Ghost of VP’s “Caregiver Initiative” Forces President Obama into Action

Dear Readers: It’s April Fool’s Day- but wouldn’t it be wonderful if some of these were true?

US Supreme Court Justice Finds Hidden Section of the Affordable Care Act Creating ‘Caregiver Czar’
John Smith, a spokesperson for the United States Supreme Court, confirmed rumors today that Supreme Court Justice Kennedy found a previously unknown section of the Affordable Care Act specifically focused on family caregivers.  Kennedy is seen as the swing vote on how the court will rule on the individual mandate and apparently found the section this weekend when he was reviewing the Affordable Care Act as part of the Court’s decision.  

Smith confirmed that the section is only two pages long, and had been missed by everyone else previously because the pages were stuck together, possibly by a hill intern who spilled a soda.  The two-page section called for President Obama to appoint a cabinet-level “Caregiver Czar” to address the variety of issues faced by caregivers, and Obama wasted no time, appointing Kathy Greenlee, who is the current Assistant Secretary of Aging.  At her swearing-in, Greenlee announced plans to increase funding for the National Family Caregiver Support Program.  She explained,

“It’s a great program, but with the current level of funding, it represents approximately one-twentieth of one percent of the value of care provided by caregivers.”(1)

Feds Abolish Medicaid Long-term Care, Re-Start with “Easy-Caid”
The Centers for Medicare & Medicaid (CMS) announced that beginning in 2013, all states will be required to convert their Medicaid long-term care programs to a new program, known as Easy-Caid.  Don Berwick, who has been rehired as a deputy within CMS, explained the rationale behind the rules:  “Y’know, we have 50 different states with 50 different Medicaid long-term care programs.  Would you want to track 300 waivers? It’s just too damn complicated, and frankly we’re all sick of the paperwork involved.”  

President Obama joined Berwick at the news conference and added: “This new program will be far easier for consumers to understand when they’re looking for long-term care, and this is also a fairer program.  In the past, states had different rules about asset and income tests, whether or not people can hire family members as their caregivers, and there has also been wide variation between states in the amount of money spent on nursing home care vs. programs that enable remaining in your home.  Waiting lists for services also vary largely between states.(2) Berwick adds:

“With Easy-Caid, we looked at the average of all the benefits offered in all 50 states, made it 10% more generous (paid for with the 10% reduction in paperwork), and voila!”

Charlene Harrington, a professor at UCSF, and one of the seven people in the U.S. who fully understands all of the policies and programs in Medicaid long-term care, said that while she enjoys the personal challenge of understanding the many aspects of the multiple program, she supports making it simpler for everyone. The U.S. Department of Justice, which has sued or filed briefs in lawsuits with 17 states in the last several years over Olmstead violations, also welcomed the news, citing the fact that a more uniform program will likely lead to less issues with complying with the Olmstead decision.(3) A state Medicaid director said, “Yes, it’s going to be a pain, but since we’re already setting up for the 2014 changes to Medicaid, we might as well do these now too.”

Consumer Financial Protection Bureau Can Regulate Long-Term Care Insurance
Ted Smith, a spokesperson for the Consumer Financial Protection Bureau, confirmed that the Bureau will begin holding hearings on long-term care insurance next week.  Because of a previously unnoticed technicality with how the financial reform law was passed, the bureau is able to regulate long-term care insurance.  Consumers welcomed the news, noting that while long-term care insurance is often suggested a solution to paying for long-term care, consumers (especially those on fixed incomes) have found themselves “trapped” when rate increases are announced or claims are denied.

State insurance regulators, who have little power to block rate increases, welcomed the news.(4) Smith noted that Kaiser Family foundation polling found that the most popular provision of the Affordable Care Act was a rule requiring insurers to offer a simple explanation of a health care insurance policy, and suggested the Bureau may consider requiring a similar explanation for LTC insurance, a product that is notoriously difficult for consumers to understand.(5)

Family Medicaid Leave Act to be Updated

US Secretary of Labor Hilda L. Solis confirmed that the Department will release a noticed of proposed rule-making this summer that will update the federal Family Medical Leave Act (FMLA).  Solis explained:

“Don’t get me wrong- I loved the FMLA when it was passed in 1993. But that was 19 years ago. We can’t continue operating with these antiquated rules.”

An aide for the Secretary explained that the move was partially motivated over embarrassment by an HRW report that ranked the United States behind 178 other countries that have national laws guaranteeing paid maternity leave.(6)

A spokesperson for the U.S. Chamber of Commerce said that while the organization had opposed such policies in the past, research released by Gallup changed their minds.  Research on almost 240,000 employees found a loss of over $25 billion in lost productivity every year by employees who are also caregivers.  In addition, despite 71% of employers knowing when their employees are serving as caregivers, only 25% of employees have access to Employee Assistance Programs.(7)

The Chamber spokesperson added that while the Chamber had expected California and New Jersey’s economies to implode after the states began offering paid sick leave programs, the fact that the programs had been successful also added to the Chamber’s support.(8) Solis explained that in addition to converting the program to paid leave (it is currently offered as unpaid leave), the definition of “family” will also be expanded so that employees can also use it to care for their siblings, in-laws, or grandparents.

