care — from cultural and linguistic barriers to overt bias and discrimination from health and aging providers, to a long-held, hard-earned distrust of medical staff internalized through years of differential treatment.

Our bodies confirm vividly the geographic dimensions of structural inequality, which can predict long-term health as early as childhood, based largely on where a person is born. We inhale the poison of inequality throughout our lives, and it inflames in our later years as a dismal diagnosis, a medical crisis or a preventable death. Yes, severe illness will surprise many of us at some point in our lives, and death is indiscriminate, but as empirical fact, poor health affects certain demographics disproportionately at earlier and higher rates, often the same people with no health coverage to manage the repercussions.

Oct. 1 aims to begin reversing these conditions. The health insurance marketplace established through the Affordable Care Act (ACA) offers opportunities to shop for state health insurance plans and begins improving coverage for the 47 million uninsured people in this country. Millions of people work in jobs with no health coverage, cannot afford insurance on their own and fall through gaps in public support that leave them uninsured or underinsured. Without insurance, people accrue unmanageable debt, delay health care and in turn watch their health worsen over time — a trajectory most often experienced by people of color, LGBT people and low-income people. These hardships intensify for older people who must also contend with age-related bias in the workplace and the challenges of paying for out-of-pocket expenses with meager incomes. An all-inclusive vision of health reform must incorporate the realities of aging as early as age 50. Read More Read More