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The Affordable Care Act at Year Two

March 22, 2012

March 23 marks the two-year anniversary of the passage of the Affordable Care Act (ACA). While some Americans remain confused about what exactly this law really means for them and their families, and others disregard it as just another big political fight, the impact on many direct-care workers has been and will continue to be positive.

Because of the ACA, direct-care workers can no longer have their pre-existing conditions held against them by a health insurance company. They can keep their adult children covered under their employer-provided plan up to the age of 26. And those who get their insurance coverage from Medicare no longer have to pay out of pocket for preventive services.

The ACA has meant better health, better care, and in some cases, a few more dollars in the pockets of direct-care workers. For them, the ACA is not confusing or political — it’s real, and it’s about health and security.

More Health Benefits to Come

Millions of low-income women, including direct-care workers, will continue to benefit as ACA provisions are implemented between now and January 2014. These include:

  • The expansion of community health centers that serve low-income communities.
  • Expanded Medicaid coverage that will make health care affordable for hundreds of thousands of direct-care workers.
  • Public subsidies that will help make health insurance premiums less expensive for those who don’t qualify for Medicaid.
  • Free coverage for women’s preventive health care, including birth control.
  • An end to discriminatory practices that make insurance premiums at least a third more expensive for women than for men.

Improving Direct-Care Jobs and Care

In addition to greatly expanding access to affordable coverage for direct-care workers, the ACA is improving the quality of direct-care jobs and care for elders and people with disabilities. For example:

  • Six states have received three-year grants to develop core competencies, pilot training curricula, and test the viability of certification programs for personal and home care aides.
  • More than 30 states developed comprehensive health care workforce development strategies using ACA grants.
  • New transparency rules are making information about direct-care worker wages and benefits, staffing levels, and turnover in nursing homes available to the public.
  • Training for certified nurse assistants includes new requirements for learning about dementia and abuse prevention.
  • States have received additional funding to transition individuals out of nursing homes into their homes or in the community.
  • Demonstration programs testing new models of care coordination — including new roles for direct-care workers — are being funded by an innovation center at the U.S. Department of Health and Human Services.

Expanded coverage, new training opportunities for direct care workers, and investments that build an aging and disability services infrastructure to better serve consumers — these are all positive outcomes of the ACA.

But there’s more work to do. Some in Congress have been chipping away at the law, and further budget cuts could undermine implementation, particularly the expansion of the Medicaid program. And the Supreme Court will hear challenges to the individual mandate and the Medicaid provisions in the ACA starting March 26, with a decision expected this summer.

Over the next 18 months, it will be important to remain vigilant, and to remind friends, family, and colleagues that the Affordable Care Act is already providing better care, at lower costs, to millions of Americans.

— by Carol Regan, PHI Government Affairs Director

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