Ghost of VP’s “Caregiver Initiative” Forces President Obama into Action
Our readers may recall that in 2010, Vice President Biden’s “Middle-Class Task Force” created a Caregiver Initiative that was projected to provide three million hours of additional respite care for family caregivers.(9)  Unfortunately, for Vice President Biden (and the nation’s caregivers) funding for the initiative was left out of the federal budget for the past two years in a row.  Apparently, a ghost, representing the Caregiver Initiative, began bothering Biden in February this year after Obama’s proposed FY 2013 budget also lacked funding for the initiative.  Michelle Obama commented: “It’s odd.  I’ve never seen Joe so quiet before.” 

The ghost has followed Biden around the VP’s mansion, rattling off statistics about respite to the Vice President at odd hours of the night.

“Joe…Don’t you know respite is one of the most requested family caregiver services?” (10)

Joe, research has found that respite is most effective when caregivers get at least two days a week, on a consistent schedule and with sufficient blocks of time that are uninterrupted.” (11)

Joe, in Oklahoma, they found that 88% of caregivers agreed that respite allowed their loved one to remain at home, 98% of caregivers stated that respite made them a better caregiver, 98% of caregivers said respite increased their ability to provide a less stressful environment, and 79.5% of caregivers said respite contributed to the stability of their marriage. (12)

President Obama explained: “I knew something was wrong with Joe.  I’d ask him his opinions on things and the most I could get was a sentence out of him.  So, starting in June this year, I’ve directed the Administration on Aging to begin offering a respite guarantee of at least 1 week of respite for our nation’s caregivers.  For people with more intense caregiving situations, they will receive at least two weeks, and we’re also building in more time the longer somebody serves as a caregiver.

Joe told me he shared the information with the ghost earlier this week. The ghost was happy, but said he’d be back in June if the program isn’t up and running.”  There are rumors that a CLASS Act Ghost has also begun haunting the halls of the US Capitol, in search of a solution to the nightmare that is long-term care financing, but this has not been confirmed.

American Men Agree to Changes to the Social Security System to Recognize Women’s Caregiving Contributions
It sounds too good to be true, but apparently men in the United States have decided to address the large disparity in Social Security benefits between men and women.  Starting in 2013, men who make more than $110,100 (under current law, social security does not collect taxes on income above this amount) will have .004 tax on their income that will be used to fund a social security caregiver tax credit for American women who pause or stop working to serve as caregivers for their loved ones, including children, spouses, and parents. 

The idea, originally proposed by Secretary of State Hilary Clinton, was adopted after a nationwide vote held during the NCAA Final Four basketball games.  A spokesperson explained, “It’s funny, we only showed two commercials, and we didn’t think the voting would work, but nearly 90 million men texted in their votes, with nearly 80% in favor of the change.”  Secretary Clinton applauded the move, citing research that the average retirement income from all sources for men age 65+ in 2009 was $37,509, but for women, it was only 57% of that amount, or $21,519.(13)

She explained, “Sweden, France and Germany always tease me about this issue when I visit because they already have caregiver tax credits. Ha! Let’s see what they say now!”(14)

As a reminder, this is a completely fictional blog posting. All quotes were made up and are not from the actual person. However, the data cited in the post (and below) is accurate. If you’d like to review more research, laws, and program changes that affected family caregivers in 2011, check out our new compilation: “Family Caregiving 2011: Year in Review- A Compilation of Research, Programs, Legislation, & Media Coverage

[1] Statistic is from an article “Caregiver Care” in American Family Physician (June 2011). 

[2] Kaiser Commission on Medicaid and the Uninsured (2011, December) Medicaid Home and Community-Based Services Programs: Data Update.

See also: Disability Rights Florida (2011, March 24). Lawsuit Asks Federal Court to Help Move DD Waiver Waitlist. [Press Release].

[3] The White House. (2011, June 22). On Anniversary of Olmstead, Obama Administration Recommits to Assist Americans with Disabilities. [Press Release]

[4]“How is a 90% long-term care rate hike OK?Chicago Sun Times, March  18, 2012.

[5]Altman, Drew. (2011, November 30). Pulling it Together: The Most Popular Provision in the ACA? Kaiser Family Foundation.

[6]Human Rights Watch: “Failing Its Families: Lack of Paid Leave and Work-Family Supports in the U.S.” February 2011. 

[7]Witters, Dan (2011, July 27). Caregiving Costs U.S. Economy $25.2 Billion in Lost Productivity. GALLUP Wellbeing.

[8] Los Angeles Times:California Family Leave Program Gets High Marks in Study” (January 2011).

[9] Caring for Caregivers, Vice President Biden’s Middle Class Task Force (January 2010).

[10]Lund, D., Utz, R., Casert, M., Wright, S.D. “What Caregivers Do During Respite Time to Make Respite More EffectiveJournal of Applied Gerontology

[11]Ibid.

[12] Testimony of Jan Moss, Senate Finance Committee, April 2004, as cited in National Respite Coalition, Benefits and Cost Savings Due to Respite.”

[13]The Met Life Study of Women, Retirement, and the Extra Long Life. (September 2011).

[14] Social Security Bulletin: Caregiver Credits in France, Germany, and Sweden: Lessons for the United States (2011).

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